When to Seek a Second Opinion for a Running Injury

Judi Ketteler
by Judi Ketteler
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When to Seek a Second Opinion for a Running Injury

Nine years ago, Tana Kirkbride was having trouble sitting down — literally, it hurt to sit. Pain radiated from her buttocks down into her leg. “It felt like throbbing,” she says. At the time, she had been running for about six years, including doing multiple marathons. “I went to an orthopedist and had an MRI done when the pain did not go away after a week or so,” she says.

The doctor said she had a tear in her fascia at her L5 vertebrae, a common place for a tear. He also diagnosed her with degenerative disc disease. And something else: “The doctor told me not to run.”

Kirkbride did physical therapy for about six weeks (including exercises at home), but she did not see any improvement. Her doctor tried an epidural steroid injection. “The epidural didn’t help and the doctor told me that the tear would just take time to heal. He said the compressed disc would never heal.” His advice remain unchanged: No running.

Running had become a huge part of Kirkbride’s life, and she wasn’t willing to simply wait and do nothing — especially since the therapy the doctor had prescribed wasn’t helping. That’s when she got a second opinion from a back specialist. “He was great. He told me that he agreed with the diagnosis but that I could continue to run.” He recommended that she do some core-strengthening exercises and increase mileage very slowly, to see what she could tolerate.

GET A REFERRAL

Kirkbride’s experience may sound familiar to runners who have battled injuries — and doctors who have advised they stop running altogether. Sports-medicine specialist Natasha Harrison, MD, an assistant professor of orthopedics at West Virginia University sees many patients with stories similar to Kirkbride’s. By the time they come to her, they are often frustrated — and looking for answers that hopefully don’t include a prescription for not running.

While some patients have been referred to her (her practice is a referral center), others have self-referred. “There is tremendous variability in what has been said or done already, ranging all the way from recommending never to run again to recommending trying to run through whatever is wrong,” Dr. Harrison says.

RE-EVALUATE IF YOU’RE NOT IMPROVING

Many runners see their primary care doctor first. “The level of experience and comfort with runners truly varies because some primary care doctors are runners themselves or take a special interest in it,” Harrison says. Still, she recommends starting there, especially if you have an established relationship. But don’t spin your wheels too long if it’s not getting you anywhere.

“I would recommend a second opinion if you’re not improving in spite of doing the recommended treatments,” Harrison says. “Either re-evaluate with your current provider or seek care from someone more specialized in sports medicine, especially if you are having pain at rest or pain with walking, not just running.”

DON’T SETTLE FOR “NOTHING MORE I CAN DO”

If your doctor advises you to take time off from running to heal, that’s a perfectly legitimate suggestion, and certainly not a red flag. Red flags include phrases like saying there’s “nothing more I can do.” There is nearly always something else to try because the majority of running-related injuries are treatable. “The back specialist I went to said that he could do surgery if things ever got too bad,” Kirkbride says. She hasn’t had to take him up on that offer in the nine years since, but she liked that he encouraged her to keep moving and trying to see what she could do. Within about a year of seeing the specialist, her tear healed and she gradually increased her mileage.

TRUST YOUR GUT

“Unfortunately in medicine there are not a lot of black and white answers, but I’ve found that patients have a good sense when to seek further evaluation and management,” Harrison says. In other words, if your inner voice is telling you to move on to a new doctor, you should probably heed it. Kirkbride is certainly glad she did. “I’m glad I didn’t listen to that first doctor,” she says. “I’m still running all these years later.”

About the Author

Judi Ketteler
Judi Ketteler

Judi is a Cincinnati-based freelance writer. She’s been running for more than 20 years, and has a particular soft spot for doing half-marathons. Her work has appeared in outlets such as The New York Times, Runner’s World, Women’s Health and Good Housekeeping. Find her at judiketteler.com or @judiketteler on Twitter

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