So You’re Injured. Now What?

Here's some advice for how to prevent injuries, and what to do when they crop up (because they will).

Photo: Getty Images

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Life is not a computer simulation, unfortunately. If it were, my hair would not be so thin, and my dancing would not look like what happens when an iguana gets hit by a taser.

RELATED READING: The 10 Commandments of Injury Prevention

Injuries happen on a spectrum, and the line between healthy and injured is blurry. The key is taking every precaution possible to stay on the healthy side of the equation, even if it means being overprotective.

The “Am I Injured?” game is one that all runners play.

Your running life will come with lots of chances to play the worst game show of all time, “Am I Injured?” On the show, runners come up and describe their symptoms.

“I woke up with a sore hip after never feeling pain before. I am running a bit more, but doing everything right.”

If you said “No, you’re not injured,” then you lost this edition of the game, because that runner had a femoral neck stress fracture.

“I have had bad pain over my big toe along the metatarsal after doing way more workouts and a few days of not eating enough.”

If you said, “Yes, you’re injured,” then you lost this edition of the game as well, because that athlete just had some innocuous tendon irritation from a bad shoe-lacing job on a run.

RELATED: When In Doubt, Take Three Days Completely Off Running

In other words, this game isn’t easy. So when in doubt, do not run. The body thrives with rest, and I ask all athletes to assume that they’ll be adding three to six weeks of rest a year in one-to-five-day bursts to prevent potential injuries. If any discomfort is localized and gets worse on a run, stop immediately. If it hurts to walk, don’t try to run. Contrary to sayings on weight-room walls everywhere, as a runner, you actually do get stronger on the couch.

How To Distribute Stress in a Week

Most of my athletes train on a weekly schedule, which is weird because it’s an arbitrary unit of time. Even if weeks are a creation of THE MAN designed to HOLD US DOWN into CUBICLE JOBS where we play MINESWEEPER, they are still a convenient way to think about your schedule. Nearly every athlete I coach from top pros to beginners uses this general structure (with exact layout dependent on life):
  • Monday: rest and recovery
  • Tuesday: easy run and short, fast strides
  • Wednesday: workout focused on improving running economy
  • Thursday: easy run or cross train
  • Friday: rest or easy run or cross train
  • Saturday: Long run (possibly with workout)
  • Sunday: easy run or cross train (possibly with strides)

See a health professional whenever you have unanswered questions.

If you take no other piece of advice from this article, I ask that you listen to this one: as a runner pushing your limits, spend extra money to get good health insurance. You want to be able to work with medical professionals that spent decades going to school so you don’t have to Google your symptoms and worry that you have leprosy of your right buttcheek. Physical therapy is both a preventative measure and good for healing, and having a PT and/or strength coach is immensely helpful in getting and staying healthy. When concerned, a doctor can provide peace of mind, and an MRI can provide more certainty. Advocate for yourself as a patient as if you’re an Olympic athlete, and expect your medical professionals to treat you with that respect.

Cross training is an all-year thing.

RELATED: Cross-Training Can Make Some Athletes Faster And Stronger

All athletes should try to have a cross-training option to use year-round, even when healthy. It makes taking time off so much easier, plus it provides strength benefits that can improve running. Good options include biking, elliptical, Stairmaster, swimming, pool running, rowing and if you want to contemplate the relativity of time and inevitability of death … arm biking.

Remember, you are an athlete, not just a person who runs.

While I love cross training, I don’t want athletes to think of injured time as a time to stress themselves out a ton trying to gain fitness. It’s OK to back off and let the body heal—healing happens in empty spaces. Instead, cross training can be an act of love rather than obligation. Hop on the bike because you love it, or you love the person it helps you become, or you love the mid-ride stop for pastries. Don’t hop on the bike just because you have a running race you want to do in four months and you have to prepare while you are on the sidelines. By framing cross training as fun and joy, you’ll get more benefits and avoid burnout.

Injuries are an important element of long-term growth.

RELATED: We Aren’t Invincible, So Injuries Are Inevitable

Here’s the weird reality of running training. If you go through the careers of hundreds of runners, many of them will trace their big fitness leaps directly to a big setback. The reasoning is uncertain. It could be psychological, it could be the physical reset, it could be related to epigenetic switches being turned on and off during times of rest. I have seen stress fractures lead to national championships, hip labrum tears lead to ultra wins, weeks or months or years off leading to big PRs.

The exact reason why isn’t that important. It’s just important to remember that setbacks don’t just make stories; they can also make breakthroughs.

David Roche partners with runners of all abilities through his coaching service, Some Work, All Play. With Megan Roche, M.D., he hosts the Some Work, All Play podcast on running (and other things), and they wrote a book called The Happy Runner.

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