Running is more violent than you think. Sure, there’s no blows to the head (although it has happened to me while trail running) or open field tackling, but every time you contact the ground there’s roughly 3-5x your body weight crashing into the earth. While we dont suit up in pads before competing, we do repeat the same foot strike, on the same side of the road, with the same mechanics millions of times.
With so much force, it’s no wonder why roughly 50% of runners are injured every year. Little dings here and there which respond from a couple days of rest would not be considered an “injury”. Let’s define injury as: pain that prevents us from performing an activity for longer than 7 days.
The true test of durability is how quickly you recover and how often your injured. Being occasionally dinged up is one thing, but chronic and recurring injury is another.
It’s no surprise that most runners and triathletes are Type A and waiting out an injury doesn’t bold well. We all want results and we want them yesterday. Unfortunately, it’s the same mentality that stops most from fully recovering. When you truly become injured there’s one secret that you should know: Recovery from a injury will take you 4 weeks or longer. YES! 4 weeks.
At the basis of every injury is inflammation: inflamed and irritated tissue. Inflammation is a normal phase of healing and needs to occur. The problem arises when the tissue remains in this inflamed state and doesn’t progress to phase 2 of healing. What keeps you in an inflamed state? Mainly…. YOU!
There are two main sources of injury: overuse and poor mechanics. The trouble is distinguishing between the two. If you’re dealing with an injury, first try to identify poor training habits by looking through your training log. Generally, you will find a “probably shouldn’t have done that” section. Chronic, reoccurring injury, is often from poor mechanics. For example, if you have had Achilles Tendinitis year after year or consistently, there’s probably a mechanical flaw along the lines that recreates tissue irritation. You would need to identify the cause–that’s where we come in (physical therapy).
Regardless of training error or biomechanical error, you need to change your training. Remember, most injuries take longer than a month to fully recover.
RUNNING YOURSELF OUT OF RUNNING is a term I picked up from a trainer while injured and training for my first marathon. It’s so true and it’s what so many runners do. You run to the point where you cannot. Here’s a quick guide to recover correctly:
1. Identify training error
2. Identify biomechanical errors
3. Be as active as possible without reproducing symptoms
a. You’re goal is to always keep your pain less than a 3/10 (see below)
b. No sharp pain
4. Plan on 4 weeks to fully recover
1 & 2 – Discussed Above
3. So in this plan it talks about being as active as possible without reproducing your symptoms. This is important. If you can cycle, elliptical, walk.. whatever, and it doesn’t hurt–well then, you’re not irritating or aggravating your injury. This is an important piece. So let’s say your running with (insert your injury), we don’t necessarily want you to NOT run, we just want to limit your running to not re inflame tissue and start the healing process all over.
The pain scale is from 0-10: 0 being no pain; 10 being maximum, I want to chop this body part off, pain.
I generally tell all my athletes for a guide that 5/10 would cause a limp. When running, if you’re pain shall ever rise above a 3, you need to stop.. whether it be walk home or hit the stop button on the treadmill. I don’t know if it’s ego or just wishing you were back to normal, but stopping is the hardest thing for most athletes to do.
4. Plan of 4 weeks of recovery. This doesn’t mean blow everything off and eat nacho’s.. simply put, be as active as you can without reproducing symptoms. Most often running injuries are weight bearing dependent and symptoms are not reproduced while biking/cycling. We generally suggest to use other methods (think of it as planned cross training). It’s usually easier for triathletes, as they can spend more time in the pool or biking.
So let’s say you can run 20 minutes and then your pain begins. We need to run and be successful. 99% of athletes will run until pain onset; instead, try to run without pain (or keep it below 3/10) and stop prior to increases in pain. For example, complete an entire week of 15 minute runs. We often suggest running off other machines: elliptical, bike, stairmaster, whatever. (ie. stairmaster (15), bike (15), elliptical (15), run (15): total = 60 minutes). Most runners look at a 15 minute run as a failure. Don’t. If you can’t run 15 without pain, how do you think you’ll ever run longer. In fact, for some runners, we start at 5 minutes.
You need to load the tissue without causing pain. We generally suggest 5-10 minute increments at a time to increase your loading to previously injured tissue. Use the methods above to get a longer workout.
Special Note: Aqua jogging is useless for rehab. You need to load these joints. You’re better off jogging in waist deep water.
The overall theme of this post is to have patience. You need to accept that healing takes time at cellular and tissue level. Use other methods and incorporate a slow return to running. Finally, locate a good clinician that can help you identify biomechanical flaws.
Let us know if you have any topics you would like us to talk about (injury, performance, run form, etc). — Think of it as a free visit to a clinician (no co pay)