No one is immune to a running injury, me included. Sparing the details of how I got hurt, I find this to be a great opportunity to talk through the treatment process that can be applied to any running injury. A “what goes on in my head” of sorts. I apply this simple treatment approach to my patients and myself. Fortunately being a physical therapist, it’s easier for me to begin treatment day one and consistently repeat it without co-pays gouging at my pocket.
The key to injury recovery lies all within the first seven days, a time where you’re most likely to freak out. Uncertainty looms. How much training and fitness will I lose? Am I going to be able to run my ‘A’ race? Doubt blankets your training schedule, catalyzing “freak out” mode and convincing you to run too early, too much, and too often.
Being a runner has helped me become a better clinician and vice versa. Each injury presents itself with a personal learning experience that I can then incorporate into my treatment. Injuries happen, but how you respond determines your ultimate outcome. The longer you deal with an injury the longer it takes to resolve. We all know those runners who have been dealing with the same, chronic, injury for the last 5 years.
My Achilles issues between mile 16-18 on my long training run. An ever slight pull transformed into an occasional ‘zap’ of pain. Almost like a tearing. Being close to the car, I finished my run and the pain immediately subsided. Within the next hour the pain re-emerged, resulting in a slight limp. Thoughts swirl of self-diagnosis. Is this a stress fracture? Is it tendinous? Is it muscle? What is my treatment plan? How am I going to change my training? I’ve had to talk many runners down from the ledge before, now I needed to calm myself down.
How it played out
Each day that passed brought more function. I was dilegent wearing The Strassburg Sock at night, but also paired it with a heating pad during the day. Day 4 marked the resolution of pain and improving function (finally). I could walk and negotiate stairs without pain. It’s crazy to have to say this, but if you can’t function in your daily life without injury symptoms, you certainly shouldn’t be running yet. Day four was my first shot at running. I knew I was a ticking time bomb so I looped my block until the “I don’t know if I should be doing this” thought popped into my head. When’s the last time you went out for a 1.1 mile run post injury? Don’t miss the value on loading the tissue without making your symptoms worse. You’re not looking to improve fitness here, but to just feed the tissue.
That 1.1 mile run is the most important piece of my recovery, a feeler run. You can’t expect yourself to run until you’re forced to stop. Symptoms magnify once you stop running. What feels like a moderate amount of discomfort while running will likely result in significant pain afterwards. Remember, pull the plug with the following thought process: “I’m not sure if I should still be running.” Trust me. It will cross your mind.
From there I decided to complete some gradual runs based on feel, including my second three miler that was completely pain free. I was ready to pull the plug on any of these runs. In fact, I never ran further than a mile away from my house (just in case). You’ll need to refrain from running until pain. Likewise, you need to be disciplined enough to stop short, whether you’re looking to round out a mile or just get home. If the “I’m not sure if I should be running” thought crosses your mind you stop, walk home, and know you did the right thing. It doesn’t matter if your 3 houses away or 30 houses away.
Day seven brought a 3 mile painless run, but given impatience, a 5-6 miler would have likely resulted in missing the following 7 and 10 miler. The key here is to be patient and let your body work its magic. The worse approach is to have no approach, blindly throwing runs in and attempting to maintain mileage. If I were to push on day four I would have likely torn my Achilles and spent the next four to six weeks rehabbing it. It’s going to be touch and go for first 7-10 days. Deal with it and get yourself a bike!
The final thought is be ready to adjust. Although I ran 7 miles pain free on day eight, I was forced to no show to a race. The race was important for my training, but it wasn’t worth the risk. I would have jeopardized my ‘A’ race with my ‘C’ race. I adjusted my training schedule. I went from running mid 60 mile weeks and recovering at 35 miles, to running 14 miles this past week. If you don’t adjust you’re toast.
Treatment consisted of hivolt stimulation with heat and ultrasound to improve healing time. I also slept in a Strassburg Sock every night… well that was after I used this ace bandage on the first night. Our online BaseSix bootcamp was used to improve strength, balance, and mobility throughout the body. Afterall, just treating the tissue and not the cause is a recipe for relapse.