RUSH Physical Therapy, CARA Partner
RUSH Physical Therapy Success Story: Courtnay Bourque
Courtnay completed her very first marathon through the guidance of CARA, but most importantly, fought through an injury to run for her father and the Brain Injury Recovery Foundation. Learn more about Courtnay’s road to recovery at RUSH Physical Therapy.
What is your personal connection to CARA?
I decided to join CARA specifically for their marathon training program in 2021. I was supposed to run the 2020 Chicago Marathon, but then due to COVID I deferred for a year. With everything going on in 2020 plus the delay, I lost some of my focus on training and hoped that joining CARA's Marathon Training Program would help me re-focus, as well as make some friends along the way.
Being a first-time marathoner who was still pretty new to running in general, I really wanted to have a support system for training and CARA was exactly that. I made great friends who I looked forward to seeing at our track runs and long runs every Saturday morning and that really added an extra layer of fun as well as accountability to training.
Tell us about the injury you dealt with and your experience working with RUSH PT to overcome it.
When running I always seem to develop shin splints. This happened early into training and I decided to reach out to the RUSH Physical Therapy hotline for CARA members. Stephanie helped me by sending over some exercises that I incorporated into my training and they helped tremendously. A few weeks later, after a run I noticed that my shin was swelling. While it didn't cause a lot of pain the swelling had me concerned, so once again I reached out to Stephanie. She recommended I see a sports medicine doctor and I was referred immediately. It was determined that I had a tibial stress reaction and I was in a walking boot for six weeks during the peak of training. My doctor told me I would not be able to run the marathon, but I tried to keep up my training with aqua jogging just in case. When I finally got my boot off, my doctor mentioned that I could try to run / walk half of the marathon, since she knew how important it was to me.
It was at that point that I started seeing Jon at RUSH two times per week (about a month before the marathon). I started running again, trying out different run / walk intervals that Jon and I would discuss at each physical therapy session and plan out. We would then discuss how the injury felt every time I came in for a session and modify as needed. Jon worked with me using blood flow restriction therapy, strength training, balancing exercises, and he even dry needled my shins in our three sessions directly before the marathon when shin splints acted up again. Over that month, RUSH Physical Therapy built up my strength in the injured leg, but also the confidence I needed to know I could complete the marathon.
What kept you motivated during this time?
One of the reasons this marathon, in particular, was so important to me - in addition to being my first - was that I was running for a charity close to my heart. My dad was in an accident when I was 18 months old and suffered from severe brain damage for two years. A few years ago, on Christmas morning, he passed away. I was running this race for the Brain Injury Recovery Foundation in his memory, but the 2021 Chicago Marathon also ended up taking place on his birthday. I always felt that it was a sign that he would be there with me, and I really didn't want to miss out on the chance to honor him. Luckily, due to the help from RUSH Physical Therapy, I was able to finish the marathon and I know he was there with me the whole time.
Do you have any advice for runners who may be struggling with an injury?
Listen to your doctors... but also listen to your body. Any time I felt pain of any kind I would immediately (sometimes via email in the middle of a run...) tell Jon about it and listen to what he had to say. Having someone who can tell you when something is bad pain (that you need to stop and rest from) versus something that is OK to run through is so helpful post-injury. It is so easy to chicken out due to fear of re-injury, or push through pain you shouldn't to reach your goals. Having someone there to guide you truly is a lifesaver.
Thanks Jon, Katrina and Cody for all of your help! I couldn't have done it without you.
Jon Williams, P.T., DPT, COMT, CMTPT, TPI
RUSH Physical Therapy
Tell us a little about Courtnay’s journey back to running with the support of RUSH PT.
Courtnay came to me for her first session of physical therapy with just over three weeks before the marathon. She had suffered a stress reaction during marathon training and had to be in a boot, not running, for about six weeks prior to that. Once out of the boot, her doctor thought that she had a chance to complete the marathon with a run/walk program; however, she needed to build up strength after being in the boot.
I could tell that Courtnay was very motivated and was going to do everything possible to compete and finish the race. We focused most of her physical therapy sessions on improving her mobility with manual therapy, dry needling and joint mobilizations, as well as getting her strength and stability back using blood flow restriction therapy, focused balance exercises and various forms of strengthening exercises. We also spent time discussing her running program progression to safely increase her activity tolerance without aggravating her injury.
Courtnay was always eager to ask questions about what she should and should not be doing and was great about following through with the instructions and home exercise program she was given. Leading up to the marathon, we started to see some significant improvement in her mobility and she was increasing her total time running without any pain. When it came time for her last session before the marathon, we discussed her race strategy and run/walk ratios and did some mobility/muscle activation exercises to get her ready for the race. I was tracking Courtnay’s progress during the race and was so excited and happy for her when I saw her finishing time. It might not have been the time she was hoping for before her injury, but it was ahead of her goal pace going into the race. I know she was really excited and proud to finish a race that meant so much to her.
What advice do you have for other runners returning to running after injury?
I think the biggest piece of advice I can give is to remember to build up mileage gradually. It’s easy to get excited about being cleared to run again and to want to go out there and quickly get back to your pre-injury mileage. But, you need to be smart about it and let your muscles, joints and the rest of your body get used to that activity again. Your physical therapist or doctor can be great resources for game planning this progression and helping you to make the best decisions for returning to running safely.
Two other things to consider when returning are to keep up with your prescribed exercises and to remember to build in recovery days. Just because you are cleared to return to running, doesn’t mean that your rehabilitation is over. This is especially true for over-use injuries as you want to keep doing the exercises that will help prevent re-injury in the future. Recovery days are a great way to let your body recoup and adapt to the stresses of running (or any exercise for that matter) and ensure you are getting the most benefit out of your activity.