You need to understand that you will be hurt. It’s nearly impossible to run, improve, and not develop an overuse injury. Your response to pending injury makes all the difference between spending two weeks out of commission or six plus. The response to injury for most runners is nearly the same. First, complete denial and one too many runs results in widespread tissue damage. It’s that one single run where in retrospect you knew you shouldn’t have stepped out the door. Once the widespread damage occurs the second major mistake occurs.
I can’t begin to emphasize the magnitude of the second mistake. This all too common mistake is a Hail Mary pass to recovery. Not only will it prolong your recovery, but it will completely zap will earned fitness. You’ll say, “I’ll just take a week or two off from running completely. That should do it.” Sound familiar? A week or two ticks by and you become infuriated with the realization that your symptoms are simply waiting for you to start running again. Too often runners use a physical therapist as a last resort. After all, you don’t want someone telling you to not run, right? All of sudden we’re the bad guy because we’ll tell you not to run, but you’ll do it yourself without any specific direction or program?
Extended rest without a progressive loading program is injury suicide. I’m not talking about the first few days post-injury, either. Sure, you may need rest in days 1-3, but I’m talking about the days that follow, the grey area where you can walk and negotiate steps without symptoms. You can literally do everything but run. Your body’s false advertisement of being “healed” is a huge problem–mainly for your psyche. I’m guessing you’ll bounce around the house, bound around up steps, and lunge onto your injured leg and brag how you dodged the injury bullet. The absence of symptoms leads you out the door smiling. With every minute (note: not mile) that ticks by your symptoms slowly emerge and within minutes you go from cloud nine to six feet under. I’ve seen this scenario play out countless times. It happens whether you’ve rested for a few days or even a few weeks. How can you rest for two weeks, feel nothing, and have your injury suddenly reemerge? The answer lies in tissue resilience to load and subsequent breakdown with time off.
Breakdown is inevitable without load. Think of an astronaut and how their bones significantly weaken while in space. Without the effect of gravity, which causes load and resistance with movement, your bones, muscles, and other tissues essentially atrophy and disappear. The same is said for those who are bedridden. Compared to non-runners, those who run have a built their tolerance to load through training. Injured tissue takes a hit to this tolerance.
It sounds self-explanatory when I say it, but injured tissue requires a progressive gradual load that slowly builds you back to running. The length of this loading program is usually related to how severe the injury and how long you wait after onset. Loading tissue (muscles, joints, ligaments) is always warranted. The feedback provided through a progressive loading program will relay the required info to determine when it’s safe to return to running. No more heading out the door “hoping it will hold up.” The program will help rebuild injured tissue while preventing breakdown of healthy tissue.
With frequent running you’re building your body’s tolerance to the associated impact. You’re building a base for both legs. Rest for say an injured Achilles will not only lower the tolerance for the Achilles, but for both legs that have adapted to the stresses of training. You’ll need to refocus following an injury. Come to terms with it and stop acting as if treating clinicians are the bad guys. Find yourself a gradual load program that doesn’t reproduce symptoms. An injury offers a few opportunities to rebuild overall strength, balance, and flexibility–areas that have likely taken a back seat during training. A gradual loading program is more than riding a bike, too. Find what you can do successfully and repeat it until the program needs to be adjusted. Plenty of research exists on the loads associated with certain activities (lunges, step ups, etc.). You just need someone to lay the blueprint. Suck it up and ask for help. PT’s are not the bad guys.