It’s Marathon Season, and Physical Therapists Are Busy

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On a recent autumn afternoon in the Chelsea neighborhood of Manhattan, New Yorkers packed into a sunny loft filled with reduced-gravity treadmills and gait-analysis software. Some lay prostrate, guiding themselves over foam rollers, while others had their legs wrapped in compression bands or bulky massage boots. There were cryotherapy chambers and a Ping-Pong table. The Ed Sheeran song “Shape of You” filled the room.

The only indicator that this space was not a trendy boutique gym was the presence of two women sitting pensively in the reception area, as if they were waiting for appointments.

They were. The women were injured athletes. And the space? Finish Line, a physical therapy clinic.

Tax experts have their peak season in early April, and physical therapists have theirs, too. In October, distance runners flock to them, seeking last-minute fixes before the New York City Marathon. Some runners need minor adjustments, while others have bodies that are broken almost beyond repair — even if it takes a licensed professional to get them to face it.

At this time of year, 11 Finish Line therapists, most of whom are also distance runners, share the work of seeing an estimate of 400 to 500 injured athletes who are still hoping to run the marathon.

“Even up to two days before the race, we have people calling and asking for help when they can’t even run or even really walk a mile,” said Cat Nadeau, a patient outreach coordinator at Finish Line. “We avoid telling people you can’t do it at all — so we’ll see them and do what we can to get them to the start line, and also, ideally, the finish line.”

At Integrative Physical Therapy of NYC in Midtown Manhattan, Frank Ruggiero estimates that he is treating about 10 people right now for injuries related to the marathon, which he has run twice. “There are always a lot more injuries now, as you get closer to the race and people bump their mileage up,” he said.

“We try our hardest – and often it works out – but I think unfortunately there are some people who have unrealistic expectations about what we can do for them, especially when they’re coming in at the tail end of a serious problem,” said Mr. Ruggiero, who spoke of bodies going into “complete shock” from doing too much too soon. “You don’t have a crystal ball, you can’t promise that the fix is only going to take three sessions,” he said. “Sometimes it’s six to eight before you can train again. And sometimes you need to defer.”

In one of the treatment rooms at Finish Line, Caroline Varriale, a therapist there for more than four years, was massaging the hamstring of Ben Meaker while she chatted with him about his training.

“This time of year, you’re past the prevention phase in terms of injury, and people put off dealing with their problems; they’re busy and hope it goes away,” Ms. Varriale said. “When they’ve been running through pain for a while, it gets harder. Sometimes it’s too late, for this race at least.”

Mr. Meaker, 32, the owner of a creative agency in Chelsea and triathlete, concentrated as she guided him through a series of exercises that were meant to evoke what she called “neuromuscular activation.” She then dispensed tips on how to stabilize his core. For him, it was not too late.

“Injury-wise, I used to have everything in the book, but now I’ve been seeing Caroline on and off for a year,” he said. “I come in as soon as I have any problem and we stop it. It’s just always a balance between training and staying uninjured.”

Ms. Varriale’s colleague Steve Mitchell, who has coached marathon runners since 2007, explained the mentality of some New York City marathoners that keeps them going, even through excruciating pain, until they finally accept that they need help.

“New Yorkers are inherently tough: If we want to go anywhere, we’re out in the rain and the snow and the heat, and we’re a fit group of people. So of course we love the marathon,” he said. He called the marathon a great outlet for many stressed New Yorkers. “But you have to watch it,” he warned. “You can’t let the stress reliever, running, become a new source of stress by going too hard and getting injured. So physical therapy can help alleviate that. Because we all want to be able to do this for a long time.”

Luckily for the therapists, other injuries keep them busy when they’re not dealing with marathon season.

“I get most of my clients, in finance and a lot of attorneys, because they have injuries from sitting too many hours at a desk every day,” explained Ruggiero. “I see them all year long.”