The Hardest Advice I Give My Patients

Last week was a rough one for me. There were a handful of patient cases that lead me to very difficult conversations. Conversations no runner ever wants to hear.

Every summer, my schedule fills up with runners who have big fall races on their calendars. For some, it’s the Chicago Marathon or another fall race. The training has been put in, the excitement is building, and the start line feels close enough to taste.

But if the patient is talking to me in my clinic, their bodies feel differently about the upcoming race.

Two of the patients I’m thinking about, are signed up for the Chicago Marathon and have acquired tibial bone stress injuries. Neither of them are running right now due to their injuries and the hardest part for me is to be the one to tell them, actually, you shouldn’t run Chicago this year…

Telling a runner they should cancel or defer the race they’ve been training so hard for never gets easier.
Telling a runner they should cancel or defer the race they’ve been training so hard for never gets easier.
From their perspective, they seek my help for that fix or plan that’s going to get them to the race they’ve been training so hard for. But when it comes to bone, there is no negotiating or quick fixes.

The body demands rest and if you ignore that, the consequences are more than just running the race with pain. It’s months, even a year, of recovery time that pushes you even further from your goals.

The healthiest option for these runners in the long term is not to race. Which feels like giving up.

But here’s the mental shift I try to help runners make: Most of us don’t sign up for races to win. We do it to challenge ourselves, to train consistently, to grow. The real value is in the journey of training, not breaking yourself down for the sake of showing up on race day at any cost.

Missing one start line doesn’t erase all the fitness, discipline, and resilience you’ve built. In fact, stepping back now protects all of that, so you can enjoy running for years to come.

Injuries heal. Races will be there. And with proper recovery and rehab, your best running is still ahead of you. Don’t beat yourself up about having to defer your fall race.

Your best is yet to come!

Dr. Michael

Valiant Physical Therapy
Evanston, Illinois
Physical therapy for Runners | Sports Rehab