Running is a repetitive activity and it makes sense at some point during our running career that we shall sustain a running injury. Bodies can take a certain amount of loading but often we are balancing on a fine line of body tolerance and body breaking. Running training is designed to damage tissue, this is how we improve, the key is the recovery stage where the repair work takes places. Below is a guide as to why running injuries happen and what can be done about them. I will also give some details about how we can help.
If we are doing more damage than repair then an injury will occur – maybe not straight away, but at some point. Bodies are good at compensating and adjusting, but they can only do this for so long. At some point they run out of options and not able to dissipate the damaging loads further, and so something has to give.
Compensations
This is when we have painful symptoms, but it is often at the end of a compensation pattern. The body has run out of options, it can’t adjust or compensate anymore and the tissue at the end of the line, or back to another point in the chain, breaks. Pain is our bodies way of letting us know that something is going on that is not good. Tissue is being damaged more than it can deal with and with running, a repetitive loading activity, this is a continuous process. The body quickly recognises this movement pattern as a problem. It knows that a certain part of the body is going to be loaded more than it is happy with, that damage will occur or has occurred and it doesn’t want it to get worse. So it sends pain to the area and tension in the tissue, or surrounding tissues to prevent further damage.
We may have already been feeling this process. Running injuries often start with a niggle, tension and tightness following a run, the next day as we go about our normal activity. Running is often fine, this is problem. But we may notice the tension a bit sooner into a run, or it lasts a bit longer after a run. It is sometimes difficult to know if this is good pain, bad pain, ok pain that we can run through. We need to be true with ourselves and listen to what is really going on. It is easy to override these feelings to start with and run through this. But often we are storing up a problem that is going to get worse.
Stress Fractures
Take metatarsal stress fractures for instance. This is what I hear in clinic so often. Felt some discomfort following runs for a few weeks, but it settles quickly. A change of shoes, or an increase in training – distance or terrain, back onto the track – something that is a bit different to what has been going. Even a city break and more walking. Something sets off the breakdown / repair process and the repair process can’t quite match the breakdown process. But we shall get away with it for a while. Then long run day and maybe a slight increase in symptoms, but all ok quite often on the run. But then two or three days later, on an easy run, a recovery run, then bam, that’s when the body says enough is enough and we get the main issue occurring.
But because it happens on the easy run, it is often over looked. A couple of rest days and it often feels fine. Try a run and pain comes on really quickly and hard. No way we are running through this now. Walk / limp back, swelling, night pain, throbbing away. X-ray will not show anything at this stage, if at all. Frustration and annoyance creeps in as nothing can be seen, but this is where clinical history and proper assessment is key. An x-ray won’t show anything at this stage, or maybe not at all, but the signs are there.
Bodies are trying
Bodies will heal up a running injury, they are trying their best. We need to help them do what they are so good at doing. Listen to our body, what is it telling us? If we keep running into pain then our bodies will get better at trying to stop us from doing more damage. Pain doesn’t always equal damage. Pain is our bodies way of stopping us doing more damage, and it can gets better and better at doing this. So we often see people who have painful symptoms with very little activity. This is not a damaged body but a body that has become very good at protecting itself.
These bodies need movement and activity, but below the alarm bell point where pain is produced. Variation is key, give your body something else to think about. Load it in the same way and you will get the same response, it has learnt to spot the signs, even looking out for them. Do something different, just don’t do the same thing. You will get the same response.
What you can do
So a good plan is to take early action. Reduce your training by 50% for maybe a week. See what happens. If things seem to be improving then slowly build up again. If not then either take a week rest or reduce again. Remember you are giving your own healing systems a chance to get going. You need to reduce the damaging load to allow this to happen. Then crack on. A suspected bone injury will need more looking after than a soft tissue injury. Bone does need time, soft tissues can be used more and often need to be used. The longer the soft tissue injury has been about the more likely it needs moving not more resting. Tendons respond to loading.
Back to the metatarsal stress fracture. Unfortunately bone needs time to heal. The less you move it the better and quicker it will heal and the less you will trigger your bodies protection response. This will take a couple of weeks to settle and allow healing to get on top of the damage. Listen and feel.
Then easy careful loading can commence. With care and variety. This is the same for any body part that is injured. Add below damage loads and in a different way. This is key. As we said, same loads will get the same response, even if the damage is healing / healed. Got to do something different.
Do Something Different – this is key
With running, if you feel the familiar symptoms coming on. Do something different. Speed up, slow down, shorten stride, lengthen stride, turn left, turn right, go up, go down, do something different to what you are doing, this is key. You will get away with it, for a short time only. Take note and do this again. Only build as fast as your body will allow you to build. This maybe a 6 week process. To get you to the point where you can start to train properly again. This is also key.
This is a snapshot of what we would discuss in clinic. We carry out an assessment but we may talk for a while before we even look at what is going on. The background discussion is key. Then we look at what is hurting and try to identify what it is. We then look at how your body works, how you stand, how you move. We have tech to help look at this in detail and show us exactly what is going on. We then give you a complete picture of the injury and what the problem is, the compensations you have adopted and what we need to do about it.
Treatments
Treatment options are varied and we shall discuss what we feel you need to address and when. It is usual to have a short, medium and long term plan. So if you have a recurring injury or one that won’t settle, injury niggles that move about, an adventurous plan for your running and you want to look at how you move and if anything needs to be addressed then get in touch and we can definitely help.
Remember everything is a balance and don’t forget the reasons why you run. It should be fun and it should be enjoyable. This is a brief overview of a very complex subject, but if anything resonates with you and you would like to try and find an answer to your many questions then please get in touch. Happy to book a chat to see what is going on and how we can help.
