Thanks to MossRehab Therapist, She Ran and Finished the Broad Street Run
A couple of weeks before the 2018 Blue Cross Broad Street Run, MossRehab occupational therapist Dina Mastrogiovanni doubted she would be able to lace up and take off down Broad Street at her usual pace—if at all. It would have been her 16th run down Broad Street.
Not to run would have been sorely disappointing. She recently turned 50, and felt like she had something to prove. A veteran of marathons and half marathons, Mastrogiovanni believed she was in a position to do just that.
“I wanted to get a good time, and I thought, I’m going to show everybody that at 50, you can still run fast,” she says. “I was all excited about it … and then my knee got hurt.”
It started in February, when Mastrogiovanni had started to increase her training in preparation for the Broad Street Run, sponsored in part by Einstein Healthcare Network. MossRehab sponsors the wheelchair division.
“I had left knee pain, so I took a week or two off, and then the next time I went out, there was a pop in the back of my knee,” she recalls. “I instantly had to stop, and couldn’t really bear weight for a day or so.”
Mastrogiovanni had a history of meniscus tears—tears in a crucial knee cartilage. After her painful training incident, she went to see an orthopedic doctor, who checked her past X-rays, which, she says, “looked fine. It didn’t look like I had any decreased joint space or arthritis in my knee. He said, ‘Take a couple of weeks off, and then try to run again.’”
So she did, and, she says, “It was horribly, horribly painful. I was pretty sure I wasn’t going to be able to run the race. The pain was in multiple areas. First it was on the outside, and then it was in the front.”
As she continued to train, she managed to get up to five miles—half the distance of the Broad Street Run—before pain made it impossible for her to go on.
Mastrogiovanni runs wheelchair clinics at MossRehab at Center City, seeing patients for specialized seating and positioning, or helping them to learn how to use power chairs or obtain a new manual chair.
On the Monday before the race, Mastrogiovanni was discussing her predicament with Ali Ladak, PT, DPT, a physical therapist at the Center City facility who is part of a team that specializes in helping runners. “He said, ‘Why don’t you let me take a look at it?’ and I said that would be great.”
Mastrogiovanni, who lives in Abington Township, Montgomery County, hopped on the train at 6 o’clock the next morning, and went to Center City to see what Ladak could do for her.
Ladak is used to runners coming to him with similar issues, wanting to participate in a race, but having three or four weeks in which to remedy the situation. “It’s one of my favorite things to do,” he says. “They have a goal, and there’s a short duration of time to get them ready.”
Now, here was Mastrogiovanni with less than a week to go before the Broad Street Run. Ladak took it as a welcome challenge, with the understanding that if he didn’t think she should run the race, he would tell her just that. “For a lot of athletes, it’s great to help them get to that race, but at a certain point you start talking about, is this race super-important, or is it the longevity—of being able to run or race 10 or 20 years from now,” Ladak explains. “Can we avoid surgery? Can we keep her healthy enough so that she is still a running athlete until she’s 60 or 70?”
In the meantime, Ladak set about trying to find a way to solve the problem to the point where Mastrogiovanni would be able to finish the race—even if it was nowhere close to her best time.
Ladak ran a video analysis of Mastrogiovanni running and saw right away that there were a few things he could fix. He helped her reduce the load on her left side, along with the amount of torque and pressure she was putting on her knee by just changing some of her body mechanics—most of it by changing her cadence to make her more efficient, making sure her pattern was more balanced and equal.
“I sent her home with some simple stretches, teaching her how to run more efficiently by increasing her cadence, at first by 5 percent, then by 10 percent,” Ladak says. “I gave her some awareness exercises for stabilization.”
They also talked about a Plan B—what to do if she ran the race, but encountered pain along the way—like running for three minutes, then walking the next three.
Finally, he educated her about what kind of pain was OK, and what was not—in other words, when to stop.
Those changes suggested by Ladak made a big and immediate difference in Mastrogiovanni’s running. “I decided to run six miles and if it didn’t hurt a lot, I was going to do the Broad Street,” she says. “That’s what I did. I went home and ran six miles, and I felt really good, and I decided to run on Sunday.”
Ladak had also provided her with a mobile phone app to listen to—a steady beat kind of like a metronome, that would help her focus on her cadence.
Mastrogiovanni ran the whole race, with a time of two hours and four minutes—not particularly speedy for her, but that was beside the point. She had run the whole race, with minimal to no pain.
She credits Ladak for helping her realize her goal.
“He’s a really good physical therapist,” she says. “He knows what he’s doing, and he definitely has a specialty there. I was really impressed that just these couple of things made such a huge difference. I’m very pleased, and I’m going to go back so that I can keep on running another 20 years.”
The Center City office will be moving in June to a new location, 2323 Ranstead Street, in the heart of Center City and right by one of the entrances to the Schuylkill Banks running trail.
The new location will be larger, redesigned for better access and improved individualized care, and continue to include a fitness center with advanced fitness equipment to fit the need of athletes, to train them at the appropriate intensity and make sure it is specific to their sport.