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This is the first post in our new Mighty Masters series covering any and all things related to masters running. Today we hear from Sue McNatt recounting her experience facing a possibly career-ending injury. Lifelong runners often deal with injuries and prevention/prehab becomes critical as time goes on. Towards the end, she shares her  7 guidelines for injury prevention so it's worth it to stick around for this one. Here's to many injury-free miles!

No, this is not my weight loss goal or personal vendetta to decrease my mocha latte consumption, but rather the story of an injury that threatened to end my running career.  The critical part of this experience took place between the final races of the New England Runner Pub series one year apart.  I wanted to share my ordeal with fellow competitors, friends, and lifetime runners in hopes that others can learn from my unnerving look into the abyss.

If you have been running long enough, you have probably heard the words, “You must rest and let it heal.” This is all fine and dandy, but how about when you’re given the ultimatum “YOU SHOULD NEVER RUN AGAIN.” This is usually followed by the advice,” try the elliptical or stationary bike.” Hah! These are words that often fall on deaf ears.  We assume that running ruination will never happen to us because we have run through injuries before and/or recovered from injuries without problem. Unfortunately, an adverse situation usually rears itself when we are running faster than we have in years, and feeling the speed of youth as our race times begin to come down. Hello, foot injury.

“You should never run again.” In September of 2005, I heard these very words from a respected podiatrist that I had seen for years and amid the fears and tears, I decided I had three options. (Well, first I ate some chocolate, rode the stationary bike like a mad woman for six months while healing, and cried multiple times on my husband’s shoulders.) Nearly 18 months later, I finally have perspective on the situation.

Leaving a doctor’s office after hearing the five most feared words in a runner’s lexicon, the first step is to research the injury. Talk with other runners, plug into the internet and Google the name of the ugly beast and discuss it with your supportive team of therapists-physical, massage, counselors and your spouse/partner, children, co-workers, friends, and psychotherapist.  Get everybody’s opinions.

Then, decide how to tackle the problem in light of three options: 1) follow the doctor’s advice fully and take up something new like curling or needlepoint; 2) ignore the advice completely and continue to run, eating anti-inflammatory pills at every meal, developing compensatory injuries and never regaining fast race times; or 3) take the more moderate approach and respect this doctor’s opinion, but seek another opinion. ( I opted for door #3.)

This doesn’t mean seeing 10 doctors until you hear the information you want. It means being thorough enough to determine the extent of the problem. There are times when expert advice MUST be heeded or you will end up in the surgical suite at the hospital, or gimping around when you are 45 years old and unable to chase your child’s soccer ball or walk your family dog.

In my case, being a physical therapist that has treated many runners, I understood the injury and knew it was a structural problem and one that could continue to haunt me.  I was having trouble separating the runner, the patient and the physical therapist.  I could not evaluate this injury objectively.

Was the MD correct? Was this the end of a 28 year running career, with highlights of racing in Germany, Canada, California and Oregon, running the country roads of my native Wisconsin and my grandparents home in Iowa, traversing the hills of Vermont and New Hampshire and making and meeting countless friends during this journey? Was Pub Series #8 the end, when I had to walk the final 3 mile race in 55 minutes, pushing my spirited 2 year old for company (he cheered me on enthusiastically despite the slow pace). I completed that final race to receive the coveted jacket and attend the grand end-of-season party.

I wanted to make sure that it really had to be the end. I needed help sorting this one out. I knew I needed a second opinion. The timing was perfect. I picked up the 2006 March/April issue of New England Runner and inside I found a wonderful, very appropriate article by a local neuromuscular therapist.  An evaluation and discussion with the therapist was exactly what I needed at that time. She helped me sort through the various issues, encouraged me to try running in small doses and then suggested a referral to a local podiatrist.

An MRI followed to determine that there was no permanent damage. A change in orthotics, many physical and neuromuscular therapy treatments, and a focused exercise program later and I was on my feet (literally) again.

There were many ups and downs, lots of races run “just to finish” and many moments of doubt until it all clicked nearly one year following the diagnoses.  I started speed work very slowly and raced sparingly until the fall of 2006.  I toed the line at Paddy’s Shillelagh Shuffle 3M race in Newton, MA on October 15th-exactly one year after my 55 minute event-and ran 20 minutes for the distance! I cried for joy! My kids thought I had lost it (and perhaps I had!)

Through this experience I have learned that you should follow these seven guidelines for injury prevention and rehab:

1) set up your support team including physical therapists, doctors, massage  therapists, neuromuscular therapists, family and friends

2) thoroughly research an injury and get a second opinion when necessary

3) continue to perform strengthening and stretching routines and progress  them as indicated to prevent re-injury

4) receive maintenance treatment, seek re-evaluation and change shoes/orthotics if appropriate

5) make training adjustments including mileage, terrain,surface and racing goals/distances

6) listen to your body and be mindful of re-injuries

7) understand that there may be a time when “you should never run again” but get the necessary evaluations and information before you accept this. Make sure you understand the injury and its impact on your long-term running and life activities.

I realize that I may never run a marathon or wear high-heeled shoes again, but these are small sacrifices to make in order to continue running and racing on into the “Golden Master/Seniors” years and beyond.  I want to run that mile fun run with my children and run in the family division in a local 5k.  I want to keep racing and challenging myself in new running adventures for many decades to come. The words you really want to hear over the years are “Go Get ‘em!”

— Sue McNatt