By CEO Robert Forster, PT
What do you do when you find yourself with a running injury just weeks before the big race? You have logged hundreds of miles in training, spent many additional hours stretching, preparing special training meals, and recovering from your arduous workouts and now you are faced with the possibility that an injury will keep you from your goal of completing the marathon.
Unfortunately, we meet too many desperate runners in this very predicament every year, including elite athletes. In the results driven world of elite athletics, we have had to develop injury management strategies that work fast to keep runners on the track. The first step is to arrive at an accurate diagnosis, which is the easier part of the process.
Most running injuries strike characteristically vulnerable structures of the body. These include the plantar fascia on the bottom of the foot at the heel bone, the illiotibial band at the outside of the knee, shin splints, the Achilles tendon, and the hamstrings in the back of the thigh. Others are more obscure, but after 30 years of examining runner’s injuries, we have seen most of these too.
More of a challenge is to identify the cause of the injury. Nearly all running injuries are caused by overuse. Either your training load was too high and outpaced your body’s ability to adapt to the stress of your workouts, or more commonly, there is a mechanical deviation in your running gait that causes excessive strain on one or more these tendons, ligaments, or fascia until it fails.
Clinical treatment focused on reducing inflammation and pain at the injury site includes liberal use of ice, the application of ultrasound to drive anti-inflammatory compounds into the tissues, and the use of electrical stimulation currents to mobilize swelling. Specific massage techniques are employed to break up scar tissue and, along with stretching and strength exercises, correct tissue dysfunction and normalize joint function. In addition to these treatment strategies, we have learned the critical importance of correcting the running gait mechanics.
Even at this late date, we can change your running mechanics to unload overworked tendons and ligaments and relieve pressure on bursa and inflamed fascia structures, and make you more efficient at the same time. This is critical to exploit fitness levels limited by missed workouts due to injury.
But what to do about your last long training run in the final weeks of training? Well this depends on the length of the last long run you were able to accomplish. If you have logged a run of 16-18 miles before an injury halted your training, then the clear answer is too skip the last long run and cross train to avoid risking further injury, while you focus all your energy on getting healthy. Cross training will preserve your fitness while you find solutions to your injuries. It’s best to cross train to maintain fitness and arrive at the starting line healthy, than risking further injury with a last long effort and hobble through the race.
The concept that guides our approach to long lasting efforts for injured runners is to match the metabolic value of that run by cross training for a duration that matches the time that would have been spent on the road.
If you have an injury that is threatening your race, please give us a call and schedule a free injury assessment at Forster Physical Therapy.