Returning From Injury (The Smart and Strong Way)

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Running is a unique sport when it comes to the physical demands on the body. Unlike during swimming, rowing, and biking, your body must support your entire weight while you run in addition to handling the forces associated with each time your foot hits the ground. Many, and I might hazard to say most, runners will eventually have to deal with an injury.

My first injury was one for the record books. I had trained hard for the 2015 Chicago Marathon throughout the summer; I had PRed the 5k distance and run two sub 1:30 halves in miserable weather during my journey to a sub 3 marathon. During the race, I held an exact 6:53 pace for 15 miles when I felt what I would later describe as
“an explosion in my hip.” I stubbornly ran on to mile 22, realizing I could still get a sub 3:05 and PR if I just could manage my way a bit further….

But I couldn’t go any further. I limped to the medical station at 22, and my sub 3 dream was over for a while. I had a strained gluteus medius; however, these pictures were taken a mere 3.5 weeks after my initial injury:

Image-112106799_10100980363375792_6007115874467096687_nI have been told many times that I heal incredibly quickly, but my healing time was actually right in line with what my doctor said it would be “IF I followed my healing plan.” And, as we all know, telling a runner not to run and to follow some kind of plan that involves no running is a tall order!

 

 

Here is a breakdown of what I feel are the most important aspects of returning from an injury. This is my “Strong and Smart” list (a little mantra I came up with as diligently followed my plan).

STOP

The first step to injury recovery is to stop running. There are various opinions on when to stop, but I feel Pete Pfitzinger’s advice is pretty sound. You should stop running:

-“If you’re limping, then your running mechanics are thrown off”

-“If you have a specific pain, and that pain is increasing progressively during the race [or run]”

I ignored a pain that qualified under both of these points; it both threw off my mechanics and was specific and progressive.

GET A DIAGNOSIS

Before I go on here, I want to distinguish between a medical diagnosis and a physical therapy or other kind of diagnosis. A medical diagnosis is given by a qualified physician; it is a determination of the source of the problem. For me, my medical diagnosis was a grade 2 strain of the gluteus medius (side note: SPRAINS are tears in ligaments, STRAINS refer to muscle with or without tendon involvement). This diagnosis differs from the diagnosis a PT or other professional might give, which deal with how the injury is affecting the body. “Decreased flexion at the right hip” could be a Physical Therapist diagnosis, and then that therapist could give direction on how to increase the movement and bring it back to baseline.

It has been my experience that certain professionals will give a medical diagnosis when they have no qualification to do so. Your chiropractor may not be qualified to diagnosis the basis of your injury, and the movements and stretches they may perform could further aggravate the problem. This may be an unpopular opinion, but I strongly feel that injuries should be diagnosed before visiting physical therapists, chiropractors, or any other profession.

If you have a stress fracture, a PT or like professional will not be able to diagnose you. Seeing these professionals before your primary healthcare provider may lengthen the time you are unable to run because it is time lost from the ability to heal from the actual source of your injury, as opposed to treating the “side effects” of that injury, like muscle soreness and decreased range of motion.

I understand that this is not the case 100% of the time, but it is a time I would err on the “better safe than sorry” side.

HANDS UP AND SLOWLY BACK AWAY FROM THE GOOGLE

Step away from Google. Just do it. You will drive yourself insane thinking the worst is happening to you. If you must google, stick with pages that talk about return to running instead of diagnosis. I googled my injury A LOT before my doctor appointment and here is the list of problems I convinced myself I had:

-fractured trochanter

-Trochanteric Bursitis

-tendinitis

As you can see, none of these were correct and I was freaking myself out for no reason.

GET A PLAN AND FOLLOW IT

My doctor gave me a very specific routine to follow: 10 days of a slow release anti-inflammatory medication, wait 2 days and then begin a stretch routine 3x a day followed by ice, on the 5th day slowly add in 5 very specific strength exercises preceded by heat and followed by ice. My discharge papers had the specific reps to do, detailed instructions on how to increase resistance for the strength exercises, and follow up appointments to track progress.

After the initial course of medication that brought the swelling down, he gave me this direction:

You may ride a stationary bike but avoid spin classes, running, jumping and lateral movement sports until your symptoms have resolved

I followed my plan exactly. I did not do more or less activity than my instructions told me to. I think this part is key. When I wondered if “x, y, z” activity was OK, I called and asked. Could I pool run? No, because of the hip movement and water resistance, he wanted me to wait 2 weeks until I was showing good progress on my strengthening exercises. I also tried to stay smart about my activities that were approved. He wanted me to limit the strengthening exercises to every other day, so I did. I also knew that, while I eventually was OKed to stationary bike, I knew that biking 2 hours would probably not have been ok.

RETURNING TO RUNNING

There are a ton of plans you can google for rebuilding mileage and returning to running in a smart and strong way. Here is one from Pete Pfitzinger. And another from the folks over at RunnersConnect .

I followed a plan that had every other day running in the first week, but not more than 20-30 minutes each run. I kept all these runs easy and resisted the urge to “test” myself. In the second week, I upped mileage and time, but I, again, kept everything easy. I actually cut back my mileage in the 3rd week and then ramped it up to near normal numbers in the weeks that followed.

By committing myself to a smart and strong recovery, I was able to train for the Tobacco Road Marathon and run it pain free just 5 months after my Chicago Marathon disaster.

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My friend and amazing running partner, Holly, and I posing for a picture after a 20 mile training run.