“As a runner how do I deal with injury and the frustration of not being able to participate in the sport that is so much a part of my everyday life?”

Most likely at some point in our running careers each of us will be faced with a running injury and possibly be asking ourselves the same question. Whether it be a major or minor injury, if it affects our running routine it can be frustrating. Why is this when most of the world would be delighted to have an excuse not to run? Runners are a different breed.

Over time, running becomes not only what we do, but it is how we identify ourselves. Running can become so much a part of who we are that when this aspect of our lives is taken away from us we are left feeling lost (I know, I know—pathetic, but true). Our focus, our drive, and our motivation become fuzzy. Now we all know it is not the end of the world to take a break from running (we do have lives outside of running…don’t we?), but when we are the one on the “injured list” life can seem kind of bleak.

I started running in junior high and I continued to run all through high school. After high school I competed for four years on the track and cross country team at Weber State University. Interestingly enough, throughout my junior high, high school, and college career I can’t remember having an injury that ever took me out for more than a week or two. It wasn’t until after giving birth to our first child in 2009 that I dealt with my first major injury. I had started running again, but I soon developed some lower back problems that halted my running pursuits for several months.

It wasn’t until the beginning of 2010 that I was feeling pain free and at a point where I could start building up my mileage again. After only a couple of months of training, I was encouraged by how good I was feeling.

So, in April 2010 I decided to run the Salt Lake Half Marathon just to see where I was at. I hadn’t raced in a long time and I wasn’t really sure what to expect. I surprised myself when I finished in third place (out of the women) and ran my best half marathon time of 1:21:50. I was still a long way off from where I wanted to be, but it gave me confidence and I began considering pursuing one of my “big” running goals again—qualifying for the Olympic Marathon Trials. My plan was to continue training hard through the summer of 2010 and then look to run a fast marathon in the fall.

Things seemed to be falling into place when I found out the Salt Lake Half Marathon time qualified me to participate in the Chicago Marathon (a great fall marathon to run a fast time) under the elite development program. I set out training with my new goal in mind, but about a month after the Salt Lake Half, I started having problems with my right foot. At first I tried to run through it, but eventually I realized I needed to take time off or it was never going to heal. Any training at this point was just counterproductive. Well, days turned into weeks and weeks turned into months and I ended up taking 5 months off from running. It was a very frustrating time in my running career, but I did learn a lot from the experience.

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Expert Panel Question???

“What could be the cause of medial calf pain? I strained my left foot about a year ago and when I started running again my right calf hurt. It went away in about a month; now it is back. Is there something I can do to ease the pain and make it go away?”

Answer!!!

Calf pain is not an uncommon problem in runners because the muscles included in the calf are key to propelling us forward. The calf actually comprises 5 muscles with 2 of these in one “compartment” (a compartment is a bundle containing one or more different muscles) and 3 in another. It is important to know which specific muscle or muscles are injured in order to determine the best treatment options.

The most commonly injured muscles are the two in the compartment closest to the surface – the gastrocnemius and its deeper partner the soleus. These are the “foot to the accelerator” muscles. They are the main muscles working when a runner gets up on his or her toes to push off, run up hills or sprint. As a result, they are most commonly injured during interval, hill or faster paced workouts. The typical injury involves a tear (known as a strain) of the muscle. Strains are often graded on a scale of 1-3 with a 1 being a severe stretch of the muscle fibers, a 2 being a partial tear and a 3 a complete tear.

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As an L.M.T at this time of year I see many clients with multiple running over use injuries (plantar fasciitis, shin splints, patellar tendinitis, IT band syndrome, SI pain/ dysfunction). As runners increase mileage and intensity to reach performance goals it is common to create myofascial irritation leading to compensation pain patterns that inhibits bio-mechanical function. Pain in a single workout that heals with rest and change of training tends to be a simple acute strain and a normal effect of being a hard training athlete. But continued or increasing discomfort with training may lead to a substantial soft tissue injury and should be evaluated by a health care professional.

Sports specific massage therapy can be a good tool to help recover from or even prevent an over use myo-fascial pain or guarding response. Myo-fascial manipulation breaks up adhesions and areas of congestion in muscle bellies and along tendon and ligament attachments. Soft tissue work opens pathways of circulation to help with ischemia (lack of oxygenated blood) and allow drainage of chemicals of inflammation (a byproduct of muscle metabolism) and the stretching of connective tissues to decompress pressure and pain receptors in the nervous system. A skilled sports massage therapist can sculpt myo-fascia along muscle compartments to improve bio mechanical function, increase range of motion at joints, free adhesions of scar tissue and improve tracking of muscles as they contract and expand.

When I work with athletes, I evaluate posture, alignment, passive and active movement, tissue health and areas of tenderness on palpation. Even with a specific diagnosed injury I will treat the whole structure to prevent secondary compensations that form with favoring the injured area.

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Nutritionally, it is important to make sure you fuel adequately for the time you will be running, not for the distance. Trail races can be significantly slower than road races. If possible, run the course before you race it. If you don’t have an opportunity to run it, look on-line for any course elevation profiles, photos, or descriptions that are available. Also look at race times from previous years to determine a realistic pace that you can expect to run. Race duration will determine whether a pre-race meal is sufficient to meet your energy needs, or if you need to bring something along for mid-race refueling. Refer to Debbie Perry’s article on pre-race nutrition for more details.

As for equipment, it’s important to be prepared for a variety of conditions. Just like any outdoor race, you should bring layered, synthetic clothing for hot or cold, wet or dry weather. Unlike the road or track, however, you also need to prepare for highly variable terrain. Trail conditions can deteriorate overnight with a sudden storm. Bring shoes for any scenario you can reasonably anticipate. Here in the Mountain West, trail racers or trail trainers are usually sufficient. But if you prefer a lighter, more flexible shoe, there’s nothing wrong with using a road trainer or even a road racing flat on the trails (ideally one with decent traction in the outsole). If you’re on grassy, soft trails like those typically found in the East or Pacific Northwest, it may even be appropriate to wear a cross country or track spike.

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