Michael Milnes of Rochester, MN, has worked as a physical therapist for more than two decades. In that time, he's treated countless patients at his private practice, including individuals with sports-related injuries. One of the common patient types he's come across is the distance runners.

When it comes to treating a distance runner, you have to set aside any preconceptions you might have regarding how far individuals are willing to run. With an increase in ultra-distance races, some patients will land on your treatment table with what may seem to be extreme endurance goals.

Right from the jump, it’s good to understand the event or distance the client is training for. This will provide an idea of the physical demands and the time frame required for the rehabilitation process. Where possible, get acquainted with common distances (half marathon, full marathon, 5k) and races such as North Face Endurance Challenges, Boston Marathon, Marathon de Sables, among others.

Is your patient trying to participate in the event for reasons such as fundraising or checking off a bucket list, or are they trying to compete fully? As the physical therapist, make sure you have the patient's goal in mind as you craft a training or recovery program.

As an added guideline, adopt an agreement with your patient that showing up healthy at the start line is the most critical objective. Runners are notorious for rushing themselves through the recovery process, which slows their progress and increases the risk of re-injury.