Running Injuries

It almost always starts as little more than a twinge. You’re shaking out the usual kinks in the first few minutes of an early morning run and you notice that one of those kinks takes longer to dissolve than all the others.  No matter, a couple hours later at the end of your outing, you’ve forgotten it even happened.  Except the next morning, maybe it never goes away completely.  You’re not forced to alter your stride—or your planned run, just yet—but now you’re carrying this twinge all the time.  Soon, it’s always in the background of your mind: you test it while jogging across the street to beat a speeding car, while ascending or descending a flight of stairs.  And then, a day or two later, you find that you are limping when you try to run, ignoring the pain hasn’t done anything to make it go away (duh!), and you’re finally confronted with the initial, anguished decison: maybe I should stop? Am I being weak or is this a legitimate reason to not run? Goddamnit, but I want to go to the top of the mountain…

I’ve dealt with this more times than I care to recall, and the past six weeks have been another of those instances for me.  After being injured for 15 months straight, I had managed to stay healthy since May 2012, but then in mid-December I developed a nag in my right hip that had me incapacitated by Christmas.  I took three weeks off completely, drank a lot of egg nog, and then ran up and down Longs Peak three times in my first 10 days back.

Will I ever learn?

I like to think so. Another two weeks of rest, acupuncture, massage, and rehab exercises and I’m finally back out on the hill again, this time painfree.

I’ve been running for 18 years now, and I definitely deal with all of this stuff better than I used to, at least on an emotional level.  I remember when I was in college and I went to the training room for a pain in my foot that ended up being a stress fracture, and the athletic trainer told me I was going to be out for six weeks.

“Six weeks!?” I queried. “But I had a metatarsal fracture in high school and it only took three weeks of rest.”

“Well, Tony, you’re not 15 anymore, Bruce replied, “Things take longer to heal when you get older.” (I was all of 20 years old at the time.)

Back then, my reaction was usually one of depression (Bruce recommended the services of a sports psychologist after diagnosing another stress fracture a few months later) and cross-training like a fiend.

After one such injury at the beginning of the fall XC season, I purchased a road bike and immediately began logging 3-5hrs/day on the mountain roads surrounding Colorado Springs. I went on a three-day bike tour from Colorado Springs to Aspen (160 miles) sponsored by the college’s club cycling team and regularly dropped the team’s riders on the many mountain passes along the way, redirecting my usual obsession for running into the bike.  On the fourth day, everyone piled into a bus for the trip back to Colorado Springs.  I elected to ride all the way back in one shot. It took me eight and a half hours—starting with a 20mi climb to 12,000′ Independence Pass—and I gained my first lesson in ultra-distance endeavors when I bonked hard pedaling up Wilkerson Pass, having ridden 100mi on nothing but water.  A single granola bar I’d tucked in my shirt pocket saved the day and I rode into the Springs in style, having caught a glimpse of the euphoria and reward that comes from spending all day traveling through the mountains under one’s own power (a year and a half later I would do my first 30mi training run and the ultra-distance seed would truly be planted).  But, with all that biking, I almost certainly delayed the healing of my injury.

Now, I’m not so big on cross-training (that first road bike was eventually stolen). Admittedly, my motivations for running have shifted fairly dramatically—“fitness” has become less a goal than mountain summits, so it’s hard for me to motivate for hours in the pool aquajogging or in the gym on an elliptical machine—but I’ve also come to realize that sometimes I just need rest.  More often than not, when my body breaks down these days it’s because I’ve been pushing too hard for too long and more than my musculoskeletal system needs a rest.  So, when I can’t run, I truly rest. This time around, my main form of coping has come in the form of climbing.  Grunting and inching my way up a rock wall is not only a reliable source of terror, but it also typically affords me a stunning and inspirational mountain setting, even if it doesn’t do much to tax my heart, lungs, and legs.

In general, when dealing with injuries, I’ve gone from managing my body to managing my mind. A few tactics:

• Don’t fight the initial let-down.  When I go from running 2-3hrs/day to nothing at all, there are going to be some major brain-chemical imbalances.  The first two days or so of not running are usually pretty damn gloomy for me.  I tend to hate everything and everyone.  However, I’ve learned that if I just accept that and allow myself to feel shitty for a couple days I’ll often emotionally rebound by day three and start being willing to do some proactive things, even if that just means leaving the house and interacting with other humans. For me, however, I know there’s really no use in resisting my bad mood in the beginning. I mean, I literally get angrier if it’s a sunny day. There’s no use in even trying to apply rational thought to the situation, so it’s best to just wait it out, because it has always gotten better.

• Do get outside. Even if it’s not to exercise. Which, for me, it typically isn’t. But it’s okay to wait until after the initial grump-fest. I tend to walk a lot when I’m injured (something I generally avoid when training because I’m typically exhausted all the time), downtown to the coffeeshop, to the grocery store, to the post office. Just 20-30min of the sun shining on my face, breathing fresh air, helps my outlook immeasurably.

• Do try everything. Here in Boulder, I have a bevy of medical practitioners that I go to when I have a new ache or pain. Jeremy Rodgers (all around sportsmed encyclopedia and chiropractor) is always my first phone call. Jeremy is very process-oriented; like me, he’s not so interested in necessarily just getting me back to running but also in identifying why I got injured and what we can do to address that so that we won’t just be putting a band-aid on a larger issue. Having said that, one of his first questions is always when my next competition is; Jeremy is a talented athlete himself (multi-sport) so he fully understands the performance aspect of things, and I appreciate that.
  Three years ago I was a huge skeptic of non-traditional medical techniques, so when Jeremy suggested I see Allison Suddard for some acupuncture for a knee injury, I went in not expecting much. But, when nothing else was working she fixed me and I was able to run fast at Miwok and Western States that year.  I now see her for regular maintenance, working to keep initially innocuous little niggles from turning into full-blown injuries.
  Finally, Jeff Staron is my man for sports massage. Rickey Gates recommended him when I was dealing with shin issues, claiming that Jeff had magically healed him more than once. Maybe I’m just weak, but the hour-long sessions on Jeff’s table are by far the most intense, concentrated instances of suffering I’ve ever experienced. The man has thumbs of steel. But, on more than one occasion, Jeff has been able to make an issue disappear after only one or two excruciating sessions. In general, different injuries seem to respond positively to different treatment. Some issues, Jeff hasn’t been able to make a difference but Allison’s needles have proved to be the key.  But I won’t know until I try it.

• Do your damn exercises. I’m still working on this. For nearly every overuse injury I’ve had in the past three years, independent opinions have all pointed to my weak hips (glute medius) as being the main culprit. In nearly every case, I’ve experienced improvement after a couple weeks of diligently doing prescribed supplementary exercises (very simple, gym-class variety stretches; Jane Fonda-esque leg lifts; balance drills, etc.). These things are unsexy, feel awkward, and require a little focus and dedication, but they work. They also have the added bonus of making me feel like I’m doing something every single day to get healthier. A lot of the emotional side of dealing with an injury is fighting the feeling that you’re helpless and an unjust victim. Doing rehab every day helps me feel proactive.

• Don’t give up. This should go without saying, but simply not losing hope is super-key. Your mental state is as important as any treatment—maybe even more so—so fighting to remain positive is crucial. Over the course of a long-running injury this can be really tough and some despair is to be expected, but the important thing is to have more good days than bad.

• If you must get injured, just break a bone. Okay, so this is being kinda silly, but honestly, when I broke my leg in 2011 it was one of the easier injuries to heal, mentally and physically. Within only a couple hours of breaking it I was seriously fine with it. I couldn’t even stand up, let alone run, so it was easy to let go. There was no wiggle room for interpretation. Just two and a half months sitting on my ass letting the bone knit, and then a few weeks of rehab to regain strength and range of motion. I’ll take such definitive healing any day over the drawn-out nightmare of questioning and second-guessing and wondering that characterizes most soft-tissue ailments.

That’s about all I got.  No magic, no silver bullets, but there never is. Over time, I’ve realized the best way to deal with injuries is to not get them. Which means sometimes tempering my passion, engaging my rational mind, and even listening to friends’ (often sage) advice.  As Buzz likes to say, “Success in running is an injury-prevention game.”  That’s certainly the case for me—finding the energy and discipline to get out in the mountains isn’t an issue—so here’s to hoping  for as healthy a rest of 2013 as possible.