Injury

Injury is always something that an athlete thinks about.  How do I prevent injury?  What do I do when I have an injury?  How do I know if an injury is serious?  As a PT I deal with helping people to come back from injury on a daily basis and I still don't have the answer.  Injury can take all forms, it can affect muscles, joints, bones, or all of the above combined.  It can happen because of overuse, disuse, underuse, faulty body mechanics, faulty biomechanics, training too aggressively, not training agressively enough, in short, it can happen to anyone regardless of the sport or even how carefully you try to train. 

I have an old injury that I sustained playing soccer, many years ago.  When I was younger and felt I was much faster, I tried to keep up with everyone as I played defense.  Most of the times I could, but there was one particular guy that was much faster than me and for some reason I always ended up gaurding him, I loathed and loved trying to guard Josh!  Most of the time I was at least able to contain him, but one morning I tried to race after him and tore my left hamstring.  Fortunately, it wasn't a serious injury and I just took a few games off to let it heal and it really didn't bother me again until I started running longer distances.  Playing co-ed soccer is easy to rest because taking "a few games off" normally gives you at least 3-4 weeks of rest.  Soccer was my exercise and I did nothing outside of the games I played once or twice a week!  So, the formula of rest, ice, stretch did work really well for me at that time. 

Through the years, this old injury will reappear periodically.  I think it is my body's way of letting me know that although I did heal, it isn't quite the same as it used to be.  The first time it reappeared was when I tried training for my first 1/2 marathon.  By 3-4 miles it would bother me.  As a PT I knew to stretch, but had also forgotten the importance of strength training and training in moderation.  As I added both to my routine, the hamstring improved and I was able to finish the 1/2 marathon without an issue.  It took awhile, but as long as I didn't push it, it seemed to improve each week and I could run a little farther without pain.  There are also a few things I have learned about this injury - it doesn't like cold, it doesn't like speedwork, and it really doesn't like hill work.  As a result, I have made several adaptations to my training, such as you will see me wearing long pants when I run long much earlier than most people, I try to start all of my runs much slower to truely "warm up" and I am very conservative as I add speedwork outs and hill routine's into my workout.  I also know that if it is bothering me that I need to cut back on speedwork and hill work. 

So, this old issue has started to plague me again.  It started a little after the 1/2 IM, but a few conservative weeks and it seemed to go away.  After the 17 mile run this past weekend my left hamstring has definately become an issue and I know I need to be vigilant.  After all, the most important part of training for an event is to get to the start line healthy.  Injury has prevented more than one of my friends from participating in a race this year! 

As an endurance athlete though, this is more challenging.  It isn't like my younger years, when I could just take a "few games off."  With endurance training your base training is what allows you to continue to build and become stronger each week.  There is importance in taking rest days to allow the body to heal, but too long of a rest and you start to lose that base!  You start to worry about if I miss this workout, how can I make it up?  Or how will it affect my overall?  You start to play mind games, if I miss today's workout, how can I add it in later in the week?  Can I just break it up and add a few miles to each of my runs later in the week??  What happens to the plan next week?  Do I just do this week over or is it okay to do the plan even though it will be adding 20% more distance than this week??  Does this sound familiar to anyone else? 

So, the advice the PT in me would give is:

1) Take a few rest days:   the athlete in me says - I can't do this or I won't reach my miles for the week.  Instead, I will modify my training and takeout speedwork, hillwork first; I will decrease mileage only if the pain gets worse.  I will also try to get at least 8 hours of shut eye per night and a nap during the day if appropriate.  I will take one rest day on Friday. 

2) Lightly stretch:  This I already do on a daily basis.  I do this after everywork out.  I think stretching is important, but it needs to be done after a warmup and it needs to be light.  Stretching shouldn't hurt and I think done too aggressively, it can cause further damage. 

3) Ice:  There is something wonderful about an ice bath after a long run, definately a must.  But icing an acute injury should also be done after a short work out, which is something I don't do enough.  It is a natural anti-inflammatory and you really can't beat it. 

4) Strengthen:  The endurance athlete in me says "when do I have time to do that?  I have to fit in all my other work outs and also go to work."  Regardless, it is important and at the very least should be done once a week. 

5) Hydrate:  Sadly, this is something I don't do enough and I think it is one of the reasons that many people to get injuries.  Especially on long runs, so if you run with someone, we need to remind each other to get enough fluids, both on the runs and leading up to and post runs. 

6) Eat well:  And I don't mean gorge on brownies, pizza, and chips - as much as I would like.  Eating a balanced diet so the body gets the proper nutrients to heal and to function is important. 

7) Massage:  For a muscular injury this can be very important.  Unfortunately do to time restraints and/or finiancial this is often overlooked.  Hopefully, I will be able to work this in sometime in the next few weeks. 

So, for the next few weeks I am going to try to follow my own advice so I don't hurt myself to the point that I can't compete.  Hopefully I can contain that awful voice inside me that tries to make me do too much.  Sometimes taking a few days off is what the body needs! 

The following video is definatly not how I will do my next long distance run, but I love Kara Goucher so I couldn't help but put it in here. Some of the comments are pretty funny, too!