Running Recovery: Coming Back from Injury

What do I mean by injury? There are lots of types of injuries, but in this case I mean athletic injuries that often result from overruse, poor form, or pushing to hard during a workout. Things such as IT band syndrome, tendonitis, pulled muscles, strained tendons, runner's knee, and many more. They're all different, and they all suck.
Why talk about it? Well other than the fact that I love to talk about myself and my experiences because I'm so awesome; most regular runners deal with injury at some point or another. I remember reading somewhere that 80% of runners have dealt with multiple injuries due to running; not to be a negative nancy, but those other 20% are probably due for some runner's knee or tendonitis soon. Running, although a great activity, is also pretty hard on the body, and without proper rest, cross-training, stretching, etc, injuries can happen. I think it's important to talk about potential injuries, their causes, their treatments, and preventative measures that can be taken. The hardest part of dealing with injury is different depending on the person, for me it's mostly mental. I just love running so much more than any other activity or exercise, and I crave it when I haven't done it in awhile. I could go to 5 spin classes back to back and still be debbie downer because I can't run. But more on my personal experience with injury later.
What are the most common running injuries? This is by no means a comprehensive list of the injuries that runners can sustain, but these are the most common running injuries to my knowledge:

That's an older picture of me heel-striking
at the end of a race; I got injured more frequently
back then......I don't heel strike anymore :)

- IT Band syndrome: This is when your IT Band which is a thin band of fascia (a type of tissue) that runs all the way from the top outside of the hip to the lower outside of the knee, becomes inflamed and irritated. This usually results in deep pain in the outer knee that is present even when not running. It is often caused by weak hip flexors, poor running form, overuse  weak core muscles, or some combination of these factors.
- Achilles Tendonitis: This is when the achilles tendon, which is the thin tendon that connects your heel to your calf muscle, becomes inflamed and possibly torn. The type of pain is similar to that of a pulled, sore, or tight muscle, but more intense. This can result from overuse  poor running form, weak calf muscles, or some combination of the these factors.
- Runner's Knee (Also known as Patellofemoral Pain Syndrome): This is the most common cause of knee pain in runners, and it is caused by a "mistracking" kneecap, which means your kneecap is out of alignment and is scraping your femur. This is often an achey type of pain that occurs towards the bottom of the center of the knee, and may increase when squatting, waling up or down stairs, or remaining in a sitting position for a long time. It can be caused by poor running biomechanics, weak quads, weak hip flexors, overuse, or some combination of these factors.
- Shin Splints: This is pain that runs along the front or outside of the lower leg (tibia) and is often described as sharp or stabbing pain. This pain is a result of overuse stress of the muscles that line the front of the leg, often resulting in slight weakening of the fibers that connect that muscle to the bone beneath. Causes of Shin Splints are running a lot after an extended period of not running, running or high intensity exercise on hard surfaces, tight calf muscles, poor running biomechanics, overruse, or some combination of these factors.
- Plantar Fasciitis: This is pain in the bottom of the foot and the heal that occurs as a result of the inflammation of the thick band of tissue (planta fascia) that runs from the heel to the toes. This injury can be caused be overuse, high arches, tight calf muscles, or it may actually occur without any discernable cause at all.
- Muscle Pull/Strain: This is one of the more common atheletic injuries across many sports. This is a small tear that occurs as a result of over exerting a particular muscle or stretching a muscle too hard. You may feel a popping or pulling sensation all of a sudden when the muscle tears, and it may feel very tight and sore for a few days.

What injuries have I suffered from? I have had IT Band problems with both of my knees and achilles tendonitis in my right ankle, all resulting from running. I have also had shin splints and muscle pulls in high school when I played soccer.

Procompression socks.

How to treat running injuries: Although there may be a few treatments that are specific to a particular injury, I have found that there are treatments that are very effective that work for all of my injuries and are often recommended for all injuries. And when all else fails, you can just drink the pain away........NOT.
- Rest: This is super important. Your injury will only get worse, not better, if you refuse to adequately rest it......trust me, I've learned the hard way. Rest does not necessarily mean no exercise, you can still exercise, just in a way that does not strain your injury or cause any pain. For example, when I had IT Band syndrome, I could still swim and cycle without any pain, so I did those to stay in shape.
- Compression: Weather you have compression gear, or you just wrap the injured area very tightly with bandages, compression is very important as it encourages blood circulation while preventing swelling. I especially love compression socks, they help prevent calf muscle soreness, and definitely have speeded the healing process for my achilles tendonitis. Procompression makes the best compression socks I've tried, so go on and get yourself a pair if you don't have one already.
- Alternate Ice & heat: I found that alternating 15 minutes of heat with 15 minutes of ice, for at least an hour, twice a day, on the injured area drastically increased the healing time of all of my injuries.
- Athletic Massage or Foam Rolling: I have never received an athletic massage, but I have been told that it basically achieves the same thing as foam rolling. I have foam rolled my IT Bands, any sore muscles, and my calf/achilles tendon, and it always seems to aid recovery and reduce pain.

How to prevent future injuries:
- Strengthen Core and supporting muscles: Many running injuries can be attributed at least in part to a weak core or weak hip flexors. I have made it a point to do exercises that strengthen my hip flexors and core in order to prevent future injuries. I don't want to say that it's working because I don't want to jinx myself.........but it's working.
- Do not increase the distance you are running by more than 10% per week: This is basically a way to prevent any potential overuse injuries.

Foam rollin like a boss.

- Foam Roll and Stretch post-run: Foam rolling and stretching after a run are just as important as post-run nutrition, if not more important. Hold stretches for at least 30 seconds to make sure that they are effective, and only a stretch AFTER the run, not before. Foam rolling is also important because it works certain important tissues in a way that stretching cannot; it's like a hybrid of stretching and athletic massage, and it keeps your fascia (a particular type of connective tissue) from tightening up.
- Take rest days: This is a MUST for running, and it was something I did not adhere to for a long time. No matter how much you can run, your body still needs rest days in order to fully recover from previous runs and prevent overuse injuries.
- Have your GAIT analyzed: Most running stores have a treadmill with a camera that films your legs, and are able to do a free GAIT analysis. This is really useful when deciding what type of running shoe to buy and how to potentially correct any major problems in your running form.
- Get all yo nutrients: This may seem silly, but not getting enough calcium, zinc, omega-3 fatty acids, vitamin C, or protein in your diet can all be factors that predispose you to injury. It is also key to take in a mixture of protein & carbohydrates within the first hour after exercise for the best results from your workout. There is no excuse to not be meeting these requirements, and it should be especially easy if you are eating a healthy, well-rounded diet built on whole, plant-based foods ;)

A little tip on the mental aspect of injury: Although technically speaking, injuries are purely physical, the hardest part of the recovery for many runners is mental. It is so hard to not be able to run, and it can leave you feeling frustrated, depressed, angry, or just sad. The most important thing to remember is that no matter how much you want to run YOU CAN NOT DO IT! I made the brilliant mistake of running to soon after an injury (read: running while I still had pain) and only ended up making my injuries worse. Try to get by, by doing other forms of exercise that you haven't done in awhile, or have never tried before, as long as they don't aggravate your injury. I know it can be tough, and at times it may seem like you will never run again (well at least that's how I felt, maybe I was just a tad bit of a drama queen about it), but I promise you will! Tons of runners have been injured before you and have come back to running better than ever, and so will you!

Well, since I'm an exercise physiologist and sports medicine doctor I am pretty qualified to discuss all of these running injuries and give tons of advice that you should follow above all other advice........NOT! As always, see an physical therapist and/or a sports medicine doctor if you injury does not start to improve within a week or two of rest and recovery; take care of your body, you only get one!

Also check back tomorrow for a recipe for corn & asparagus risotto or po'boy sandwiches (I haven't decided which recipe to post yet)!