Injury Prone or Under Prepared?

Recently, a runner told me he was injury prone because he ran his first marathon and got shin splints and then a week later his achilles tendon started hurting. He wanted to know what to do to address the shinsplints and what type of training plan is good for an injury prone runner.
Just because you end up with different injuries in close proximity does not mean you are an injury prone runner. You could just be a beginning runner or new to the distance or type of race you have chosen. If you are an experienced runner in both time as a runner and at the distance/type of running, and continue experience a reoccuring injury or multiple injuries in a row, you may be an injury prone runner. However, if you have not been running long, increased your distance, or changed from road to trail running (or the other way), you are probably under prepared.
Let’s address under prepared runners first. The runner may actually have prepared to the best of their ability and still have some aches and pains that extend beyond a few days after a race, such as shin splints or IT band issues. This is very normal especially for a runner who is taking on the marathon for the first time. Most beginning marathon training programs build miles up to, but not beyond, a single twenty mile long run. If you tack on 6.2 more miles in one go, you’re likely to have some aches and pains. As you gain more experience you can increase the number of 20 mile long runs and build your miles beyond the twenty mile mark. This will reduce the chances of aches and pains after a marathon.
Let’s look at what I mean by under prepared. Training for any race should include race specific training as much as possible. This means if the race includes hills (up and down), run hills in training. If it includes trails, run trails in training. If it includes roads, run roads in training. All of these will impact your body in a different way, so if you don’t train specifically for the challenges of your race, you are likely to be sore or even get injured.
Both experienced and new runners can neglect strength training or not realize how important it is in training. Runners do not need or want big muscles, but strengthening muscle supportive muscle groups can prevent injury and post race aches. Runners as a group tend to have weak hips and tight hamstrings. Weak hips contribute to a multitude of common running injuries such as shin splints, runners knee, and IT band syndrome. Your hips work to stabilize your legs as you run. They make sure your leg swings back and forth with the right alignment and speed. Include a hip strengthening workout three times a week in your training. It only takes a short amount of time and you don’t need a gym membership. You can search the internet or use the one above. Tight hamstrings reduce your range of motion for your leg swing and if you over stride you can strain or tear them.
What’s an injury prone runner? An experienced runner who struggles with chronic, reoccurring, or consecutive injuries on an ongoing basis. Runners who fit in this category can do a few things to increase the likelihood that they will be able to continue running and participate in races. First, either go see a physical therapist or google rehabilitation of whatever condition you have. Use the strength exercises four days a week. It can take three to four months to feel a difference, especially if it is a chronic issue. Even if it is a reoccurring issue and you don’t currently have symptoms or they go away, keep up the exercises for 4-6 months.
Second, use a foam roller at least every other day. Roll on the area for two minutes at a time and don’t neglect the surrounding muscles because if they are tight, it will pull on the injured area. Stress fractures are another matter. Do not roll on a stress fracture. Follow your doctors instructions for any stress fracture.
Third, change your training program to reduce impact. A normal training program has a rest week every fourth week, which means miles are reduced by 20-25% for the week. Injury prone runners should change the rest week to a pool running week, mini-trampoline running, or an elliptical (zero impact machine) week. If you look through my training programs you will find such a program.
If you are new to running or new to the distance you are running, take a hard look at whether that could be the cause of your injuries or if you are actually an injury prone runner. Using the injury prone training program will keep you running, but you may not make the same gains you would if you took the steps under the new/under prepared runner section.

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.

Swing Those Hips

swing those hips

It’s all in the hips my friends. I know you’ve heard that it’s all about the base, and there is no doubt that having a strong base before building miles is essential, but if your hips are weak you will end up injured once your body reaches its threshold.

What types of injuries am I talking about? Shin splints, IT band issues, and runner’s knee for starters, and these can lead to additional problems if you don’t address them including stress fractures.

Your hips are a part of your core, but most people focus on the abs when doing core exercises and leave out their hips entirely. So what do I mean by hips?

Vastus Lateralis muscle: this connects the side of your thigh to your knee and then runs down the front of your leg attaching to tendons at the knee, which attach to tendons on the tibia.

Satorius Muscle: this is the longest muscle in the body. It goes from the outside of your hip down to your knee and attaches to your tibia. It helps with hip rotation, and flexing. It also helps with knee flexing.

Iliopsoas muscle this is actually two muscles but they work together. They are your major hip flexors. You can’t run without them, or walk. They help you sit up while lying on your back too. They also control hip rotation in order to keep the knee aligned properly.

The Pectineus and Adductor Longus muscles (inside of your thigh at the hip) help pull the hip toward the center of your body and help flex).

Rectus Femoris is a part of a group of four muscles that make up your quadriceps. They are the primary extenders of the knee and connect to tendons at the knee and the tibia.

Gluteus medius and gluteus minimus these are on the outside of your hip and a little toward the back. They help with rotation of the hip away from the center.

I knot this may come as a surprise to some, but your body is all connected. When you have an injury at one point along the kinetic chain, it is most likely caused by a weakness in the muscles above and/or below the point of injury.

Just reading these very simple descriptions of these muscles (Disclosure: I’m not a medical doctor or a physical therapist) shows you all the connections between your hip, knee, and down to your ankle (by way of the tibia). If you have extra rotation in the hip, it tweeks your knee and tibia the wrong way. Basically, if your hips are not working properly, everything below the hip is screwed up too. This is why you need to strengthen your hips. If your hips are strong and stable (no extra rotation toward or away from the center) you are going to enjoy injury free running a lot longer and be at a lower risk for injuries.

How do you strengthen your hips? Here is a simple workout you can do three days a week it takes about twenty minute.

3 x 20 donkey kicks

3 x 20 fire hydrants

1:30 of clams holding up for five seconds then drop and come back up to hold for five seconds. Repeat for the full one minute thirty.

One minute single leg glute bridge (do each leg)

One minute bent leg plank, this is a single leg exercise. It’s done in the same position as a plank but one leg is bent underneath you and the other is up and extended no ground contact.

3 x 10 single leg squats

3 x 20 lateral leg extensions (this can be done standing with a band or lying down Jane Fonda Style)

3 x 10 squats

Happy Running!