Updated: May 10, 2022
I’m assuming you’re reading this blog post because you’re a runner. And you’re either dealing with an injury right now or you’re trying your best to prevent one. Maybe you’re haunted with past injuries or have a big race coming up and are trying your dambedest to prevent one before the big day. Well, you’ve come to the right place. First, I’ll start with a quick intro so you know what makes me qualified to discuss running injuries. My name is Dr. Ashley Bertorelli, Doctor of Physical Therapy since 2008 and working with numerous runners rehabbing from a variety of injuries for over 9 years. I also have quite the extensive running history myself, having completed two full marathons, numerous half-marathons, a few warrior dashes, and countless 5k’s, 10k’s, 15k’s, and trail races. So, I’ve also been there, done that. I’ve had Achilles tendinitis, IT Band syndrome and hip bursitis, hamstring strains, knee/patellar pain, and the list goes on. But luckily, I was able to successfully rehab myself along the way so that I never missed a race due to injury. I love working with runners, I know how Type A we can be and how we don’t like sitting around waiting to get better. So for today’s blog post, rather than discussing every single running-related injury out there, I’m going to discuss basic training and recovery principles that can be applied for any runner dealing with any ailment or trying to prevent every ailment. Let’s start with some basic training principles. When starting a new training program or ramping up from 5k’s to 10k’s, it is important to follow the 10% rule. That is, don’t increase your mileage by more than 10% from week to week. This is especially important to follow if you’re injury prone. So if you’re running a total of 15 miles one week, your mileage shouldn’t be over 16.5 miles the following week (15 plus 1.5). It is easy to think you can get away with not following this principle because you might feel great ramping up your mileage quickly for 3-4 weeks or so, but eventually this will catch up to you. You don’t usually notice overuse injuries in the first few weeks, it’s several weeks or even months into abusing your joints that you start to notice the damage that’s been building up. There are always those genetically gifted people that don’t have to follow this rule but for the sake of injury prevention, assume you’re not one of those people. Another training principle is proper warm-up and cool-down. What do most people do before a run? They stop, do nice long, static stretches of their quads, hamstrings, calves, etc. That’s wrong. So, what thousands or millions of people have been doing for decades is wrong? Yes. And there is research to back that up. Static stretches before exercise impair your performance and can actually promote injury. Static, or long-held stretches are great for after a run or workout or even during non-exercise times such as the middle of your work day. But a dynamic warm-up including dynamic stretches is essential for optimal performance during a run and for injury prevention. Start your warm-up prior to a training run or race with a nice brisk walk or a few minutes on a bike or elliptical if you have one handy and then perform your dynamic stretches. And what are dynamic stretches? They are stretches performed actively throughout the range of motion of your joints. You’re not stopping and holding for 30 seconds. You’re moving continuously. A proper dynamic warm-up may include leg swings, high knees, walking lunges, and other dynamic movements. Your body is limbered up and prepared for the demands ahead. Then after your training run or race, feel free to do your static stretches at that point. A third training principle important for running injury prevention or recovery is cross-training. This may include swimming or pool running, use of an elliptical, and definitely some specific strengthening exercises of the legs, back, core, and even upper body. This way, your body is well-balanced and can better absorb shock and the demands of repetitive pounding through your joints and muscles. An appropriate cross-training program will vary from runner to runner, depending on that person’s running/distance goals, areas of current or past injury, and areas of weakness or restriction. So we discussed some important training principles, though there are SO many more including proper nutrition, hydration, rest, sleep, proper footwear, and more. Now, I’d like to talk about some important recovery principles.
One important step in recovering from a running injury is identifying exactly what you’re recovering from. An injury that might seem like a strain may actually be a partial tear, bursitis, or something else. An orthopedic outpatient Physical Therapist can help you diagnose your injury and establish an appropriate treatment plan. And thanks to Direct Access, you can just bring yourself to your local Physical Therapist without seeing your PCP or an MD first. Because of the extensive training that Physical Therapists get regarding orthopedic injuries, they will likely be able to better identify your injury than your PCP would anyways. If your PT feels that you may benefit from further medical imaging or evaluation, they will recommend a visit to a local Orthopedic specialist. However, if you do have a running injury, there are some principles of recovery that should help in most cases. An over-the-counter NSAID such as ibuprofen, Aleve, or Motrin should help in the short-term. These should not be taken on a continuous basis over weeks or months on end. They work best for acute inflammation. Ice can also be used to reduce pain and inflammation, especially right after an injury for the first 48-72 hours or for pain that lingers after a training session. You can apply ice to the injured area for 10-15 minutes at a time, several times per day as needed. Heat should not be applied to an acute, or new injury. It can promote further swelling and inflammation. Some gentle, pain-free stretching to the area of injury can help prevent loss of range-of-motion (ROM) and scar tissue formation. Again, relatively pain-free is the key. So if you have an acute Achilles or calf strain, it is important that several times throughout the day, you are moving your foot up and down to maintain maximal ROM. This can also help prevent faulty mechanics in your walking and running gait in the short and long term. Another principle in recovering from a running injury is relative rest. This doesn’t necessarily mean no exercise at all. It can mean swimming, pool running, or using a bike or elliptical to maintain your cardiovascular fitness. Injuries also provide runners a good opportunity to catch up on some strengthening that they have been neglecting. (Come on, you know you are probably guilty of this). That way, when you are recovered from your injury, you can come back better and stronger than before. If you are a runner recovering from an injury and are unsure of what you are doing, it is definitely in your best interest to see your local Physical Therapist, especially one that is experienced in working with runners. This can save you a lot of headache, heartache, and in a lot of cases, extra money wasted on unnecessary trips to the doctor and over the counter remedies. Depending on the injury, even just a few trips to your PT may be enough to get you back on the road to recovery and on those roads and trails again. Some clinics like mine even offer free workshops for runners where they can learn how to prevent and recover from injury and get back to running again. Whatever route you take, don’t wait it out, don’t keep running on an injury without addressing it, and definitely don’t let an acute condition become a chronic one. Your body and your PR’s will thank you. Dr. Ashley Bertorelli, PT, DPT/Owner and DPT at The Green Room Physical Therapy Enjoy this blog post? Follow The Green Room Physical Therapy on Facebook and Instagram and fill our our Contact form to keep up-to-date on our latest articles and events!
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