Today’s topic is injuries. This is always a relevant topic, because injuries are pervasive in our sport. From an odds perspective, the chances are very good that, as you read this, either you or someone you know in the sport is currently dealing with a running injury.
Entire books – heck, entire professions! – have been dedicated to the topic of endurance sports injuries. For today’s post, we’ll focus on one specific aspect of the running injury topic: How do you proceed, in the here and now, with your current running injury?
Before continuing, it should be noted that if your injury is bone related – stress fracture or stress reaction – the “how do you treat it” conversation is quite short: You must rest it! Depending on the severity, you may even need to immobilize it with a walking boot or by using crutches.
For the purposes of this conversation, we’ll focus on soft-tissue injuries: Faulty muscles, tendons, ligaments, and/or the joints that they support or protect. Some examples: Calf and Achilles strains; leg muscle strains or pulls; other ligament and tendon strains or pulls; knee, hip and ankle pain; foot and ankle discomfort not related to stress (bone) injuries. And that’s just a short list!
OK. So, something is barking, or you feel a tweak – before, during or after a run. What do you do? As always, “it depends” is a great (if not entirely satisfying) answer!
From my perspective, these are some of the common approaches that runners take toward their injuries.
1-Train through the injury! I once had an athlete who would brazenly say: “Injuries are fake. I’m not taking time off.” Oddly enough, this warped mentality usually worked for him! He was, indeed, able to “train through” most injuries. In reality, this approach rarely is effective.
2-Take 7-10 days completely off. This is a common-sense approach. You’re in pain, you have to let that pain calm down and subside. Rest the injury and it will improve.
3-Modify activity level (do not completely cease running training), while getting appropriate, therapeutic treatment -- such as physical therapy, massage, etc.
4-Take 7-10 days off from running training, while getting treatment such as physical therapy, massage, etc.
As stated above, I do not recommend option #1. As a former streak runner, I took this path multiple times during my 13-plus-year running streak. Did it “work?” Well, yes, I didn’t take a day off … but it was definitely not the smart approach. Sometimes, especially in the case of bone fractures, it can be dangerously reckless. So yeah, don’t “train through” an injury – especially if you are feeling discomfort while walking.
Option #2 is a logical approach and it can work in some cases. But, as we’ll discuss in the coming paragraphs, options #3/#4 might make the most sense. I ran these ideas past Justin Feldman, founder of Feldman Physical Therapy & Performance, and here’s what he had to say.
Options 3 or 4 are much more preferred to 1 and 2. I often use the analogy of a pebble in your shoe. Soft tissue injuries are like a pebble in your shoe. If you take the shoe off, wait seven days and put it on again, the pebble is still there and so you may still feel it. You need to dump the pebble out of the shoe.
Your muscles and tendons speak the language of force, and so they need some force to trigger your brain to make a change and heal them. Also, if you aren't doing the thing that caused the symptoms at all, then you won't know when you are better.
Oftentimes lowering intensity, frequency and duration of training, but continuing to have some training stimulus while doing structured rehab, will be the most effective approach.
I believe this is excellent advice from an excellent practitioner with stellar credentials (his email signature includes a long list of acronyms proving his mettle: PT, DPT, FMS, FRCms, CFSC, CertMST). Many readers of this Substack have been treated by Justin or other professionals on his staff, with great success.
No matter which path you choose, be smart in your approach. Because, after all, being injured is certainly no fun at all!
Foam rollers!! Can't count how many times this device got me out of soft tissue jams.