John Mayer had been an avid runner since high school. But at age 45, in 2005, a pain in his knee was getting worse, so he went to see a physician. "This fellow came highly recommended," says Mayer, of Chicago. After diagnosing a torn anterior cruciate ligament, "he told me there was nothing to do. He was so respected, so convincing, and so definitive that I didn't even bother to get a second opinion."
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Mayer was crushed and didn't lace up for six months. When he tried to run again, the pain came back. Finally a friend suggested he see another doctor, who confirmed the problem but recommended arthroscopic surgery and physical therapy. Mayer's pain eased, and he's since run eight marathons.
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Not every treatment plan requires a second opinion. But when you're undergoing rehab—and anxious to run again—it's important to know when to seek a different perspective.
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You're told that there's nothing to be done
Almost all running injuries are treatable. So if a doctor tells you he can do nothing for you, make an appointment with another expert. That diagnosis most likely means "there's nothing more that that doctor can offer," says Michael Ross, M.D., medical director of The Rothman Institute Performance Lab in Cherry Hill, New Jersey. And while some conditions, such as severe arthritis in the hip, ankle, or knee, could certainly curtail your career, you'll want to confirm a diagnosis like that with another physician before you quit running altogether.
You've developed a new pain
Sue Walsh was a month from the Chicago Marathon in 2008 when she developed an IT-band injury and visited a physical therapist. "The IT band got better, but my hip flexor on that same side started to hurt," says Walsh, 33, from Brooklyn. "I couldn't get it together for the marathon."
An appropriate treatment plan should not cause new aches. "A patient who is experiencing increased pain or pain in new locations is likely getting therapy that is overly aggressive for their condition, or was misdiagnosed and should be reassessed," says Michael Chin, D.P.M., medical director of The Running Institute in Chicago.
Another doctor later diagnosed Walsh with femoroacetabular impingement, a bone deformity of the hip that required surgery. She finally got back to running two years after the initial IT-band issue.
You notice no improvements after two to four weeks
Most injuries should improve and pain should diminish after four to six sessions of therapy, Dr. Chin says. If they don't, the rehab plan may be too conservative. David Bakke, 45, of Atlanta, was diagnosed with runner's knee a week after he started bounding up the steps of the local football stadium. He was told to do some stretching exercises and rest for seven to 10 days. After two weeks, when he'd noticed no improvements, Bakke went to see another doctor who prescribed exercises to strengthen his quadriceps. "In about 10 days, I was finally able to resume my full workout," says Bakke.
Your injuries keep recurring
Repeat injuries—or a series of different injuries—suggest you may have an underlying health problem that isn't being addressed, says Lewis Maharam, M.D., a sports-medicine doctor in New York City and author of The Running Doc's Guide to Healthy Running. Dr. Maharam says he once treated a woman who had recurring fractures in her hip and feet every three months. "She was biomechanically sound, and her bone density test was normal," he said. "But we did a blood test, and found she had a parathyroid tumor."