Pain Free Running: Dr. Boleslav Kosharskyy 04/08/2020
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Pain is a universal occurrence and is considered one of the most important factors impacting runners. How can we avoid pain in the first place? And if we are unable to avoid pain, how can we manage it to continue training safely?

Dr. Boleslav Kosharskyy is board-certified in Anesthesiology, Interventional Pain Medicine and Palliative Care. He is Associate Medical Director of Pain Medicine and Director of Anesthesia for Joint Replacement Center at Montefiore Medical Center, Albert Einstein Medical College. Dr. Kosharskyy employs multimodal therapeutic modalities to treat musculoskeletal pain of the back, neck, and joints, neuropathic disorders, and cancer pain.

In this episode, we learn about pain avoidance and management techniques as well as how Dr. Kosharskyy treats his patients in his practice. He dispels some common myths and provides clarity on using common and alternative medicines for treatment.

Dr. Kosharskyy specializes in minimally invasive therapies such as: Spinal Cord and DRG Stimulation, Kypho- and Vertebroplasty, Percutaneous Discectomy and MILD Procedure (Minimally Invasive Lumbar Decompression) for Spinal Stenosis as well as an alternative medical marijuana treatments. He is involved in several clinical trials as well as basic science research on neuroprotective properties of enolate forming compounds.

He completed his fellowship in Interventional Pain Medicine at Upstate University Hospital, Syracuse, NY in 2005. He completed his Anesthesia residency at Boston University Medical Center, Boston, MA in 2004. He earned his Medical Degree in 1997 from Free University of Berlin Medical School, Berlin, Germany.

He is an active member of the American Society of Anesthesiology (ASA), American Society of Regional Anesthesia and Pain Medicine (ASRA), and the New York State Society of Anesthesiologists (NYSSA).

  Questions Dr. Kosharskyy is asked:  

2:16 When is it safe to run through pain?

2:49 When should you definitely not run through pain?

3:53 What about ‘Phantom Pain’?

5:04 What is your opinion on NSAID’s?

6:01 does acetaminophen work differently than ibuprofen?

6:30 Can each of these exacerbate certain conditions?

7:20 What are some pain relief alternatives can people use for day-to-day pain?

8:40 Is running bad for your knees?

10:49 How can runners prevent knee injuries?

12:24 Should runners who are very heavy do more low-impact activities?

13:35 What is your opinion on KT Tape for knees?

16:07 Platelet Rich Plasma--what is it and how can it help runners?

20:20 Are there any side-effects or people who should avoid PRP injections?

22:24 Is it a last resort treatment for injuries?

23:15 Why is it important to keep the thoracic spine flexible and the lumbar region stable?

26:05 Your clinic also is a leader in medical marijuana therapy for pain management.  Can you explain how this can apply to runners?

27:42 Would you recommend topical CBD for local pain?

28:26 What advice would you give yourself back when you started running?

29:16 What is the best gift running has given you?

30:44 How can people connect with you? Quotes by Dr. Kosharskyy:  

“I avoid the term ‘in your head’ because I think it’s very diminishing and insulting. I think everything is in our heads, it’s true, but we always have to listen to the concerns, especially as physicians.”

“Everything is connected in your body.”

“Running is good for you if you do it recreationally; meaning if you do it 3-4 times a week and you don’t obsess over it, it’s actually good for your knees and prevents arthritis.”

“I would not use PRP injections as prophylaxis for anything because there is very little data to support the prophylactic use.”

“Biomechanics are very important when you run. If anything has shifted, it’s going to create a chain reaction. If you don’t have a flexible spine in the thoracic area, it will create an enormous increase and pressure on the unilateral joints. So instead of evenly redistributing the pressure on both knees, one knee will get a lot more of it and is more likely to get injured over time.”* *

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Pain Management NYC's website)

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