If you're not moving, you're getting more injury-prone | DOC

#136  If you’re not moving, you’re actually getting more injury-prone

Today on the Doc on the Run podcast, we’re talking about how if you’re not moving, you’re actually getting more injury-prone.

If you’re not moving, you’re more injury-prone. If you got an over-training injury from running, and you’re not moving, if you’re not exercising, things are actually getting worse for you. You are actually getting more injury-prone, not less.

This is the misconception. People think that if you get injured, you have to sit still. You have to rest. You have to ”take care of yourself,” and you have to heal. That is sort of true. And that is what physicians feed us runners most of the time; this idea that they should just calm down, sit down, chill out, relax, recover, take it easy…whatever. But you know as an athlete, there are only two possibilities: Either you’re getting stronger, or you are getting weaker. And if you’re getting weaker, you’re actually more injury-prone.

That’s the thing. You have to remember that there is a phase, for sure, when you have to protect an injured part, like a metatarsal stress fracture, or injured achilles tendon. During at least some short phase of recovery, you have to keep that part still. You have to let it rest. You have to let it start to heal.

But that all quickly changes, because you are healing. However, you should not stay in that same phase for six weeks. You can’t just wait in that same phase of sitting completely still and do nothing for the entire time it takes for that structure to actually heal. The healing of that structure; the complete recovery, takes a long time.

What you have to do is determine when you’re ready for the next phase of healing. How do you do that?

How do you determine when you’re ready for the next phase of healing?

And when can you determine if you’re safe to move it a little bit more, or not?

First of all, you have to evaluate more frequently. You need to think about what’s changed, and then you have to communicate to your doctor or your coach, whoever is helping you, you have to communicate that something has changed.

As soon as you have less swelling, you’ve improved. As soon as you have less pain, you’ve improved. As soon as it feels better, you’re improving. That’s when you are most likely to be able to make some little jump in improvement. You have got to work with somebody who knows runners, like your coach or your doctor, talk with someone who can really help you through that process. And then, you’ve got to start moving!

You need to think, “when can you get your mobility back?”

When can you start strengthening all of the structures that support and surround that one injured part, so that it’s going to be fortified and protected when you get back to more activity?

What can you do to get stronger this week, that you could not do a would ago?

What do you know that hurt last week, that probably isn’t going to hurt this week?

And what plan would work for you this week that wouldn’t work for you last week. You need to figure that out if you want to heal faster.

You can’t just sit around waiting to heal. Waiting is not a plan. Waiting is not action.

Stuff is happening if you’re healing. The whole healing process is action. We always think of healing as inaction when we are injured runners, because we’re sitting still. We’re not doing what we want to do. We’re not out running on trails. We’re not out doing track workouts. We’re just sitting still and it bums us out. It’s terrible to sit still. I understand that.

I’ve been injured myself. I’m a runner and I have to exercise. I’m grumpy when I don’t exercise. I’m not easy to get along with when I don’t exercise, and I’m not as happy when I don’t exercise. I understand that you really want to run, and you want to get back to moving.

I understand, also, that you know and understand the process of training is an active process. You do not sign up for a race and expect to just be strong enough for the race when you show up, unless you do something.

You know that your have to go out and do training workouts. You have to let that tissue heal. You have to supply nutrients for that tissue to heal, for you to get stronger after your workouts. And the same is true when your injured. It’s the same thing; you’re doing stuff. It’s not a passive process. It’s an active process just like training.

The more you move it, the better it’s going to heal. If you sit completely still, not only do you get weaker, not only do you atrophy and things shrink and just get weaker, but you also get scar tissue. You have an active process going on all the time.

If you’re not moving anything, you get scar tissue building in all kinds of directions indiscriminately. That scar tissue connects and binds things that are not supposed to be connected. Scar tissue creates shear forces within those tissues that cause problems later.

If you’re moving it, the cells actually will lay down collagen in the right direction; in the direction to resist that stress, instead of just forming indiscriminate scar tissue. That’s why it’s beneficial to move sooner.

That’s part of the reason I say that if you’re not moving, you’re more injury-prone.

Because you’re not just getting weaker, you’re not just getting stiffer, you’re not just just losing aerobic fitness, you’re not just losing all of your neuromuscular connections that help you have good running form to protect you, you’re also getting indiscriminate scar tissue that’s going to lock things up, make it stiffer, make it less resistant to injury, make it less resilient.

Basically, your foot, if you think of it as a lever on the end of your leg, it’s going to make that lever stiffer. Then more force gets applied through the structures in that lever, your foot, when you run.

Any time you’re sitting still and you’re doing nothing, you’re probably doing damage. Now, again, there is a time and a place that you have to sit still to let things start to heal. But once they start to heal, you need to keep them healing. That means advancing your activity as quickly as possible, moving as soon as possible, and strengthening as soon as possible, so that you really can get back to running sooner.

Remember: the whole goal when you talk to a doctor is to get information from them. You want to help the doctor by saying, “Look, this what’s changed. This is what’s changed in the last three days. The swelling’s down. The bruising is gone. It doesn’t hurt anymore when I wake up.” Explain what specifically has changed.

You need to think about those things and then, when you see your doctor, you want to say, “Look, okay, this changed. What can I do now? How can I move it now? Can I move my leg and not move my foot? Can I move my foot? And can I move my foot in one direction, but not another?”

“How can I move it in a way that’s going be productive and helpful in moving that healing process forward, instead of just waiting for some magical passive process to happen.”

Because just waiting really doesn’t help when you’re an injured runner.

If you want to run sooner, just remember, if you’re not moving, you’re getting more injury-prone. Figure out some way to get moving sooner and you will get back to running sooner.

If you have a question that you would like answered as a future edition of the Doc On The Run Podcast, send it to me. And then make sure you join me in the next edition of the Doc On The Run Podcast.