When to stop running from injury…and how to start again
Posted January 22nd, 2007 at 9:00 AM by Paul Petersen
Section: Running & Training, Injury & Rehab, Health & Fitness, Injury & Rehab
If you browse through any running magazine, website, or forum, you are sure to see a menagerie of articles and posts about overuse injuries. Stress fractures, tendonitis, “runner’s knee”, groin strains, and that beast, plantar fasciitis, all come up with surprising regularity. Let’s face the unfortunate truth, injuries can be a part of running.
Many of us have lost significant time due to injury, time loss that I argue is preventable. Often an injury starts as a minor problem that we ignore and try to train through. Perhaps the next big marathon is coming up and we can’t “afford” to lose the training or the $80-$100 entry fee that we’ve already paid. But the minor injury soon grows into a major injury, and all that we sought to salvage is lost: training is down the tubes, entry fees wasted, and beyond that even more money lost on doctor bills and physcial therapy. Who has been down this road? I have!
It doesn’t have to be this way. Injuries should be treated immediately, and running usually needs to be reduced at the very least, and doing so will prevent chronic problems and long-term layoffs. Fortunately, we can and even should remain active while treating injuries.
“We want to keep you moving,” said Dr. William Roberts, a sports medicine specialist at the University of Minnesota and a past president of the American College of Sports Medicine. “Injured tissue heals better if it’s under some sort of stress.”
But to how much stress should we subject ourselves and for how long? There is enough conflicting injury advice out there to make your head spin, so it is important to be able to read your own body. You can use a simple, common-sense system to evaluate whether or not you should keep running through the initial phases of an injury.
- Document the very first time you feel any sort of pain while running. Continue training as before for 3-7 days. If your pains diminishes or is stable and does not hinder your running, continue with your training program. If pain is strong and persists, or simply grows worse, go down to Step 2. See a medical authority at this early stage to formally diagnose your injury.
- Reduce running intensity for 5-7 days. Keep your volume (mileage) the same, but simply eliminate speedwork and slow down your normal pace by 10%. This may give your body a chance to heal itself while continuing to run. Also, if your shoes have over 300 miles on them, this would be the time to buy a new pair. If your pain diminishes, go up to Step 1; if it persists or grows worse, continue down to Step 3. If you have not already sought medical counsel, do so now.
- Reduce running volume for 5-7 days. Since lowing intensity didn’t work, it’s time to slash the miles as well. Either cut your daily run distance in half, or cut the number of days you run in half. Find a crosstraining activity that produces absolutely no pain to supplement your running. Elliptical, biking, and aqua-jogging are all viable options, depending on your particular injury. If your pain diminishes, go up to Step 2; if it persists or increases, continue down to Step 4.
- Stop running for 5-7 days. Face it, this is a full-blown injury! Simply admitting that fact will go a long ways toward preventing the malady from becoming chronic. Your body needs healing, and the pounding of running is preventing that from happening. Bite the bullet, cancel your upcoming races, and focus on getting healthy again. This is a most difficult, even tearful, decision, but is a better alternative than popping prescription doses of anti-inflammatory drugs every day and struggling through workouts and races. I’ve been there and done that! By now you should have had your injury diagnosed by a medical professional. Consider seeing a licensed physical therapist and start a rehabilitation program under their direction. Correcting imbalances and biomechanical issues will address the root of the problem and reduce chance of recurrence. Crosstrain and take other steps to maintain your sanity. Think long-term.
Once you become healthy again (and it will happen!), build your mileage slowly and follow Steps 1-3 in reverse. When you are 90-100% pain-free, try running just a few miles at a time, no more than 3 days per week. The days off give you time to evaluate the effects of the run, since some injuries, such as plantar fasciitis, may have a delayed response to activity. Continue to increase training volume through slowly increasing daily distance and number of days running. Once you reach your pre-injury training volume without any setbacks, slowly increase training intensity over several weeks to your pre-injury speeds. If this produces no setbacks, resume your normal training habits, while closely monitoring your body. It’s time to build a big base and race again!
Most problems will go away during Step 1, or be squashed at Step 2. Following all these steps with most overuse injuries can help reduce or eliminate time off, and keep you running smooth and strong.
Research sources and for further reading: [Runtex]
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Tags: groin strain, injuries, marathon, physical therapy, plantar fasciitis, rehabilitation, stress fracture, tendonitis
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