Physical Therapy Helps Runner Get Past the Pain

Washington Hospital’s Community Outreach Project Manager Lucy Hernandez, MPA, loves to run. Now in her fourth season of running half marathons (slightly over 13.1 miles or approximately 21.1 kilometers) and other races, she started running to honor her grandfather, who is a retired marathon runner.

“My very first half marathon was the Giant Race in 2012,” she recalls. “Finishing that race was such an achievement, I cried. I also managed to get a second medal from the race for my grandfather, and when I gave it to him for Christmas, he was so proud he showed it off to everyone.”

Hernandez has participated in the Giant Race half marathon every year since then. She also has run in about 15 “Rock ‘n’ Roll” half marathons and a number of shorter races. In October 2014, however, she pushed herself a little too hard, running three half marathons within one month.

“As I ran, I felt pain in my left knee, but I just ignored it,” she says. “After the last of those three half marathons, I laid low until January, when I started running again. By March 2015, I still wasn’t completing races in the amount of time I wanted, but I kept running with the pain – which at that point extended from my hip to my knee. I tried various exercises, including yoga and Pilates, to strengthen my core. Still, I ran with pain throughout all of 2015.”

Then this year in January, Hernandez ran the “Star Wars Rebel Challenge” sponsored by Disneyland, combining a 10K race on Saturday, January 16, with a half marathon on Sunday, January 17.

“During the half marathon, I really started hurting at about mile 10,” she notes. “I felt a ‘click’ in my knee. I had never felt that kind of pain before. I finished the race in tears, walking to the end of the course while talking to my cousin on the phone. I really thought I would have to give up running.”

The next week, back at work, Hernandez called Lead Physical Therapist Sharmi Mukherjee in the Washington Outpatient Rehabilitation Center.

“My insurance provider offers ‘Direct Access’ to physical therapy services without a physician referral,” Hernandez explains. “Sharmi got me in for an appointment within a few days. She had me run on a treadmill to analyze my running technique. She noted that I am flat-footed, which causes balance problems. She also realized that my pain was actually coming from the iliotibial (IT) band, the tendon that runs down the outside of the hip to the knee. The IT band inflammation was due to my poor running techniques and weak gluteal muscles. Fortunately, Sharmi said I did have the right running shoes – I had gone to a quality athletic shoe store where they fit you for proper shoes.”

Mukherjee notes, “IT band inflammation may be more common among female runners because of their anatomy. Each person has a different running style and body mechanics, though, which is why it is a good idea to have a one-on-one evaluation to determine the cause of a runner’s pain. Runners often have a high pain threshold, and they will simply try to run through the pain. You need to listen to your body, however. Chronic pain can take longer to heal.”

Hernandez went to physical therapy sessions with Mukherjee twice a week for six weeks, working on exercises to improve her balance and strengthen her body core. In addition, Hernandez learned how to do “dynamic” warm-ups, instead of static stretches, before starting to run.

“I’m still doing my exercises at home,” Hernandez says. “I even do my balance exercises, standing on one leg at a time while I’m washing dishes or standing in line somewhere. I now do extended runs of 6 to 10 miles on weekends, but I do other types of cross-training exercises for an hour every other day, during the week. Before I started working with Sharmi, there was so much I didn’t know about how to run. I thought all I had to do was throw on running shoes and run.”

On April 3, Hernandez ran her first half marathon since starting physical therapy, competing in the San Francisco Rock ‘n’ Roll event.

“I ran up and down hills and over the Golden Gate Bridge – all with no pain!” Hernandez marvels. “I felt really positive and so, so happy. I got an extra medal from the race for Sharmi – just as I had done for my grandfather years ago – to share the honor of getting me across the finish line pain free.”

Now that she is able to run without pain, Hernandez plans to compete in the California International Triathlon in Pleasanton in June, graduating to an Olympic category competition of a 1.5K swim, a 40K bike ride and a 10K run. Then she will be running in a full marathon in Honolulu, Hawaii later this year.

“I will turn 40 years old next year, and my goal is to run my first full marathon before I reach that milestone,” she explains. “With the proper training, I am positive I will be strong enough to reach that goal. I plan to be ‘running in paradise,’ pain free.”

Contact the Washington Outpatient Rehabilitation Center at 510.794.9672 to find out if your insurance provider allows “Direct Access” self-referral for physical therapy.

For more information about Washington Sports Medicine and the Washington Outpatient Rehabilitation Center, visit www.whhs.com and click on “Orthopedics” under the “Services” tab at the top of the home page.