OUCH! Injuries- Prevention, Recovery, & Maintenance Part 1
Injuries…more specifically, sports injuries…suck. No sugar coating that fact here. Sure, no injury is “fun”. Many injuries are accidental. Not saying that a sports injury can’t be accidental, but many are preventable.
If you fall down when running and bang your knee, sure your knee is likely going to hurt. What happens if you go out for a run one day, and your knee starts to hurt, and I mean like really bad, out of nowhere? Chances are, you go home, ice, roll, ask all of your fiends on your Social media running group. Try six other things that were suggested, and maybe it feels a little better, here and there. The problem…even if it feels great, did you unlock the “why” or the “how”? Hey maybe you got the “sports massage” that was being offered on the daily deal, and they asked you when it hurts and you said it starting bothering you when you were running. Surmising that it must be from running! Nope. (Disclaimer: There is nothing wrong with deal sites, massage chains etc; just be aware not all massage therapists are created equal. Everyone has their own set of skills and knowledge)
As an athlete, we want to be “pain free”. What does this mean? And what about that “no pain, no gain” stuff people like to bark?
I will explain. First, understand that pain is a nervous system response indicating something is not right. Sometimes it may start as discomfort and progressively increase. There are even different pain descriptions, like sharp, shooting, intense. Some descriptions are subjective, and are specific to the individual; while others are more about the pain itself. Eventually this “not right” feeling may be this is a “not good” feeling, and then even “STOP!” Pain is warning you, telling you, and then making a demand on you to knock it off! Pain is a survival mechanism. It is also basic common sense, something us humans do not seem to want to embrace. So we create phrases like “no pain, no gain”, “pain, is temporary…” Typically this is not referring to the “real pain” but the discomfort, or soreness from a workout. Our body testing it’s limits, and moving further. If you are training for a marathon, for example, you will experience some pain, but it should not be injury or hurt pain so to speak. Even after the race with much training, you may feel pain. Your body went out and pushed, and tested its limits. You need to recognize your body’s signals and the information it is attempting to communicate. This is why a training plan, recovery days, tapering, good nutrition, warm up/cool down, and many other things are so important. This is allowing your body time to heal, it is communicating back to your body that you understand and recognize what it needs, and you are willing to work with it accomplish great things together. Create balance for your body. I like to say “Balance in your body. Wellness in your life”.
That being said…tell me what “it’s a good pain” means?!?! Ok…truly it means that something is working itself out. Personally, as a massage therapist, I really dislike this phrase. Someone should not have to jump up and down on your shoulders or hips to make the muscles feel better. This has potential for even a greater response from the nervous system. Also don’t forget, just because it hurts here, does not mean that is the starting point, source, cause, or whatever. The relief felt upon massage, or other work in an area that has pain, but not source, may be temporary. Get to the source.
Pain-free. This is a goal. One does the work, without shortcuts, to become pain free. Whether it be when training or in recovery from back surgery. Do the time, put in the work, listen to your body, get it what it needs. This is your first and only real “home” you will ever live in. Take care of it. It may not just be “getting older”. If something persists, get it checked out.
The main components for injury prevention (or if too late for that…rehabilitation) are proper form, strength training, and what’s on your feet! I like to throw in self care as a piece of this as well. Self care (the rolling, the stretching, the warmup, the cool down, even nutrition) helps to keep you on target with your goals by helping to maintain the body’s health and to help you recognize potential warning signs of over use.
Form is huge. No one is likely going to have “perfect form” but everyone should aim for more efficient form. Why put extra stress on the body? When I speak of form, this also is for walking, standing, sitting….now I sound like a nag! With regards to running, a gait analysis can be helpful, but what happens later in your run when you are tired and your posture is collapsing. Or when cycling it is important to have a great bike fit, but what happens when you are tired and your body no longer “fitting” with the fit. I often refer to this as false advertising. What the form looks like at the beginning of an activity (or day even), is not likely what it will look like at the end, or even halfway through. An athlete needs to understand what efficient form looks like and work on their own form bit by bit. I will be addressing form more in another post.
Shoes. Just because they fit and are comfortable, does not mean they are the appropriate shoe for you. Just because you have run 12 marathons in that style shoe, does not mean they are still the right shoe for you. Purchase shoes for the runner you are, not the runner you were, or want to be. Get a proper fit. Actually go to a specialty running store and have a fitter size you and explore the options for you. If you go to a brand name shop, those will be the only shoes you will see. If you go to a massive sporting goods store, and handle a box on your own…you may think you will save a couple dollars, but really you are over paying for self service, as usually the price is the same. Let someone take care of you and spend time with you picking out something; and if they are not the right shoe, many stores have a fabulous return policy so you can check out something else. Go to some sponsored fun runs and try different shoes even at your local running store! Inserts often can help with form and foot fatigue. Rigid orthotics however have not been proven to prevent injury. I am not telling you to forgo wearing them if you do, just explore.
Strength training. Strong muscles, tendons, and ligaments, help the body to provide a strong defense against athletic injuries. Strength training will help the “support team” of the body. This team consists of muscles, tendons, and ligaments that help stabilize the joints of the body as well as supporting the movement for more balanced and fluid flow. The support team will also help as the main movers begin to fatigue, allowing for more endurance.
What about self care? There is much to do here! Rolling, stretching, ice, compression, recovery boots, meditation, massage therapy, sufficient rest and more. Self care, no matter what you are training for (or not even training!) is important daily. Self care will help recovery and aid with efficient body movement. This topic will be discussed further in another post.
The most common injuries that runners and other athletes suffer from can be prevented. Injuries happen. After rehabilitation from an injury, it is also important to make some changes. Discover the cause of the injury. A doctor, a physical therapist, a movement specialist, or a coach, can all assist with this. Not all of them will have the same abilities, or knowledge…or even time. Each of the following injuries will be discussed further.
1. Patellofemoral Pain Syndrome sometimes referred to as Runner’s Knee.
2. Iliotibial Band Syndrome
3. Shin Splints
4. Achilles Tendonitis
5. Hamstring Issues
6. Plantar Fasciitis
7. Stress Fractures
When a client of mine has a potential injury complaint when they are training for something I ask them (or interrogate them!) I am not a doctor so I am unable to actually diagnose, but I can assess and work with injuries. I help athletes return to activity, and help to determine the cause of issues, or potential overuse injuries. An injury does not have to be caused by the sport but can be several contributing factors. Injuries also can be related to each other. Tight calves (gastrocnemius and soleus muscles) can lead to Achilles tendon tightness, and then in turn lead to Plantar Fasciitis issues. All of which can have contributing factors such as how one walks up the stairs (and how many), driving position, how one sits at their desk, hip placement, and more!
Some examples of questions:
1. Are you following a training plan
2. What are you doing in addition to your training plan
3. Work atmosphere (or life activities when not running or training)
4. Are you doing any other cross training?
5. What is your nutrition like?
6. Missed workouts/miles; are you making them up? How are you altering plan?
7. Are you increasing speed?
9. Trauma/prior damage
10. Running/activity surface
What can YOU do?
Stop activity if you are experiencing inflammation. If pain is present, and does not go away after you warm up, try walking, if it persists, stop activity. If the area is not functioning normally, stop activity.
The longer you continue activity, the longer it may take to recover completely and return to activity. You can take time off of running without losing a significant amount of your conditioning. Just be sure not to pick up where you left off, but ease into it.
Try to decrease your risk of injury by inserting walking breaks from the beginning. Allow for plenty of recovery by spacing out your training plan and not loading it with intense workouts everyday. Account for other outside of training activities that will also affect your body (moving, a day on your feet at an amusement park, etc). Ease your way into faster running with shorter speed workouts, and eventually add into your longer runs (make sure form stays consistent, as the lower body may be moving fast, but the hips may not be), be careful with your stretching. Don’t overstretch, or stretch too much. A warm up and a cool down is different from stretching and often even more important.
Next up in Part 2: Warm Up and Cool Down as well as some other self care measures; coming soon how to return to running and more about injuries and what to do!