Category Archives: running injuries

Ankle Sprains

Ankle sprains are a common occurrence among runners. Especially, trail runners. I recently sprained my ankle for the second time in ten years, not a bad record considering how much I run. I have lose tendons in my ankles anyway, so I can turn an ankle and not cause any damage 90% of the time. Two weeks ago, I was running down a mountain and another runner was coming up. I stepped up onto the slope of the mountain to avoid the runner and when I came down on my left foot it rolled over.

Pain shot up my leg and I heard it tear and said some choice words. I limped along for a bit, but was able to slowly run down the last little bit. I stopped at the first gas station, picked up ice and iburprophen. The swelling isn’t totally gone, but I think I’ll be back out on the mountain in another week.

True to form, I researched how to rehabilitate a sprained ankle and how long it takes to heal. During the acute phase injury to 3-4 days taking iburprophen, icing 4-5 times a day for 15 minutes each time, compression and bracing when you are walking on it.

There are three grades of ankle sprains. Grade one isn’t too bad maybe a minor tear and over stretching. It can cause some pain when walking and some swelling. This takes a week or two to get back to your activities. Grade two is a minor-moderate tear and over stretching. It causes swelling, bruising, pain, and imbalance. It takes 3-4 weeks before you’re back to your activities. Grade three is severe or complete tear of the tendons, which may make surgery necessary. You’ll definitely need crutches to get around. Recovery time on this one is going to be six to eight weeks at a minimum.

Rehabilitating any injury requires strengthening the muscles and tendons that were injured and then the surrounding and supporting ones, balance and proprioception and maintaining mobility. Physical therapy/rehab exercises should begin as soon as you can do them without zero to minimum pain (2 or lower on a 1-10 scale). Exercises should continue for three to four months.

Start mobility exercises about 4-10 days after. Move the foot forward and back, start ankle rolls and writing the ABC’s with your big toe, heel on the floor. You also want to stretch your Achilles and calf muscles.  For strengthening, use an exercise band. Wrap it around your forefoot and pull it to the outside, inside and away from you. You can also do this against a wall. Calf raises are also good.

For the balance piece, start slow and work your way up: standing on one leg on the floor, then with your arms out and bent over, and finally using a balance board. To reestablish the brain body communication (proprioception) write the ABC’s with your whole foot while balancing on one leg.

Be patient in your recovery. Once you roll an ankle it is easier to do it again in the future, which is why continuing the exercises for three to four months is so important. When you do return to running, tape your ankle (youtube) each time you run for a week or two. You’ll have to reduce your miles and build them up to reduce the risk of overloading the healing tissues.

You can cross train doing things that don’t cause any pain. Getting out there as soon as possible is important, but keep in mind, going out too soon poses a high risk for re-injury and starting from square one or causing more damage.

Stuck in the Injury Cylce

Getting stuck in a cycle of injuries is one of the most frustrating things for any athlete, but it happens to many of us. Why does it happen and how do you get out of it?

The why of it is often overtraining/lack of rest and recovery time. We love our sport and we want to do it as much as we can and we want to get better. The thing we forget is rest is part of the getting better process. It’s also essential in preventing injuries.

When an injury occurs and we don’t give ourselves enough time to recover and slowly/gently come back to our regular training routine, we increase the chances of getting another/different injury along the kinetic chain or on the opposite side of the body.

Allowing the body time to heal and regain its strength to be able to tolerate the load we are going to put on it takes time and it takes a gradual increase in training. Even when we are resting enough and are strong, our body goes through a cycle of training stimulus to fatigue/minor damage to recovery/building. If we push hard during the fatigue/minor damage phase, we risk injury. This is why we alternate intense days with easy days in our training programs. It’s why we take a rest week every fourth week.

The bottom line here, is realize your body is not a machine. It has to recover before you can build. Patience is a virtue in these matters.

One of the best things you can do to prevent injuries and stop the cycle is to add strength training to your training schedule. This will help get injured muscles back to pre-injury status and it helps improve the strength of supportive muscles.

I cannot stress enough how important strengthening your core, including your hips, is for runners. These are your stabilizing muscles. Strength in this area will prevent injuries both up and down the kinetic chain. Add a routine three days a week to work on this area and if things get easy, increase the repetitions or change your program. You don’t need a gym membership to do many of these workouts. Your own body weight is enough. My routine requires some home equipment. You can also add in a short arm routine if you’d like.

Here is my routine:

I do them in super sets and repeat each superset three times. It takes me about one hour.

Super set one:

Inner thigh lift one minute

Front plank one minute

Side planks one minute

Leg lowers with or without weight 15 times

15 burpees

Fifteen clams with a band

Single leg bridge on a swiss ball, lift and lower 15 times hold at the top for five seconds

Super set two:

Kettle bell swings 15 times

Kettle bell gobble squats 15 times

15 jump squats

15 piston squats each leg

 

Super set three:

15 wall ball toss with squats

15 Ball toss sit ups

15 Box jumps

15 Jane fondas

15 fire hydrants

Run-It’s who I am.

What does it mean to be a runner? Do you have to run a certain number of days a week? Do I have to run a certain number of miles or time? Do I have to have been running for a certain amount of time? Do I have to race? What if I take a break from running of a month, two months, three months? What if I’m injured and have to take six months or more off of running?

These are all questions I’ve contemplated while out on the trails, especially over the last four months. These questions and other similar ones, have jogged around my head because my ability to maintain a consistent running schedule over the last six months has been seriously compromised by a hamstring injury.

I began to ask myself what it really means to be a runner. I’ve written blogs about being a jogger or a runner.  The defining feature addressed in that blog was speed, but I’m talking about something different here.

I’ve been running for awhile and I’ve run in races from the 5k to the 100 mile. Being a runner is a big part of who I am, it’s more than what I do. It’s not I run, it’s I am a runner. Losing running is like losing a part of myself. Some may think I’m being overly dramatic, but many of you will understand.

Running has made me a better person; more patient, understanding, compassionate, and mindful. It’s given me appreciation and gratitude for what I have; opportunity, health, material objects, freedom, and dreams.

You do not have to run for a specific number of days each week or a specific number of miles, or a specific amount of time. You do have to run on a regular basis though. You’re not a runner if you jog across the street to get lunch every day. I’m comfortable saying you are a runner if you run two days a week for twenty minutes, even if you run walk those twenty minutes. As to distance, it’s whatever you cover in those twenty minutes. Many runners don’t measure by miles. They measure by time.

You can call yourself a runner after you’ve run consistently for a month. It’ takes 21 days to form a habit, and if running has become a part of your weekly routine, you’re a runner.

Now the big question for this post—taking time off. Runners have to rest for a lot of different reasons and runners get injured and have to heal. Sometimes this takes a long time. If you’re still a runner in your heart and mind, if your intent is to get out there as soon as you can, if the reasons for your time off is to make you a better stronger runner, You’re a runner.

As long as being a runner is woven into who you are, you are a runner.

Graduation

’tis the season of graduation. Every May and June, thousands of people graduate from high schools, colleges and universities around the United States. So with graduation on the brain, how do you know you’re ready to graduate to the next race distance?

There are multiple opportunities for graduating in our life times. Each time we achieve a new level in any aspect of our lives we could say we have graduated. When most people think of graduating, they think of transitions in the educational setting to the next level.

Our youngsters graduate from kindergarten, elementary school, middle school, high school, with their associates degree, bachelors degree, masters degree, and doctorate degree. As far as running goes we move up from 5k to 10k; 10k to half marathon; half marathon to full marathon; marathon to 50k; 50k to 50 mile; 50 mile to 100k; and 100k to 100 mile.

Basically, you graduate when you successfully complete a course of training. That’s all fine and good, but when it comes to running how do you know you have “successfully” completed a course of training?

Many runners don’t begin with the shortest distance and work their way up. They just jump in where they want too. Some proceed to longer distances and others stay where they are comfortable. Here we are talking about those runners who want to move up in distance, although there is nothing wrong with staying put. It’s a personal lifestyle choice because as you move to the next level, your running impacts more and more of your lifestyle.

We know the training that goes into each level of achievement is more difficult than the last.  It takes over our lives a little more with each step. It can change our sleep needs and nutritional needs. It changes the way our body functions (usually for the good but there are injuries too). Our time commitment to running increases and we develop friendships with new people.

We learn about new skills and absorb new information by reading books, blogs and magazines. Our vocabulary increases as we throw out the latest terminology such as being chicked, attitude training, Athena class, Clydesdale class, bandit, aquajogging, and PR. We learn a lot about our  bodies including various tendons, ligaments and muscles.

We put into practice the skills we have learned from the prior level such as foam rolling, stretching, tempo running, packing drop bags, how to stay awake and run all night, how to manage stomach problems while running, and hydration.

You’re ready to graduate when you develop the enthusiasm, drive and grit to take on the challenges of the next level even though you don’t know everything about them.

 

 

 

 

 

Hello past me…

Dear twelve-year-old me,

Remember the wind in your hair as you ride your bike around the neighborhood, and the bliss of chasing friends, siblings, and cousins at the park, through the woods, and over mountains? Running will become your true freedom; your most loyal of friends. It will save your life and see you through the most difficult of times.

Within the next year, you will fall into a darkness so deep the possibility of a happy ending will never even occur to you. The existence of a warm heart and soaring soul will be a faded dream. You will lose touch with the places you love; the woods, the streams, the mountains, and lakes. As incredible as it seems you will lose your connection with the earth, your love of dirt between your toes and sifting through your fingers, the sun on your bare skin, and the rain tickling your face.

It will be years before you find these things again, but they have never left you and are waiting for you to return. The mountain trails of the Wasatch Front will be come your home away from home. They will become your comfort, your therapist, your peace, and your clarity.

The trails will teach you patience, mindfulness, forgiveness, and acceptance. They will heal your deepest scars because on the trail you are strong and complete. There is no judgement in the wild. Every tree and every flower is beautiful just the way it is and so are you.

Running will give you confidence to take on any challenge and fortitude to accomplish your goals. You will find grace in a face plant; warmth in the snow; rooted in the clouds. Running will be more than a pastime, hobby, or a way to stay fit. It will become much more than you ever imagined weaving itself among the very core of who you are.

The hours and hours you spend alone in the mountains will remind you how much you have to be grateful for in your life—health, friendships, family, education, financial means, and living in a place where you have the opportunity to run.

You will work through major and minor injuries carefully trying to balance your mental need to be on the mountain and your physical need to heal. There will be anger, frustration and many tears, but running is not going anywhere. It waits for you and the reunion will bring more tears, those of joy.

You will see the world as a child sees the world—an exciting adventure with discoveries around every bend.  This perception will spread to many aspects of your life. All of the lessons running teaches you will make you a better friend, mom, advocate, significant other, daughter, and member of society.

I wish you could have found it sooner, but know it is always waits for your return.

With love,

Nicole

 

Are You Strong?

All you have to do to train for a race is run, right? Wrong.

Wait a minute, my legs are really strong. I mean check out these calves, quads and glutes. I used to think the same thing. The number one reason to incorporate strength training into your running training is injury prevention. The other reasons are increasing your speed during your long runs.

Running beats up your body, if you haven’t noticed. If you don’t have a lot of time to add in strength training, and who does, work on your hips. Strong hips are essential to preventing injuries. There is tons of research that supports this. You can prevent some of the most common running injuries such as runners knee, shin splints, and ITband issues.

Your hips stabilize your upper and lower body. The muscles surrounding the hips are recruited when other muscles become tired which can cause overuse injuries and compensation injuries. Weak hips throw off your gait, causing your knee and ankles to be unstable, in addition to your hips. You can develop mid-line crossover of your arms and feet. Cross over is an over rotation of your upper body during running. This twisting action wastes energy and can cause you to fall if you’re running on an technical surface.

You don’t need to do strength training every day, three days a week is best, more is not better. Your body needs a chance to build after you work the muscles. It doesn’t take a long time to add in some hip strengthening either, you can throw in 20 minutes after a run or on your cross training days. Let’s eliminate one more excuse too, you don’t need any equipment or a gym.

Here are some exercises that will get you started:

Fire hydrants: Get down on all fours. Lift your right leg out keeping the knee bent at a 90 degree angle. Lift slow for four counts and then lower for two counts. Repeat this for 10-20 times and three sets. Repeat on your left side.

Side Leg Raises: Lie on your side with your legs stacked on top of one another. Lift your top leg to about 45 degrees and then lower it back down. Repeat 15 to 20 times per leg.

Bird Dog: Get on all fours on the ground. Focusing on balance, lift your right arm and extend it straight out in front of your body. Simultaneously, lift your left leg and extend it out behind your body. Bring your extended arm and bent knee back to center under your body, and then extend them both out again. Repeat 15 to 20 times on each side.

Hip Hikes: Standing on one foot, drop the right side of your pelvis a few inches downwards while keeping the left side in a neutral position. Activate your left hip muscles and lift your right side back to the starting position. Repeat 15 to 20 times on each side.

Single-Leg Bridge: Lie on your back with both legs bent and your feet flat on the ground. Lift your left leg off the ground and extend it while you raise your lower back and butt. Hold the position for two seconds and lower back downwards in a controlled manner. Repeat 10 to 15 times on each leg.

Donkey Kicks: Get on all fours again, but this time you will only be lifting and extending your legs, keeping your hands on the ground. Instead of extending the leg backwards like you did during Bird Dogs, keep the knee slightly bent and kick upwards, with the bottom of your shoe facing the sky. Repeat 15 to 20 times on each side.

 

 

Time to Heal…

Being patient with your body and allowing time to heal is difficult, but absolutely necessary if your goal is to run for a long time. I struggle with taking time off just to rest and recover; an injury is just as difficult for me. Usually, I continue running on it-telling myself I can run through it. And many times running through minor injuries is fine. It’s the not so minor ones that you can’t run through. Even some minor ones, get worse if you try to run through them. Knowing the difference, is the difference between an experienced and novice runner.

Injury and time off is unfortunately part of the running experience. Alternatives to running are just not the same. You don’t get that runners high. You don’t get that peace and sense of freedom. The longer it takes to heal the more agitated you become. It’s easy to fall into a pessimistic and defeatist attitude. You become an expert at positive self talk or you fall into a depression. The longer you are in the recovery mode, the farther off running feels.

You definitely go through the seven stages of grief: shock, denial, anger, bargaining, depression, testing, and acceptance.

Shock and denial are lumped together most of the time, “It’s not that bad,” “I can’t believe this has happened.” “It’s nothing to worry about,” “I can still run, it’s fine.” “It’s the shoes, I’ll just get a new pair.”

Anger is directed at pretty much everyone including other runners and yourself. You beat yourself up about not taking time off right when it happened. You decide you could have prevented it and were just stupid.

Bargaining-” Dear God, I’ll take time off right away next time, if I can just have my running back now.” “I’ll volunteer more and donate money, if I can just get back out there.” “I’ll do anything to get back out there!!” Anything, but take the time to heal that is. You  begin doing research about the fastest way to heal. You spend hours looking at new training programs, super foods, stretches, miracle vitamins, and strength training.

Depression comes in the form of the defeatist. “I’ll never run again.” “this is going to take years to heal.” “It will always hurt to run.” “I can’t be happy without my running.” “I can’t live without my running (you think this is going to far until you’ve been there).”

Testing-“I’ve taken a few days off, I can go back.” “I know it still hurts a little, but a little run won’t hurt it.” “Just an easy three miles.”

Acceptance- “this sucks, but my goal is to run until I die, so I guess I’ll spend six months doing physical therapy and then I’ll take the time to get back to running in the right way because if I don’t, I’ll be back where I was when this started.”

When you’re ready to start your epic return to running make sure it’s slow. Review my return from injury training program found above under the 5k and 10k training program link.

It’s a shame that we can’t start with acceptance. Maybe that should be our goal for our next injury because if we’re honest with ourselves, the next injury will come.