Can Runners Learn from “House?”

I was talking with Joni last week and she was giving me the latest report on her foot/ankle injury. Like many running injuries, there was no unambiguous explanation for it, only a combination of hard runs and exercises that, in retrospect, overloaded something. It was one of those injuries that only announce itself in the morning, after a good night’s sleep. “Oh, you thought you were going to run today? There’s been a change of plans.”

We’ve all been there.

Fortunately, Joni’s latest report was good. After a couple of days off with icing and ibuprofen, and despite some continued pain, Joni had started short runs again, testing it out and monitoring the results. After several days of experimenting in this way, she had been able to better isolate the pain, and had noted some patterns of when it did and didn’t hurt. That had led to more effective icing, etc., and finally, that morning, she had been able to run ~4 miles completely pain-free.

It’s interesting to me that Joni’s injury seemed to get better even though she continued running. The real question in my mind is whether it got better DESPITE her running or BECAUSE of her running. And if it was BECAUSE of her running, what did the running do, exactly? Did continuing to run hasten physical repair, or change the feedback mechanism, or what? As we pondered these questions, Joni suggested it was like an episode of the TV medical drama “House,” and the analogy got me thinking…

On the show, Hugh Laurie plays the brilliant but caustic Dr. House. Although he heaps verbal abuse on his patients and his colleagues (perhaps because he lives with a painful, permanent injury himself), he also excels at identifying the mysterious ailments that baffle the conventional medical minds around him. One of House’s favorite techniques is to bombard his patients with treatments that aren’t necessarily designed to solve the problem, but rather to force the body to show its cards, so to speak, and to reveal what’s really going on.

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The conventional, by which I mean conservative, approach to most injuries is to rest them until they get better. A more advanced form of the conservative approach is to throw in physical therapy to strengthen or correct the weakness that led to the problem in the first place. It’s an old joke that when a runner tells his or her doctor that something hurts when he runs, the doctor says, “well, don’t run then!”

But in my experience, almost every serious runner keeps running through a lot of minor and some major hurts. Stubbornness? Yes, but not only that. In addition to not wanting to miss the daily run, the injured runner has another compelling need, that is, to get better information about the injury: What hurts? When does it hurt? What makes it hurt? Is the hurt getting worse or better or staying the same?

Some injuries present clear and classic symptoms, making diagnosis easy. But many injuries present inconclusive symptoms, or they masquerade as something else: the “hamstring pull” that turns out to be a hip flexor issue; the “IT band inflammation” that turns out to be bursitis; the “plantar fasciitis” that turns out to be a bone chip in the heel; the calf muscle strain that turns out to be deep vein thrombosis. Oh yes, there is plenty of material here to supply several seasons of a medical melodrama.

And because few of us know real-life versions of the Hugh Laurie character, we act as our own Doctor House, trying stuff — experimenting on ourselves — to see what will happen. Can this approach work? It seems at least a little unwise, but sometimes it does work. By running a little, by exposing the body to some of the stress that got it hurt in the first place, the patient — I mean, of course, the runner — begins to figure out the injury, its extent and severity, and maybe even what to do and what not to do to coax the injured part back to health.

There are risks, surely. One of the biggest risks is that patient in us is in a state of denial (this is usually the case for Dr. House’s patients, too). It’s tough to be objective when you are the object under consideration. Or, as Richard Feynman put it, “The most important thing is not to fool yourself. Unfortunately, you are the easiest person to fool.” Why? Because you, of all people, want things to come out a particular way.

Hugh Laurie’s character understands that his patients are often part of the problem, and that’s why he tends to ignore what they say (“Everyone lies”) and instead focuses his attention on what happens to their bodies with each new treatment. I wonder whether we’re capable of reaching that state of detachment that enables us to focus on the experiment without having too much invested in the results.

I’m sure that real doctors (Robin, are you out there reading this?) cringe when people like me bring up this fictional doctor. I’m sure that real medicine doesn’t look anything like the fictionalized version in the popular show. My point is not that House represents reality, but rather that House represents a longing for insight and knowledge in a confusing world full of unexplained pathologies.

Can runners learn from House? Yes, but only if we are really committed to learning, rather than simply looking for reassurance.

About Jon Waldron

Running and Racing have been important parts of my life for as long as I can remember. I ran Track and Cross Country at Amherst HS, back in the day, and am proud to have been training and competing with the Cambridge Sports Union (CSU) for more than thirty years. If my bones hold out, I hope to continue for another thirty. Sixteen years ago, I began coaching, first as an Asst. Coach at Newton North HS in Newton, MA, and for the past ten years, as Head Track and Cross Country Coach at Concord Academy in Concord, Massachusetts. I've been writing about running for almost as long as I've been running, dating back to high school, when I would write meet summaries for the Amherst Record for about $0.33 per column inch. I've been blogging about running since 2005, and began blogging at "the runner eclectic" in 2014. Until recently I also had a day job, working full-time as a Technical Product Manager for Nuance Communications, based in Burlington, MA. But I am now on what might turn out to be a permanent sabbatical. Thank you for reading my blog, and please consider leaving a comment.
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