For massage therapists and manual clinicians proper orthopedic assessment is key. That means thinking beyond our original training at times, and using what we know about specific populations to our advantage. The following are some observations and questions you should be asking runners during clinic.
Whenever you are performing a assessment ALWAYS find out what kind of shoe they are wearing. It will give you clues to what kind of problems they have.
Many runners get into the sport because all they need is a pair of shoes and themselves. Because of this, they often neglect maintenance care until there is a problem, then book shorter appointments looking for a quick fix. Because of this your time management and home-care instructions will be particularly important. Part of this ethos comes from the fact that although running is healthy, and improves the quality of life, acquired overuse injuries take a long time to show up, therefore runners are lulled into a false sense of confidences that they are fine, whereas they are really experiencing micro-traumas.
Recently there has been a trend in barefoot running. Then that moved to minimalist running. In the last 10 years shoes had become very expensive and structured, with a large heel. As running popularity boomed, and injuries became more prevalent, many of them were blamed their injuries on shoe structure, claiming that their injury was arising from the fact that the shoes' structure was training the feet to be weaker. As a backlash there was a pull to barefoot running, which was all the rage until, of course more injuries were reported as millions hit the pavement with little or no training or prep for running barefoot. Neither method is right or wrong. It really depends on your foot and personal biomechanics. Running in a traditional shoe with loads of padding means you are going to hit the ground heel first, and that the long-term effects of running for this wearer will likely be impact related problems in the knees, low back, and hips, including stress fractures as it travels straight up the body on impact. Running barefoot means you are using the leg and foot biomechanically as a spring and shock absorber. Force zigzags up the muscles rather than the bones, making the tendons and muscles more prone to wear and overloading that leads to overuse conditions such as plantar fasciitis and tendonitis. Most runners are now in a mid-foot shoe, which is a blend of the two.
So whenever you are performing assessment ALWAYS find out what kind of shoe they are wearing.