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Recovery

Principles of Recovery – The Injured Runner

The annual incidence of injury in regularly training recreational runners is estimated to range between 37 and 56%. Unfortunately, for those of us who enjoy running, the likelihood of getting injured is quite high. Running injuries are often an interaction of several factors; however, an understanding of a few principles can help you more effectively manage an injury and prevent future injury.

Self Evaluation: It is essential to have an understanding of why runners get injured. If you don’t know why you developed an injury it is more difficult to treat it and also more difficult to prevent an injury in the future. The following are common reasons runners get injured:

  • Too much, too fast. The human body has an amazing capacity to adapt to increased loads (whether that is distance or intensity), this is what allows us to improve. Unfortunately, each person has a limit as to how much training the body can adapt to and how quickly it can adapt to that higher level. When we exceed the level that our body is able to adapt to then each training session can become destructive and injury follows.
  • Cumulative stress. Just as increasing the volume or intensity of training can exceed the limit of the body to recover; prolonged training, without distinct periods of rest, can also lead to injury.
  • Biomechanics. You don’t have to watch many runners to realize there is a lot of variability in running styles and the way our bodies are formed. Some of you may recall when men with flat feet were not allowed to join the military. Flat feet where thought to be a deformity that would lead to injury. Further research conducted by the military actually found that those with high arches were more apt to develop injuries. Runners who are naturally extremely flat footed, have high arches, have a difference in leg length, are bow legged or knock kneed may be more susceptible to injury. Your body mechanics may limit the amount of training your body will tolerate. Some of these conditions may be improved with the use of strengthening exercises, good running shoes, Save Up To 56% OFF & Get FREE Shipping Today! braces, orthotics (custom foot supports) or in extreme cases surgery. Running form can be improved with practice. For a simple but effective approach try LARS.
  • Training surface. The terrain you train on may contribute to an injury. Running downhill tends to cause more strain on the knees and lower back. Running uphill may overstress the Achilles tendon. Angled roads substantially alter running mechanics. Reapeated laps on a track place uneven strain on the legs. Trail running decreases impact but may result in unanticipated twists or sprains. Sidewalks are safe and level but the stiffness is far greater than asphalt, meaning your body gets to absorb that extra force.
  • Shoes. In a recent study of runners in British Columbia, shoe age was significantly related to injury. The optimal time to retire a running shoe is unknown. However, the older the shoe the higher the risk of injury. Your shoe is the mediator for all of the above factors. If you have great biomechanics and running form you may not need new shoes as frequently. If you have to run on sidewalks or have high arches you may want to consider replacing shoes more frequently.

PRICES: Apply the principles of sports medicine that create this acronym.

  • Protection. The area that is injured may need protection or support. Plantar fasciitis, or heel pain, heals more quickly when supported. This can be from an over the counter arch support or an orthotic (custom foot support).
  • Rest. Rest is a word that makes many runners cringe. Rest does not necessarily mean that you have to stop exercising. Often, you will be better off continuing to exercise. However, you may need to supplement with cross training. Different grades of injuries require a different degree of rest.
  1. Grade 1 Symptoms are experienced primarily while running and you can run with only mild to moderate discomfort.Your symptoms are not severe enough that you limp or anyone else would think that you are limping. The pain is no worse after your run. This type of injury is usually best treated by continuing to run and perhaps decrease distance or intensity slightly. You may want to consider cross training for more vigorous workouts (as long as you do not feel the symptoms during or after training). Initiate treatment that is specific to your condition. Injury Identifier
  2. Grade 2 Pain is moderate and may ease after you are warmed up, or pain begins after a certain amount or intensity of running (symptoms may worsen after two miles or when running at six minute per mile pace). Your pain is usually worse after the run and you may have a slight limp. Limit your running distance or intensity to what you can do without hurting after the exercise session and supplement your running with a type of cross training that is pain free. Initiate treatment that is specific to your condition.
  3. Grade 3 The pain is getting worse, it is moderate to severe and others can tell that you are limping before, during or after a run. You need to be off of your feet if you want to train! Get in the pool or on a bike so you can stay in shape and let your body heal. Initiate treatment that is specific to your condition.
  4. Grade 4 You are now wearing a cast and no doubt feeling very sorry for yourself – understandably. But someone in town has an arm cycle or Upper Body Ergometer, so work out a deal to be able to train on their machine a few days per week. You could also do upper body and core strengthening circuit training – but it has to be pain free and non weight bearing.
  • Ice. A runner’s best friend! A bag of peas works a treat! Ice can help stop the inflammation process (similar to an anti-inflammatory medication) and also numbs the nerves, which blocks the pain (temporarily). Ice application should last around fifteen minutes. I recommend a thin wet towel as the only barrier between the ice and skin. Several applications can be applied throughout the day depending on how sore you are. Ice massage is another great form of icing. Take an ice cube, or frozen cube from a paper cup and rub it back and forth over the injured area. At first it will feel insanely cold, then it begins to burn and finally after about five minutes you are good and numb at which point you are done.
  • Compression. This principle works great for a swollen ankle.
  • Elevation. A swollen joint (sprained knee or ankle) will recover more quickly if it is elevated. Elevation helps to reduce swelling which inhibits muscle function.
  • Stretching. There is some recent evidence that stretching an injured hamstring in the traditional approach may not be the best approach to recovery. A diagnol stretch improved healing time and reoccurence. See hamstring strain. Another review of studies conducted on stretching as a method to prevent injuries concluded that there is not good evidence to endorse or to discontinue stretching to prevent injury.Although the effects of stretching are not fully known, you don’t have to talk to many runners to find out that gently stretching an injured area, as well as other tight muscles, can accelerate your recovery. You will probably get the best results by stretching after you exercise. If you are injured, try to get two stretching sessions in each day. To improve the flexibility of a tight muscle, hold the stretch for thirty seconds or more and repeat three times. If you are using stretching as a general warm up or to gently stretch the tender area, then a shorter stretch perhaps five to ten seconds repeated five times will work better for you.
  • Strengthening. Recent research has made substantial breakthroughs in the understanding of strength and running injuries. Unfortunately, the emphasis in treating runners has primarily been flexibility. While flexibility is important, much more can be done to speed recovery and prevent future injury. Strengthening exercises for runners should emphasize movements that are similar to running and target the muscles involved in running: the hamstrings, hip abductors, lumbar extensors, gluteals, abominals, calves and quadriceps. Gluteal strengthening appears to be especially beneficial for runner’s knee and IT band syndrome.

Sleep: Sleep may be your body’s best opportunity to rebuild itself. Ensure you are getting sufficient sleep for your body’s needs.