Doctors For RunnersRoad Runner Sports Run Today Newsletter
Runners Should Look for In a Doctor
we hope that you're staying healthy and uninjured, at some point in time you're
going to need the services of a medical professional. Choosing the right doctor
can be downright confusing, even scary, these days. Managed care, HMOs, PPOs,
utilization review, gatekeeper
and on and on! What's a runner to do?
Yes, you are. As a runner you have special needs,
it doesn't matter whether you can run a mile in 4:00 minutes or a marathon in
six hours, the fact that you run sets you apart from many of the patients most
Keep in mind that physicians are used to seeing people who are sick. The
average American is getting heavier and more sedentary, as a result many of the
diseases they develop are illnesses that reflect their lifestyles: diabetes,
heart disease, and some cancers. When a fit runner (or anyone who works out
regularly) walks into their office, some doctors don't understand that their
low blood pressure and pulse rate, enlarged heart, and perhaps small amounts of
red blood cells in their urine (particularly if they're a distance runner) is
When I was running three or four marathons a
year, I once had a doctor order an EKG and extensive blood work when I
presented with symptoms that indicated that I was dehydrated from a 22-mile run
in 60+ degree weather the day before. She even questioned me over and over
again about my "drug use", convinced that I was a regular cocaine user! Finally
a nurse (who was also a distance runner) and had talked to me about my
training, was able to convince the doctor that what I really needed was fluids
and I would be fine. I appreciated the physician's concern and getting an EKG
and having blood drawn certainly didn't hurt me, but my insurance company might
have been spared the cost of all those tests if the doctor had had a better
understanding of how "different" runners can be.
There are many different kinds of health care professionals for
you to choose from. They include:
- Medical doctors (M.D.)
- Osteopathic doctors (D. O.)
- Podiatrists (D. P. M.)
- Physical therapists (R. P. T.)
- Chiropractors (D. C.)
- Neuromuscular therapists (C. N. M.
- Holistic health practitioner (H. H.
Some of these doctors may be "sports
medicine specialists", but keep in mind that as of only a few years ago, the
American Board of Medical Specialties still does not officially recognize
sports medicine as a specialty. Until recently "sports medicine specialists"
have learned their specialty on-the-job, but luckily that has begun to change
during the last several years. Fellowships are now available for interested
physicians to apply for fellowships. Doctors who are trained in another area
(perhaps orthopedic or internal medicine) spend one or two years training in a
sports medicine clinic. Once the training is completed, they take an exam so
they can receive a Certificate of Added Qualifications.
It pays to be
aware that just because a physician or physical therapist is certified in
sports medicine still doesn't guarantee that they will have experience treating
runners. An orthopedist who treats your local high school football team may not
be the best choice for you. Most football injuries are traumatic, while the
majority of running injuries are caused by overuse. Find a doctor who has
experience working with runners, you're more apt to get the proper care and
treatment for your injury. Definitely steer clear of doctors who treat
professional teams. Pro teams often choose their doctor group based on
economics, rather than skill. Physician groups place bids with the teams, and a
group may be chosen because its numbers look favorable.
I See First?
If you're a member of a health maintenance organization
(HMO) or preferred provider option plan (PPO), which the majority of people are
nowadays, you will have to see your primary care physician or "gatekeeper"
first. They can refer you to other specialists as needed. A primary care doctor
can be either a medical doctor or an osteopath. The main difference between
medical doctors and osteopaths is in some aspects of the training. Osteopaths
receive much of the same training, and are usually admitted to the same
specialty residency programs as doctors who graduated from "traditional"
medical schools, but osteopathic training emphasizes holistic medicine and
What to Expect if You're Referred
Whether your primary care physician refers you to another doctor depends on
your injury and/or condition. He or she can probably treat you for most
non-musculoskeletal problems. However, chronic overuse injuries such as
Achilles tendonitis, plantar fasciitis, shin splints, and knee pain require a
- Podiatrists have had several years
of residency beyond internship during which they study musculo-skeletal
problems exclusively. They limit their practice to treating conditions below
the knee. Since many running-related conditions affect the feet, a good
podiatrist can certainly help you keep you the road! Podiatrists can assess
your gait and make orthotics.
- Physical therapists may hold
certifications in subspecialties such as neurology, cardiopulmonary, sports
medicine and orthopedics. Sometimes they hold free sports screening
appointments (or "runner's clinics"), particularly during the days immediately
preceding a big race such as a marathon.
- Orthopedists also have had several
years of residency beyond their internships. Many orthopedists further
sub-specialize in areas such as back surgery or joint replacement.
- Chiropractors are helpful if you
don't require prescription medication or surgery, which many runners find to be
much more palatable anyway. Many chiropractors have massage therapists who work
with them to treat conditions such as sciatica, lower back pain and hip
- Holistic health care practitioners
use non-invasive, non-pharmaceutical techniques and therapies such as
acupuncture, medical herbalism, homeopathy and other non-traditional methods to
treat conditions and illnesses.
- Neuromuscular therapists use a
precise system of evaluation and application of advanced soft tissue therapy to
treat various problems such as postural distortions, dysfunctional
biomechanics, ischemia (lack or loss of blood flow to tissues), trigger points
and nerve compression and or/entrapment.
Keep in mind that your primary care
physician will probably not refer you to a chiropractor, holistic health care
practitioner or a neuromuscular therapist if you're a member of an HMO or PPPO.
If you want to explore one of these options, you will have to pay out-of-pocket
for their services.