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Can shockwave therapy cure running injuries?

OCT 25, 2023


Minute 1: Could shockwave therapy fix your running injury?


Ozempic was originally developed as a drug to treat diabetes but is now mitigating the obesity crisis in America. In a similar vein, shockwave therapy was first used to break up kidney stones in middle-aged folks who ate a lot of cured meats, but is now deployed for repetitive stress injuries in elite endurance athletes. Over coffee in Boston earlier this week, we sat with two accomplished masters competitors, one of whom runs a top physical therapy and chiropractic center for treating runners. As both a patient and a healthcare provider, they sang the praises of extracorporeal shockwave therapy (ESWT) for running injuries. A good overview of the treatment is here: “How shockwave therapy helps heal sports and overuse injuries.” The concept is similar to using a Theragun, but the vibrating head produces acoustic pressure waves that can penetrate tissue up to 6 cm, reaching deeper than human massage or at-home percussive therapy devices. ESWT has had remarkable success with difficult running injuries like plantar fasciitis, achilles tendonitis, shin splints and runner’s knee. The concept is that these shockwaves produce micro trauma in tissue, stimulating blood flow and healing. As you can see from the list of treatable injuries above, it is particularly useful in treating tendons, which have inherently low blood flow. The good news is that most patients see long-term results after only 3-5 treatments, which take about 15 minutes or less per session. The bad news is that most insurance policies don’t cover the treatment and a package can run more than $500. For more detail, check out this overview: “Shockwave Therapy.”


Minute 2: Why do athletes hit a plateau?

The initial gains you make as an athlete are like the first half mile of a mountain hike – pretty easy going before the trail steepens and your pace slows. Generally speaking, the fitter you become, the more effort it takes to improve. This phenomenon of diminishing returns in exercise is well documented, but Outside magazine says there are still some mysteries surrounding: “The Physiology of Training Plateaus.” According to a recent review paper from the University of Mississippi, there are four potential causes of the slowdown in progress. First, as people become more trained, their muscle cells may become less responsive to growth signals. Second, evidence suggests it becomes increasingly difficult to ingest and break down adequate amounts of muscle protein. Third, there might be a fundamental limit on how large muscle cells can grow in relation to their nuclei. Lastly, anabolic resistance increases with age, reducing the response to muscle-building triggers. Whatever the cause, if you’re looking for a way to break through training barriers, consider these: “6 Ways to Bust out of a Running Plateau.” Running with a friend can be an easy way to add some intensity and enjoyment back into your runs. You can push each other to run faster with healthy competition, or chat and share encouragement to keep your runs fun. Adding cross training or strength training days can mix things up for the better as well. For ideas, check out: “9 Best Cross Training Workouts: Complete Guide for Runners.”


Minute 3: Should you ditch your plastic cutting board?

Plastic cutting boards may have found themselves on the chopping block. For a long time, scientists recommended plastic cutting boards because they appeared easier to clean, reducing bacteria in the kitchen. However, new research is calling that into question, as we learned in a recent video from @olivercareco. They say that using a plastic cutting board can cause microplastics and bacteria to enter your food. To investigate these claims, let’s look at: “Which Type of Cutting Board Is More Sanitary: Plastic or Wood?” or this review from Consumer Reports: “Should You Use a Wood or Plastic Cutting Board?” The evidence bodes well for wooden cutting boards, especially those made from hardwood like maple. They can actually absorb fluid which would otherwise pool atop plastic boards for extended periods of time, providing bacteria with an environment in which to feed and grow. Furthermore, a study entitled: “Cutting Boards: An Overlooked Source of Microplastics in Human Food?” identified “plastic chopping boards as a substantial source of microplastics in human food.” Regardless of your cutting board’s material, experts recommend having multiple boards for different types of food. While we’re on the topic of microplastics, let’s talk about disposable water bottles. It’s often been stated that disposable plastic water bottles pose a risk of contamination, especially after being left in the heat, but experts debunk that one: “It’s safe to drink water out of plastic bottles without a risk of cancer.”


Minute 4: Don’t forget to get sunlight this winter

We’re long past the summer solstice, and unfortunately, that means shorter days, longer nights, and an increased risk of things like Seasonal Affective Disorder. You’ve got to be especially careful if you live up north, because “Living Above the 37th Parallel Likely Leads to Vitamin D Deficiency During Colder Months.” Some of the larger cities impacted in the U.S include Seattle, Chicago, New York, St. Louis, Salt Lake City, and Boston. Not only does the sun shine less during the fall and winter, but cold temperatures also force us to bundle up and cover our skin. That deprives us of vitamin D by limiting sun exposure, putting us at risk for a number of health issues. Bone weakness, fatigue, and loss of appetite are just some of the “9 vitamin D deficiency symptoms (and 10 high vitamin D foods).” Be sure to get plenty of fatty fish, egg yolks, and orange juice in your diet as the cold months progress. Some folks have found success by using “SAD lamps: 5 of the best.” SAD lamps have long been recommended as a way to help regulate your circadian rhythm and reduce symptoms of depression. However, they can’t actually cause you to produce much vitamin D, according to “Do Sad Lamps Work for Seasonal Affective Disorder?” since they don’t emit UVB rays.


Minute 5: Quick Intervals

  • We’re always looking for ways to mix things up in our workouts, and it doesn’t get much more unpredictable than rolling the dice. We don’t mean that as a figure of speech, because some runners have literally incorporated chance into their workout routines to keep things exciting and challenging. To see for yourself, “Try this “dice” workout to change up your interval sessions.”

  • Most of us don’t plan many beach days in the fall, but according to some runners, that’s a missed opportunity. Beach running offers a lot of benefits, from increasing stabilizer muscles to lowering impact forces, so why should that stop when the weather cools down? If you want to keep the fun times rolling, read: “Why You Should Bring Your Fall Workouts to the Beach.”

  • Cycling is one of the most popular methods of cross training among runners, and for good reason. It can improve cardiovascular health and build lower body strength and endurance, all while reducing the risk of overuse injuries that plague some runners’ experience. Since cycling generally causes less gastrointestinal distress compared to running, athletes can take advantage of mid-ride fueling to extend their performances. To learn how to master the meal on the go, check out “What To Eat & Drink During A Long Distance Bike Ride.”


Minute 6: Daily Inspiration

Five years ago a Runner’s World video went viral, when amateurs at the Chicago Marathon Expo tried this foolhardy challenge: “Runners Attempt Eliud Kipchoge’s World Record Marathon Pace.” Many good athletes went “splat” when they tried to run at 13 MPH for more than a few moments. (Kipchoge keeps that pace for 2 hours.) The video does a good job of showing what WR pace looks like, but what about mere mortals trying to break 4 hours? Finally we have a good video that shows what various marathon paces look like to a bystander. Thanks to @thebuffnurse, here’s an entertaining overview for those not considered the GOAT. Click here to watch.


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