For 25-year-old Emily Mellen, running is everything. So when hip and knee pain started flaring up during her runs, she knew one thing for certain: She wasn't giving up her sport without a fight. "Running has been my passion for so long and it brings so much joy and peace to my life," she says. "Quitting would have been truly heartbreaking."
Emily had plenty of previous experience with athletic injuries. A former collegiate track and field athlete, she had leaned on her team's athletic trainers for help with injuries. Now, she's a doctoral student studying psychology at Harvard University—and while she still competes in long-distance races and enjoys running, she no longer has immediate access to the athletic trainers who kept her in healthy, running shape.
A Female-first Perspective
Determined to continue running, Emily contacted the Women's Sports Injury & Performance Clinic, a new service launched by the Women’s Sports Medicine Program at Massachusetts General Hospital. The clinic has a unique model that provides sports-specific care for female athletes and includes evaluation for surgical, nonsurgical and rehabilitation options. It felt like a perfect fit. She met with the Clinic Director, sports medicine physiatrist, Dr. Kelly McInnis and lead physical therapist, Rachel Lampros, PT, DPT, SCS, in consultation with Women’s Sports Medicine Program Director and Orthopedic Surgeon Miho Tanaka, MD. These clinicians—who were also athletes themselves—had a different perspective than other providers she had seen for similar issues in the past. In this clinic, they focus specifically on injuries in women and addressing the unique sports-related problems that female athletes can have. Previously, when she experienced pain during athletic training, she didn't speak up about it because she didn't want to seem weak. With this team, however, she felt supported because they understood her desire to correct the underlying issues that limited her ability to train.
"I wanted to know how to take care of myself," she says.
The multidisciplinary team at the Women’s Sports Medicine and Performance Clinic provides a comprehensive assessment of the athlete. They are interested in the underlying biomechanical risk factors that led to the injury. The team evaluates the structure and function of the entire kinetic chain and addresses any deficiencies through a targeted rehabilitation program.
Kelly McInnis, DO
Our goal is to not only treat the current injury but also prevent future injury and ultimately optimize performance.
Clinical Director, Women’s Sports Injury and Performance Clinic
“Our clinic is designed to address the unique needs of female athletes by providing coordinated treatment from a team of physicians and providers who have specific expertise in female sports. And who understand how important a sport can be for athletes of all levels,” says Dr. Tanaka.
Retraining Body and Mind
The team decided on a conservative but active approach, which involved physical therapy with a focus on sports rehabilitation and education. This aligned with Emily's hope to avoid medication or surgery, if possible. She started physical therapy sessions with Lampros, which began in person and transitioned to phone and video sessions at the height of the COVID-19 pandemic.
Through these sessions, she learned about muscular deficits that can be more common among women, such as weaker gluteals muscles, that put her at risk for injury. Better yet, she learned how to build strength in exactly the right way to correct these imbalances.
"Weakness of the core and gluteal musculature (specifically, hip abductors) as well as poor neuromuscular control is extremely common in female athletes. This characteristic movement pattern can lead to a host of lower extremity injuries that are more prevalent in women." Dr. McInnis says.
Emily quickly discovered that her specialized team of providers understood the fundamental differences between men's and women's bodies. And their viewpoint enabled them to make critical progress in unexpected ways. For example, Emily learned she may have been performing squats incorrectly: Previous trainers had advised her to keep her toes straight forward while squatting, but the Mass General team explained that for women, that position can over-stretch a tendon around the knee. By correcting this motion, she was able to eliminate pain that previously "felt like a knife." She learned to make tiny tweaks to how she runs, like keeping her pelvis level and avoiding rotating her hips during her stride.
Emily also learned how other activities might be contributing to her problem, and she made small adjustments to her lifestyle. She avoided crossing her legs when she sat, she bought new running shoes and she added low-impact exercises, like cycling and yoga, to her routine.
Coming to the Women's Sports Injury and Performance Clinic, she says, was the first time she had received specific instructions on how to perform activities that felt right for her body. She eliminated her pain and learned how to take care of herself so she could train independently. Her team of providers educated her on ways to treat and prevent injuries specifically for her body, and for her sport.
"That is something I didn't learn until I was 25 years old," she says. "I wish I knew this when I was 18 and starting my college athletic career."
A Fearless Return to Running
She completed the treatment plan including a "return to running" program. Now Emily is back to running up to 30 miles each week. And this time, she doesn't have to worry about hurting herself. While she felt other treatment plans in her previous athletic career had aimed for a quick fix, the Women's Sports Medicine Program at Mass General educated Emily for a more long-term solution. She feels empowered to push her running to the next level and is now on her way toward running longer distances.
"I feel more comfortable pushing myself in competition," Emily says. "And now I know that if something does go wrong, I can go back to this clinic."