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10 Rules of Running Injuries

October 25, 2010

These rules may not be golden, but hopefully they're helpful.

So I’m officially out of the boot–just minutes before my left side permanently shifted an inch downward, I’m certain–but am still in no shape to run. My right foot, the supposedly healed one, is super crampy and tender. Dang it. And my already angry left glutehing (combo of butt, hip and hamstring, of course) is downright pissed from being such a supporting player for over a month. Insert expletive here.

That’s the bad news. The good news? I have quite a bit of wisdom I’ve gleaned from this and my numerous other injuries, and, as always, I’m willing to share. But before I spill the beans, one caveat: as SBS and I have said before, we’re not doctors, nor do we play them on t.v., so take this as the free, unsolicited advice it is.

1. If the body part hurts while you’re walking, sitting, standing, it’s unlikely that running will make it feel better. Unbelievably–and against what all of us wish to be true–you can’t run through a real injury. You can run through minor aches and pains, but shin splints, plantar fasciitis, and IT band issues aren’t solved on mile 4 of a six-miler. Sorry.

2. How do you know if it’s a minor or major ache? I wrote this in RLAM but it bears repeating some of the best advice I’ve ever heard was from Bob Wilder, a real MD, at the University of Virginia Center for Endurance Sport. If the pain you’re feeling when you’re running ranks a 3 or lower on a scale of 1 (hardly feel it) to 10 (where’s the stretcher?), you can keep going. Higher than that? Take it down a notch until it doesn’t hurt as much or call it a day. I have run past three too many times in my life. No more.

3a. If that major ache doesn’t go away with rest and ice after a few days, seek out professional help: a doctor, a physical therapist, a masseuse. Find somebody who is sympathetic to and really knows runners, so your concerns aren’t whooshed away with a curt, “You probably shouldn’t run anymore.” How to find such a person? Call a local running store, e-mail the president of a running group (even if you don’t belong to it), ask for recommendations from sporty friends.

3b. Once you’re in the appointment, ask as many questions as you want and be sure you’re clear on what is wrong with you. I’ve nodded my head so many times, afraid to look ignorant, as somebody mentions piriformis and tensor fasciae latae and other muscles I know about but am not entirely sure of how they function. I don’t do that anymore. The doctor I saw last week was probably like, “What was up with that demanding woman?” after I left, but I’m sick of paying a whopping co-pay and leaving after a 3-minute appointment just as confused as when I went in.

4. Sweat helps ease your pain and clear your head. If you can–and that means, if your injury doesn’t hurt at all from one of these activities–ride a bike, if you can, or swim (although no cleansing sweat–just eau de chlorine), or go to a warmish yoga class to get your yayas out. Deep water run if you can handle it. I can’t. It helps me to set a goal for the week: 3 workouts or 2 hours of sweat or whatever sounds good in the moment. I meant to write a “training” schedule for my booted weeks, but never got around to it: a little to ambitious and anal, even for me.

5. So soak those temples if you can, but also let yourself rest. I slept in way more mornings than I thought I would’ve–in my mind, I was swimming or biking 5 days a week, when in reality, I probably biked twice weekly–but I tried to be o.k. with the ultra-groggy mornings and the days that weren’t as driven. Cue the Byrds: A time to work, a time to heal.

A close approximation of what I feel like these days.

6. You will feel bloated, even if you haven’t gained a pound. Especially in your calves. Do not study your calves.

7. You will have to be proactive about recovery. In my experience–again, no MD after my name–there are very few running injuries that heal simply with time. You may need to stretch, foam roll, strengthen, wear a torturous sock, get stuck with needles, ice, pray. As much as I dread anything that involves lying on a Lego-covered rug in our basement, I have become downright aggressive with stretching, moderately better at foam rolling and pretty good at praying.

8. If you’re knocked out for a while, the first week is the hardest. Running is my drug of choice, and that first 7 days is the withdrawal period, minus the shakes and crazy sweating. The middle stretch can be bearable (see #4 above), but once an appointment, which might give you the o.k. to take another mileage hit, is five or so days away, the impatience and jitters set in all over again.

9. You will notice runners everywhere, even if they’re not in their running garb. Something about the speed of their walk, the glow in their cheeks, the lemony perspective with which they approach the world. Do your best not to stare–or hate them.

10. If your injury is visible–i.e. a boot, crutches, a really compromised gait–and a stranger asks you how it happened, you will inevitably hear something along the lines of how running really is bad for you. If you have a crutch, do your best not to whap the “helpful” person in the knee.

Once you’re able to start out again, you’ll entertain notions of running as easily and as far as you were able to, pre-injury. Don’t be fooled. As Dr. Wilder says, a one-minute walk, one-minute jog pattern is best for at least a week until you feel like you’ve gotten your groove back.

Fingers crossed, I’ll have my maiden voyage later this week, so there’s still time to pile on more advice. What are your rules for running injuries? (Or, if you’re in the blessed group who has never been out, how do stay that way?)

26 Comments leave one →
  1. October 25, 2010 7:33 am

    Good rules!

    When I was coming back from a (very painful) pelvic stress fracture, I found it useful in the early weeks to do my runs on a treadmill rather than in the world. Easier on a treadmill to be very strict about doing only 1 mile or 1.5 miles or whatever’s on the schedule, and easier to stop if something’s painful without still having a walk back (or, worse, the temptation to keep running anyway). In general I don’t much enjoy treadmill running, but there is nothing like an injury-induced layoff to make even 15 minutes of jogging on the treadmill seem like utter bliss!

    • October 25, 2010 12:59 pm

      I was diagnosed with a pelvic stress fracture about a month ago. Good to know that you used the treadmill. And to know you are running again!

      • Cathleen permalink
        November 4, 2010 5:26 pm

        I was just diagnosed with a pelvic stress fracture this week (although it happened about 4 weeks ago). Of course, I was supposed to run my first half next week. Glad to see I’m not alone. Happy healing!

  2. October 25, 2010 9:06 am

    After I ran my first half, my right foot/ankle hurt real bad. I made the mistake of stopping all together for about almost 2 months which made getting back into a routine difficult – starting all over again is no fun and much harder than it was to start in the first place. Plus, I wasn’t in a happy mood anymore. So my rule for an injury – keep moving! Swim, bike, pilates, whatever. Keep moving!

  3. October 25, 2010 9:08 am

    Great rules, so easy to understand, appreciate it ! Thankfully I have not suffered an injury, with that being said, I have suffered from my own fragile mind, and when I am in a funk, or a post-race blues period I have so experienced some of these 10x! I just went through my period of run/walk and thankfully back on the track!

  4. October 25, 2010 9:18 am

    When I am in the midst of it, I need to remember the same thing that we say in the middle of a difficult kid spell….

    “This too shall pass.”

    Last month I strained my tendons (too hard too fast with the VFF…yeah yeah yeah, I know. I know!) We needed to rule out a stress fracture and had to cut running down to almost nothing. I didn’t know how long it would take to heal.

    Now on the other side of it, it was only 3 weeks of no or little running. I KNOW that is NOTHING!! I say that now, but during those three weeks, I was one crabbyassmama.

  5. October 25, 2010 9:26 am

    First off, so glad that the boot is off! Your advice is spot on, especially about being proactive about your recovery. My PT told me that if I wanted to run again after my back injury that it was in my hands—don’t overdo it and stick with the exercises and stretches and *eventually* I will be back to my previous speed and distance. The hardest thing for me was not to overdo it—even with the exercises and stretches she gave me: If 10 reps x2 of one stretch was good, then surely 20 reps x3 is better, right? Wrong. I was a little over zealous at first because I was so eager to get back to running. It was tough to learn patience with my body when I knew it had done so much more before. But after a few setbacks during recovery mode I learned to go slow (run/walk, increase running sloooowly) and stick with the prescribed stretching/strengthening program—not my “more must be better” version. Well, with the exception of one slip—when you were out in MN and ran with Moving Soles, I think I was only supposed to be running a couple of miles, but I got swept away with that awesome trail run and ran 5! Oops. But, here I am –just this past April, I couldn’t put my socks on by myself and next week I’m running my first half! And there is so much more there than just getting over my back injury.
    Oh, Dimity, I hope you will be patient with yourself during recovery. It sounds like if you follow all your advice you should be golden—tough, I know. Keep hanging in there!

  6. Stephanie permalink
    October 25, 2010 9:31 am

    I am in week 5 of 6 of my diagnosed stress fracture in my foot. I didn’t do anything about it for the first 3 weeks and then finally went to the doc. After 3 weeks in a shoe (got the choice between a boot and a shoe and picked the shoe)and 2 weeks in my regular shoes, my foot is still tender. I get to try to run in about a week but got the 400 yards, then maybe 800 yards, and then building from there rule. I have to be honest, though, that resting and just giving my foot time is the best policy. Running through this one wouldn’t have been possible and as much as I want to run (and honestly hate those who I see running) rest is the best policy. I have biked, swam and even walked a bit (got that go ahead 2 weeks ago). All in all, a very humbling and realigning process. Not bad but definitely patience growing.

  7. October 25, 2010 9:32 am

    Great advice and tips. I went out for a 6-mile (turned into 4.5 mile) run on Thursday after a marathon Sunday. My hamstring seized up and I walked home. Since then, I literally cannot “jog” across the parking lot to my car. Heading to the gym today for weights and then a massage.

    Love your advice on non-running MDs. Luckily this masseuse is cool (“oh, you qualified for Boston? what was your time?”) I’m gonna like this guy. 🙂

    Happy healing – Stephanie

  8. Heidi permalink
    October 25, 2010 9:33 am

    I really could’ve used #6 last time I was on the bench. I found myself mesmerized and horrified by the size of my calves, which seemed to get bigger and bigger every day. I was pretty sure the Ben & Jerry’s I was using to self-medicate was going directly into my calves. What a relief to find out someone else has experienced this phenomenon – and has a much better explanation for it. 🙂

  9. canuck_grad permalink
    October 25, 2010 9:36 am

    Yay, I’m happy for you that the boot is off!

    I was hoping to be running again this week, but it’s not looking likely. The worst thing is, I haven’t run since my (first) 10K on Sept. 19, and I wasn’t even *really* injured. First I came down with a nasty flu/cold right after the 10K (like literally right after, I took to bed that afternoon and woke up sick) – that kept me out for almost 2 weeks. Just as I was feeling better, a short walk to get my son from daycare in a newish pair of flats (that I’d worn a few times before and had no problems with) completely tore up the back of my right heel. Just layers and layers of skin gone, oozing and tender – completely nasty, and painful to walk in shoes, let alone run. Now that’s just starting to get scabby/crusty, so I can tell it’s getting towards healed – and I woke up yesterday morning with a knee so sore and swollen I can barely walk!!! AND I have barely moved for weeks, what the heck? I have a doctor’s appointment this afternoon – hopefully it’s just a freak thing and will be short-lived, and I can be back to running next week.

    But thanks for the reminder that I need to take it slow. I usually do 10&1s, but might need to start out lower than that and work my way up again.

  10. October 25, 2010 10:29 am

    Dimity, congrats on getting the boot off:) Do you have a crystal ball? I’m sitting here reading your post as I ice my “severly inflammed” left IT band trying not to cry (no crying at work) because I am supposed to run the Philadelphia Marathon (my first) in 27 days. I saw a very running friendly ortho (his wife is also running the race) who told me it’s not entirely out of the question, we’ll “have to wait and see”, and I could have an injection but that may do more harm in the long run. I rested for a week, medicated regularly with Ibuprofen (and some Breyer’s ice cream), got the roller, got the band. I’m going to try and run the half marathon (same day), but I still feel like I (my body) has failed me. In a way I’m glad there’s no boot/brace as I’m already getting conflicting advice (everything from ditch the race all together to rest completely and then push through the marathon) from well meaning friends and family. At least I know to stay away from calf mirrors….

  11. Heather permalink
    October 25, 2010 10:39 am

    Yea for you!

    I am just starting out wanting to be a runner & went 110% out for 3 weeks & got a pain in my foot last week – I read the books including Running for Mortals that even explained in scientific words why I needed to take my rest days – but I just felt SO GOOD! argh.

    I appreciate rule 10… I heard that from people when I said I wanted to run – I was still just fast walking & I heard it….. didn’t even want to fess up that my foot hurt bc I knew I’d hear it again. 🙂

    I rested a few days, used some Voltera gel (no Advil-ish meds for me bc of tummy issues) and did 3 miles with my local walking group on Saturday. It felt good most of the walk – but I slipped once on my own & was taken down once by the gal next to me (puddles, wet leaves & a dead snake on the trail) and it felt like an electric shock when I had to put that odd pressure on it. It was pretty sore yesterday/today so I am debating a doctor visit but I have a bad feeling it’ll be….rest, ice, gel. 😦

  12. October 25, 2010 10:40 am

    Be a fairly new runner. That’s how I’ve avoided injury. Now…hopefully my lucky stretch lasts! I also feel the need to rest while I don’t feel well. A crappy run will only make me feel crappier.

  13. Sel permalink
    October 25, 2010 12:56 pm

    LOVE “glutehing” – add psoas in there, and it’s precisely what’s been bothering me forEVER! Bookmarking this post, for in a few weeks when I too, will hopefully be seeing the light at the end of the tunnel. Safe re-entry into running life for you!

  14. October 25, 2010 1:12 pm

    I am one of the crazy barefoot people, and I will say that after the initial phase (VFF mama above, learn to run BAREFOOT barefoot and it will go much smoother when you put the VFFs on!), I have had no injuries. I mean, NONE. My knees, hips, everything, feel awesome. I’m 35 and have two kids, and am not a super skinny mama, by the way.

    this is why they call us “converts.” 🙂

    Best wishes on your recovery, Dimity! It IS miserable to be out and I hope you have a lovely run this week!

  15. Annette permalink
    October 25, 2010 2:33 pm

    Oh Dimity! I SO appreciate your humor and candor! Being a whimp, I usually don’t push myself to injury… but discussion of injury does make me come to the realization that very few humans can run their whole natural lives. (I have actually known a couple.)
    But my own mama, who began running in her late 40’s had a short running career due to arthritis in her back and hips. She moved down to (briskly) walking (and walked her first marathon at 60.) She still walks 4-5 days a week at 75. Will we be satisfied if we find ourselves in that catagory? I don’t know, that will be hard!
    Praying for your return voyage!

  16. Jess M permalink
    October 25, 2010 2:37 pm

    Dimity – I seriously need this one! I hurt my foot several weeks ago – still unsure what happened exactly, but it’s getting better (if I’d just stop trying to sneak in a little test run…). In the meantime though, I took my first Spin class and fell in love with it!! Besides running, it’s the next best sweat. 🙂 Keep wobbling…

  17. Erica Richards permalink
    October 25, 2010 5:22 pm

    #6 cracked me up! I swear that during my super long, slightly injured marathon taper my upper thighs were rubbing together from my decreased mileage. Thank goodness I didn’t look at my calves too! That really would have sent me over the edge!!!!

    Good luck with reentry. Happy running!

  18. October 25, 2010 5:46 pm

    I heard this once: The body whispers before it screams. Thanks for this insight on how to handle those inevitable time outs when they happen. Good luck with your maiden voyage.

  19. October 25, 2010 7:17 pm

    Thanks for all the well-wishes and helpful tips, you smart, funny, cool women. I appreciate them all so much, and feel all the love and good vibes coming my way. xo.

  20. KathyinMN permalink
    October 25, 2010 7:36 pm

    I needed this today. Whooping co-pay, hours in the doctors office, I have to wait 2 weeks for a bone scan and another half week after to get back to see the doc. Thought: stress fracture. My thought: if I don’t run soon I’m going to mentally lose it. So thanks for these reminders…I did really need this today.

  21. October 26, 2010 4:10 am

    thankyou for this. I am not injured but had lots of small things happen to keep me away from running. Your last piece of advice was a good one. Thanks!

  22. Sarah permalink
    October 26, 2010 10:22 am

    Consider the time spent in treating your injury and your recovery as an investment into your future. I ran through achilles tendonitis to finish up last summer’s track & field season. It was painful and I am sure it made the situation worse, but once the season was over, I took the time for rest, lots of icing, a couple of weeks of regular ibuprofen ingestion, and it paid off. Back at training now — off season training for the next track season.

  23. October 26, 2010 2:01 pm

    Man, #9 is killing me along with their happy, jovial facebook updates about running a leisurely 7 miles that morning and now they feel like a million bucks…. Well, I don’t, thank you very much. Thanks for the tips. Unfortunately, they are needed right now.

  24. Raunda permalink
    October 28, 2010 9:20 pm

    Had to laugh out loud at #1. It is so so true. That’s what got me in my predicament. I am going to bookmark this because I am a bit hard headed at times.

    P.S. I told my husband I BETTER have a Bad ass mother runner shirt in my stocking for Christmas. 🙂

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