How does a marathon runner address training setbacks without losing ground?

Complete rest is seldom the best treatment for aches, pains, and full-blown injuries and is only required in rare instances where running is simply impossible to undertake (e.g., stress fracture). But what is the balance between continuing with training and recovery? When should you consult a health-care professional or when can you manage the aches and pains yourself? Is it an injury, or are you just sore? Knowing the answers to these questions will prepare you to meet your goals and take the frustration out of bothersome aches and pains.

Below are presented some of the common causes resulting in many of the classic running injuries and specific tips as invaluable tools to help you maintain your training schedule.

Complete rest is seldom the best treatment for aches, pains, and full-blown injuries.

Causes

Running surface

Finding the right running surface is often a challenge because what's available in our immediate surroundings. Put simply, the tendon stress of repetitive training, uphill or downhill, on cement sidewalks, because of the rigidness, asphalt roads or beaches, due to the camber, or in the same direction around a track are all risk factors for lower limb injuries. To reduce excessive effort in propelling yourself and to reduce impact forces, running on softer flat surfaces such as gravel roads and dirt paths is best to help recovery. Be careful, though: dirt paths and grass surfaces can be uneven, heightening the risk of twisting an ankle. Nothing is ever simple!

Inadequate warm-up and cool-down

We are all guilty of using the first few minutes of our run as a ‘warm-up.' Just run slowly for the first ten minutes or so to let the body warm up, right? Wrong. One of the best method to prevent an overuse injury is to warm up properly. This means doing something other than running. Side shuffles, bum kicks, jumping jacks, and skipping are all good ways to adequately prepare the body for running. This gives all those stabilizing muscle for running a chance to get warm and the joints to get lubricated in order to best deal with the repetitive nature of the running mechanism. A warm-up of seven to ten minutes is usually adequate.

Cooling down is just as important. A key to not developing tighter and tighter muscles is to stretch after the run and to engage in a light activity for five to ten minutes after the run to help the muscles ‘cool down.' This is accomplished by contracting the muscles in a different way than the thousands of times they contracted during your run. How about walking backwards? It may look strange, but it is good for you.

Running too hard on easy days

For those competitive ‘Type A's,' this is for you. As a general rule of thumb, if your run workout is less than seventy-five per cent of maximum effort, your body recovers and you are ‘good to go' for another run in twenty-four hours. Approximately eighty-five-per-cent effort requires two days' recovery, and greater than ninety-five-per-cent effort requires three days' recovery. Trying to run hard on successive days (to get the training in) only sets you into a fatigue cycle and dramatically increases the likelihood of injury. Added to that, your performance goes down! So remember that the recovery time between the runs is really where the body adapts. It is the most crucial time cycle in your training.

If your training dictates a recovery day, take it! If you just don't feel up to going for a run, take the day off or exchange for a different activity. A rigid, unwavering attitude toward the training schedule is a recipe for disaster.

Shoe selection and age

It is not uncommon to hear a recreational runner say that they get a new pair of running shoes every two years whether they need it or not. Yikes! Running is perhaps the most inexpensive of sports; your main equipment is a pair of running shoes. Too many injuries are caused by shoes that are worn out. Although they may look new and they keep dirt and water off your feet, running shoes quickly lose their structural integrity and absorbative capabilities. Three general rules to determine that your shoes are worn out: 1) if you have run four hundred to eight hundred kilometres (this adds up quickly); 2) if you start feeling little stones through your shoe, or 3) if any of the outsole is worn down to the foam.

STOP running, running, running: Cross-train and resistance train instead

The evidence is clear; cross-training and resistance exercise (weight training) reduce injury rates in runners. Oftentimes, one day less of running in exchange for a different exercise or some resistance training clears those aches and pains, and it allows your body to cope with the repetitive demands of distance running. It cannot be stated enough that a general resistance exercise program is the best medicine for preventing and rehabilitating injuries.

Tips

Calendar notice every six (or so) months: In the electronic world we live in, it's easy to set a note to pop up on our computer six months down the road telling us to change up those running shoes.

Understand the pain: Believe it or not there is a difference between good pain and bad pain. Pain that gets better with activity and goes away when the activity is over is generally good; more damage is not being done. However, pain that lasts when the run is over (residual pain) or gets worse with activity is usually bad, and consultation with a health-care professional is indicated. Listen to your body and become a ‘pain specialist.'

When is it an injury? Oftentimes aches and pains are simply that: aches and pains. But when is it a real full-blown injury? As a general rule, when there is swelling, loss of function and range of movement, the pain gets worse with activity, and it lasts for more than a week, it's time to consult a health-care professional.

When in doubt, ice: Icing reduces swelling and can really aid in the initial recovery process. A ten- to fifteen-minute session followed by letting the area return to room temperature is appropriate. If you're brave enough, an ice bath (to a maximum of ten minutes) is an excellent way to help the body recover. Get permission from your health professional first, though.

Cross-train: Try a day of biking, deep water running, swimming, hiking, a team sport, etc. Other activities are an excellent way to continue to train your body's cardiovascular endurance while giving the muscles and joints relief from the repetition of running.

Avoid taking medications: Listen to your body. Pain and anti-inflammatory medications often mask what your body is trying to tell you. Develop a feel for what your body is going through, and you will soon gain greater body awareness. This ‘feel' is the best safety mechanism for warding off new injuries.

Training surface: Mix it up! Often a mixture of various surfaces is the best way to give the body a break from the repetitive nature of the activity.

About the Author

Dr. Gregory Uchacz, clinic director of Chiropractic Performance and Sports Therapy Centre in downtown Calgary, Alberta, is a chiropractic sports specialist, certified strength and conditioning specialist, and president of the College of Chiropractic Sports Sciences (Canada).