Physical Therapy for Runners in Boston: Your Complete Guide to Injury Prevention and Peak Performance

Boston isn't just a city that hosts the world's most prestigious marathon—it's a city that's got running in its veins. Every day, Bostonians take to the bustling streets of Back Bay, the idyllic Charles River path, and the rolling Newton hills to get their miles in. These runners train through brutal winters, conquer unforgiving hills, and navigate cobblestone streets that test even the strongest bodies. Some people might call them crazy! But they just don't understand.

That's why when Boston runners get injured, they need specialized physical therapy for runners in Boston—specifically, a physical therapist who understands running culture. At Alterra Physical Therapy in Back Bay, we focus exclusively on treating runners because we know that a general PT who tells you to "just reduce your mileage" and doesn't know what a fartlek is simply won't cut it.

We specialize in treating running injuries with one goal: getting you back to running stronger than before. We don't just address your pain—we analyze your running form, identify biomechanical issues, and create personalized treatment plans that keep you training (safely) while you heal. Whether you're dealing with IT band syndrome, runner's knee, or shin splints, we look at you as a whole athlete to optimize every factor that impacts your running.

Whether you're training for Boston, nursing a nagging injury, or want to prevent problems before they start, this guide will show you how specialized physical therapy for runners in Back Bay can transform your running.

In this comprehensive guide, you'll discover:

• Why runners need specialized physical therapy (and what happens when you don't get it)

• The most common running injuries we treat—and how to recognize the warning signs

• Injury prevention strategies for conquering Boston's unique terrain

• When to seek PT before a small issue becomes a season-ending problem

Let's dive in!

Why Runners Need Specialized Physical Therapy 

Running places unique demands on the body. In biomechanical research, authors use “body weights” to describe how much load the muscles, tendons, and bones need to handle. On top of that, runners have to manage these forces thousands and thousands of times with every step that they take, often four to five days per week. This repetition magnifies problems. That’s why it’s so important for runners to work with a running specific physical therapist who understands the biomechanical demands of running, as well as the most commonly injured areas.

A general physical therapist might just assume that the only approach to rehab with an injured runner is to tell them to stop running. If you’re training for a marathon, eventually you have to start running again and if you don’t have an expert guiding you through that process, you’re in for some setbacks. But as running specialists, we at Alterra understand the importance of keeping runners running, and we have the expertise to distinguish between a “red light” (no running) and a “yellow light” (train with caution). 

For example, if I have a client who is training for the Boston Marathon with some achilles tendinopathy, I know that I can probably modify their training so that they can continue running, but we’ll take a break from running the Newton hills for a couple of weeks. This blend of deep clinical knowledge and familiarity with the sport of running is what runners should prioritize when choosing a physical therapist.

Most Common Running Injuries We Treat in Our Back Bay Office

Knee Injuries

We see a lot of knee injuries in Boston runners (for a variety of reasons), but especially those who train a lot on the Newton hills, including the notorious heartbreak hill. Running downhill causes an especially high amount of strain on the knee joint. Often, Boston Marathon runners get caught by surprise by how much downhill there is in the first half of the course, and then when they get to Heartbreak, their quads give out. Here are some common knee injuries that we see in our runners:

Runner's knee (patellofemoral pain syndrome)

Runner’s knee, or patellofemoral pain syndrome, is an injury that causes pain at or under the knee cap that doesn’t fit the pattern for other types of knee pain. It typically has a gradual onset, it’s more than 2x more likely to occur in females, and it’s more likely to occur in those who specialized in one sport early. Another reason to play a variety of sports growing up!

Physical therapy helps runner's knee by adjusting how much you're running to calm the pain, fixing the underlying issues causing the problem (like muscle imbalances or form issues), and slowly building your knee back up so it can handle your training load.

Read more about runner's knee recovery time.

IT band syndrome 

IT band syndrome (or just IT band pain) is one of the most common injuries that Boston runners face as running downhill tends to feel especially bad with this one. It typically causes pain on the outside of the knee, often just above the joint. Research suggests that ITB syndrome is caused by compression of a fat pad between the IT band and the thigh bone. This happens when the IT band takes on more load than normal, which can be caused by your training environment, running gait mechanics, and in some cases your knee alignment.

A physical therapist can help with IT band pain by identifying and modifying training factors that might be prolonging recovery (running on a banked road, running downhill), restoring normal mobility to improve running form, and providing treatments like dry needling or cupping to help alleviate symptoms.

Read more about IT band recovery time.

Patellar tendinitis

Patellar tendinitis, or more commonly patellar tendinopathy is typically an overuse injury to the tendon that attaches the knee cap to the shin bone. It is sometimes referred to as “jumper’s knee” because it most commonly affects athletes who jump a lot, such as basketball or volleyball players, but it can also affect runners.

Physical therapy is the BEST treatment for patellar tendinopathy and should implement a pyramidal approach. Learn more about our approach to treating patellar tendinopathy. 

Lower Leg Injuries

Shin splints

Shin splints are common in Boston runners but not for the reasons you think. It’s not because of the gnarled brick sidewalks or the storied Newton hills, but because Boston runners often train too hard. Shin splints are one of the most classic overuse injuries that runners so often face, and they are simply caused by over training. 

At Alterra, we take a holistic approach to treating shin splints because over training can’t be fixed by exercise alone. We have to fix the training too. After advising patients how to improve their recovery (sleep, nutrition, etc.) we help them create sensible training progressions that reduce their chances of getting stuck in the injury-rest cycle.

Achilles tendinitis

Achilles tendinitis, or more commonly known as achilles tendinopathy, is one of the most common injuries that we treat in our Boston office, again because of all those dang hills! But this time, the uphill part is the culprit. Runners push their boundaries training on the Newton hills, winter hill, and even up Beacon street next to the Boston Common. Sometimes, the hill wins, and the achilles tendon loses.

But fear not! Physical therapy is the BEST treatment for achilles tendinopathy and I have had great success helping many runners get back out on the road in no time. Want to learn more? Download our free ebook: A Runner's Guide to Achilles Tendon Pain.

Foot and Ankle Injuries

Plantar fasciitis

Plantar fasciitis occurs relatively often in runners, but the reason isn’t always clear. Runners often produce multiple body weights of force per step in the lower leg muscles, and lower limb injuries are common. For plantar fasciitis, we can sometimes point to a specific training detail like increased running speed or more uphill running in a more minimalist shoe without enough of a ramp up. Sometimes we can point to some specific running gait mechanics that may be putting extra stress on the plantar fascia. But sometimes, it can come out of nowhere.

Even when the cause is unclear, physical therapy can help with the solution. Having expertise in how the body moves and what movements stress certain tissues is a vital skill that our physical therapists use to help calm down symptoms and then gradually build up strength.

Stress fractures

A stress fracture is a repetitive stress injury to a bone that happens when your bone can’t recover enough between training sessions and starts to break down. Stress fractures in the foot are relatively common in runners, and in my clinical experience, are often strongly related to running at higher speeds. There are some bones in the foot that have a higher likelihood of needing surgery to fix, so working with a physical therapist and orthopedist to get an accurate diagnosis is incredibly important. 

Taking some time off of running is essential for stress fractures in general, but especially if one of those higher risk bones are involved. Afterwards, physical therapy can help regain strength and mobility in the muscles of the foot and calf to gradually get strong enough to run safely. Read more about how we work with tibial bone stress injuries at Alterra.

Hip Injuries

Hip flexor strains

True hip flexor strains are more common in shorter distance and faster running like sprinting, but they occasionally happen in long distance runners. They are often caused by postural imbalances in the hips and low back, and usually get better with some core strengthening and running gait modifications. The more serious cause of groin pain in runners is a femoral neck stress fracture. Read more about why runners should never ignore hip flexor pain.

Proximal hamstring tendinopathy

The proximal hamstring tendon is where the back of the thigh muscles attach to the pelvis (near where your thigh meets your butt muscle). This is another injury that affects Boston runners especially because it is often caused by doing lots of uphill running. Physical therapy can help with proximal hamstring tendinopathy by calming down symptoms using massage, dry needling, and cupping, and then gradually building up the strength of the hamstring muscles. Read more about how we approach proximal hamstring tendinopathy at our Back Bay office.

Our Approach to Running Physical Therapy 

First Visit

Your first visit at Alterra is all about getting to the root cause of your problem. We are very thorough during your first visit to make sure we aren’t missing anything important. We start by reviewing the details of how your injury started and where it is at now. I am a running coach in addition to being a physical therapist, so I want to see your Strava, Garmin, or whatever you use to track your runs to see what kind of training you were doing when you got injured. Then, we’ll go into a functional movement assessment where we evaluate how well you perform on tests that closely mimic the physical components of running. This helps us know what to look at more closely when we go through the rest of your exam. 

By the end of this session, we will lay out a clear path forward for you starting with getting your symptoms under control and optimizing your movement patterns, then gradually building up your capacity through strength training, and then reviewing how we will build your running capacity back up. 

Gait analysis and video assessment

Have you ever had a running gait analysis session and walked away feeling more confused than informed? Yeah…us too. That’s why we take a very pragmatic approach to running gait analysis. We use software called Runeasi and our clinical experience to focus on the most actionable data to make your running gait analysis session super valuable, rather than a confusing intellectual exercise. Read more about gait analysis at Alterra in Boston.

Exercise therapy

Exercise is truly the most effective tool at getting our runners back to running without pain. It’s our bread and butter. We use these to help target specific deficits that we found during our clinical examination or running gait analysis that we think are holding you back from running without pain. Exercise therapy can help improve mobility, body awareness, and strength to help offload unhappy tissues and get you moving more fluidly. 

Manual Therapy and Dry Needling

In addition to a deep working knowledge of movement and the demands of running, we use a full arsenal of modalities like massage, joint mobilization, cupping, and dry needling to help get our runners moving better with less pain. These tools accelerate your recovery by helping control symptoms faster, getting you back to training sooner.

Return-to-running protocols

One of the most challenging tasks for an injured runner is doing the tetris of overhauling their training program without digging themselves deeper into a hole. That’s where we come in. We have deep knowledge of marathon training program concepts and have helped many Boston Marathon runners modify their training program to get the finish on Boylston street without breaking down. (when to see a PT marathon training edition)

Injury Risk Reduction for Boston Runners 

Strength training

While there are some runners out there who enjoy strength training, they are not in the majority. But strength training is our not-so-secret sauce to helping build fast and durable runners. There’s just no replacement for the benefits that runners can get from strength training. It helps build resilient tendons and bones, and might even make you faster. If you want to learn more about how strength training can make you a stronger and more resilient runner, check out our free e-book Strength Training For Runners: Foundation.

Mobility work 

While the mobility demands for running are not as intense as say, Olympic lifting or gymnastics, there are a few areas of the body that can wreak havoc on a runner if they don’t move well. It all starts from the ground up! As soon as the foot hits the ground, the body tries to get weight onto the big toe. Why? Because that’s the toe that was built for the job. But if the foot is stiff? The body will find a way. That’s often where compensations happen that cause knee and hip pain. And that’s just the start of it! Runners often deal with tightness in their calves and hips, so a good mobility routine is essential to keep them healthy.

Training load management

Having a sensible training progression is one of the best things a runner can do to reduce their risk of injury during a training cycle. Many runners find themselves in trouble when they follow a program that wasn’t built for THEM. Runners are all at different levels and have different needs, so a one size fits all approach just doesn’t work. Since becoming a running coach, I have SO much more insight into all of the training factors that impact a runner’s ability to stay healthy.

Boston-specific challenges 

Some winter runs around Boston make you feel like you’re trying to run on the frog pond! Slippery sidewalks, icy temperatures, and wet feet are all hazards that Boston runners face. Especially when they don’t plow the carriage road on the Newton hills. While it may sound silly, slipping on black ice while out on a run is a sure fire way to miss your chance to run one of the biggest races in the world due to injury. Wearing micro spikes or taking the run inside are essential options to those that train in Boston.

When to seek PT (early warning signs)

When in doubt, see a PT sooner rather than later. I always get an influx of patients about 5-6 weeks out from a marathon because that’s usually around when runners have been nursing an injury for a few weeks and are lying awake at night stressing about whether they’ll be able to do their longest long run. Don’t wait that long! Getting out ahead of injuries ensures that you’ll have the best chance at being healthy on race day. Read more about when to see a physical therapist while training for a marathon. 

Location & Accessibility: Physical Therapy in Back Bay

Alterra is conveniently located for Boston runners right in the heart of Back Bay inside of Lynx Fitness Club. You could finish your appointment at Alterra and be running on the Charles River Esplanade 5 minutes later, or get inspired by walking 5 minutes down Boylston street towards the Boston Marathon finish line. Being just a 2 minute walk from the Arlington green line stop, a 13 minute walk from the Park Street T stop, and a 12 minute walk from the Back Bay orange line stop makes it easy to access by public transportation, and Lynx Fitness Club validates parking for $5 at the motor mart garage if you can’t find street parking. 

We understand that early intervention with running injuries makes all the difference, which is why we prioritize being accessible to our clients (especially during marathon training season). Your therapist is just a text message away, and we can almost guarantee an appointment slot available for you within the week. No more waiting for four weeks just to get an evaluation. Runners don’t have that kind of time! 

Success Stories & What to Expect 

Success Stories

Here’s what some of our runners have to say about their experience at Alterra:

I worked with Jordan for about 3 months and those 3 months made all the difference in training for my first marathon! I was struggling with glute and hip weakness, along with some knee issues that were setting me back in my training. Jordan created an individualized treatment plan to help me feel ready for the starting line. He is very 1 on 1 and is quick to respond if you have any questions or concerns. I have done regular physical therapy in the past, but this was truly a different experience. It is a much more personalized experience than a regular clinic. Highly recommend!

I cannot recommend Alterra PT enough! While training for my first marathon, specifically Boston, I experienced an IT band injury and shin splits weeks from the race. I started treatment with Jordan and thanks to his expertise, passion for running, and his extremely attentive care, I RAN THE MARATHON PAIN FREE and finished strong!! I was a nervous wreck and Jordan made me feel confident, comfortable and at ease every session. I am forever grateful and will continue to work with Alterra throughout my future running journey!

Jordan has been so so supportive during my whole PT recovery journey! I felt a lot of pain in my foot less than two months til the Boston Marathon and I was so nervous and scared I stopped running completely. Jordan was so helpful in diagnosing the problem, helping me discern what is pain and what is discomfort, I was so shocked to learn that sometimes the right strength exercises help way more than rest! I learned so much about fueling properly, taking care of my body properly. He was also very stern when I wasn’t doing what I was supposed to be doing (ie running beyond my training plan) at the same time super supportive and noting that we’re on a learning journey! Would one HUNDRED percent recommend him! I will be coming back the next time I train for a marathon, definitely before I am injured haha

Common treatment timelines for different injuries

While every case is unique, here are some typical recovery timelines that we see:

• Achilles tendinopathy: 4-12 weeks

• IT Band Syndrome: 4-10 weeks

• Tibial bone stress injury: 8-16+ weeks

• Plantar Fasciitis: 4-12 weeks

What realistic recovery looks like

The recovery process from a running-related injury is not linear. There will be some ups and downs. Could we calm things down faster if we totally stopped running? Sure, but that’s just kicking the can down the road and doesn’t prepare you for race day. Most injuries calm down within the first couple of weeks working together. It’s when we start building your mileage back up where we pressure test all of your hard work. It’s easy to make emotional training decisions that end up biting you in the long run when recovering from an injury. That’s why we’re here to help keep runners on track.

How PT helps runners not just recover but improve performance

Injuries impair your consistency of training, which is the most important training factor in improving performance. While PT can help improve your ability to train consistently, working on all of your “weak links” can help actually improve your performance. 

Getting Started: Your Next Steps

Ready to get back to running pain-free? Scheduling your first appointment at Alterra Physical Therapy is simple, and we've designed our process to get you on the path to recovery as quickly as possible.

Book Your Evaluation

The first step is scheduling a comprehensive running evaluation. During this initial visit, we'll assess your movement patterns, discuss your training history and goals, and create a personalized treatment plan to get you back on Boston's streets and trails.

Book Your Evaluation

Call/text us: 978-737-8195

Most patients can be seen within a few days of reaching out, and we offer early morning and evening appointments to work around your schedule.

What to Bring

To make the most of your first appointment, bring:

• Your current running shoes (even if you think they're not the problem)

• Any recent imaging (X-rays, MRIs) if you have them

• Comfortable athletic clothes you can move in

• Your training log or app data, if you track your runs

Insurance & Payment

Alterra is an Out-of-Network provider, meaning we do not directly accept insurance.

However, you can call your insurance company and ask them “what are my out-of-network physical therapy benefits?” It’s usually a quick call to the number on the back of your card. Sometimes they may reimburse you for all or some of your PT services, especially if you have a PPO (instead of an HMO).

We’ll give you all the information you need to get reimbursed. The traditional insurance model does not allow us to treat the way we feel is best for you or spend the time with you that you deserve.

This allows us to spend more quality 1-on-1 time with clients and will help you feel better faster. While most PT clinics see you 3x a week with many other patients at the same time, we usually see you 1-2x a week. You tend to need less visits, and in the long run may end up spending less with us than a traditional PT practice when you consider your deductible, co-pay, and extra visits needed.

Visit Us in Back Bay

Alterra Physical Therapy

64 Arlington St. 

Boston, MA 02116

Inside of Lynx Fitness Club

We're conveniently located in the heart of Back Bay, just steps from the Boston Common, with easy access via the Arlington green line stop and street parking available nearby.

Don't wait for that nagging pain to become a serious injury. The sooner you address running injuries, the faster you'll be back to the miles you love. Book your evaluation today and take the first step toward stronger, pain-free running.

FAQs

• "How long does physical therapy for running injuries take?"

Recovery from running injuries can vary wildly depending on a variety of factors. Most soft tissue injuries can improve significantly within 4-6 weeks, while bony injuries can take upwards of 12 weeks.

• "Will I have to stop running during PT?"

It depends! Every case is different. If you have a bone stress injury, then the answer is yes. But our goal is to get you back to running in some capacity as quickly as possible and will only advise you to stop running if we think it’s truly necessary.

• "Do I need a referral for physical therapy in Massachusetts?"

No referral needed! You can legally see a physical therapist without a doctor’s referral in Massachusetts.

• "What's the difference between PT and chiropractor for runners?"

Sometimes there isn’t a huge difference! On the whole, physical therapists focus more on using exercise and movement as the primary treatment while chiropractors often focus on more passive treatments, however there are exceptions to that rule.

• "How much does running physical therapy cost in Boston?"

Alterra Prices:

-Single 60 minute session: $205 

-10 pack of sessions: $164.50/session

-16 pack of sessions: $155/session

Costs can vary anywhere from 0$ if you have full coverage from your insurance to $300+/session. It’s important for runners to weigh their options and consider their priorities when deciding where to get PT in Boston. Some runners may feel it’s a worthwhile investment to get quicker access to a PT who specializes in running even if their insurance doesn’t cover it. 

• "Can physical therapy help me run faster/prevent future injuries?"

Nothing can prevent future injuries with a 100% success rate. Physical therapy can absolutely decrease your risk of developing future injuries. Working on specific deficits in physical therapy can absolutely make you a faster runner, as will the improved consistency of training that runners gain from being injury free.

Physical Therapy For Runners In Boston- Conclusion

Every sport places unique stresses on the body and produces unique injuries to its athletes. Working with a physical therapist that specializes in running injuries ensures that you will get to the root cause of your injury faster, waste less precious training time, and likely improve your overall running performance. 

Alterra is committed to providing expert care to runners in Boston to ensure that they have the best possible chance of staying healthy for whatever race they’re training for (even if it’s just your local turkey trot). Getting in front of a running specialist early is essential to ensure that you can get to the finish line healthy.

If you're a Boston runner dealing with an injury, especially if you're in the Back Bay area, we'd love to help!

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