Today on the Doc On the Run Podcast we’re talking about the slope of 2 lines you need to compare when you’re returning to running after an over-training injury.
Many doctors tell runners they have to wait until they are completely healed before they can start running again. If you’re runner who got an over training injury you’ve probably heard this before. And it probably didn’t sit well with you.
Four weeks, six weeks, three months or maybe even six months of no activity. How long do you really have to wait before you can start running again?
What’s going to happen to your running fitness if you simply wait for two, four or six months. What is your aerobic fitness going to be like after six months of no aerobic exercise?
What is your running form going to be like after just two months of not running?
What are the chances you will have a PR in your next marathon if you take months off from running and training now?
When you’ve been injured and you are starting to run again you have a very delicate balance to maintain.
Your number one goal is to increase your fitness without stressing the injured tissue enough to inhibit the recovery. The goal is to get stronger without slowing the healing process.
That healing process is always in motion. Every day the healing tissue gets stronger. And every day for healing tissue can withstand a little bit more activity than the day before. Once you understand this fact, it’s hard understand why doctors tell you to sit on the couch for weeks or months simply to recover from an over training injury.
There is a fine line between getting stronger and getting re-injured. But as a recovering runner you can compare the slope of two lines to help you maintain the healing/activity balance. Those two lines are “Activity” and “Pain.”
Tell me whether or not you agree with the following two statements.
As you heal, your pain goes down.
As you increase activity, your strength goes up.
If you agree, it follows that you can you have two possible scenarios when you are a runner healing an overtraining injury.
If you are increasing your activity level but the pain in your foot is increasing, you may feel like you’re getting stronger, but the injured tissue is likely getting weaker because it’s getting abused, traumatized or otherwise re-injured.
If you are increasing your activity level, but you have no increase in your pain level then you are simply getting stronger. If you’re simply getting stronger without any increase in pain, then your activity level must be safe for the level of strength in the healing tissue.
When you are in your normal training progression you’re always ramping up activity. As you ramp up activity you notice certain things. You feel tired. You may feel lethargic. You may even feel emotionally overwhelmed and overworked. But as long as you rest and bounce back you can feel confident you are making progress.
When you are recovering from an over training injury you wont’t be exercising enough so you will feel completely exhausted. So instead of expecting to feel exhausted, overworked or overwhelmed, you just have to pay attention for pain.
Any pain you feel, which resembles the discomfort you felt when you were first developing your overtraining injury, has to be taken seriously. This is your only indicator of too much activity.
You have to pay close attention. You have to be aware of subtle changes and new sensations. You have to observe closely for any tightness, achiness or vague soreness.
And you have to track your pain.
Many people are confused about what exactly they should write down when tracking their pain. But you don’t have to try to figure that out. I have created a one page PDF simple pain journal. It’s free. You can go to DocOnTheRun.com and at the bottom of the show notes page for this podcast episode you can download it.
Then all you have to do is make note of your pain and keep track.
Start adding exercises that you think will apply as little as possible amount of stress to your injured foot. Think about what you can do to increase your strength in all of the other muscles to help stabilize that injured foot.
Start ramping up your activity. Keep track of how much time you spend during each particular exercise. Keep track of how much intensity you put into that workout. Write it down and track it the same way you track your long runs and speed sessions.
At the same time you will keep an eye out for any pain, discomfort or other indicators that your injury may be getting aggravated by your activity.
If you plot these two variables, pain and activity, you should see the activity line going up and the pain line going down. That would be the ideal scenario. You are getting stronger all over. Your pain is going down. Your activity is going up. You’re getting better.
But even if you notice a small amount of discomfort, some odd sensations or other things that you might think are worrisome, you’re still probably recovering if your activity line is a lot steeper than the pain line.
The goal is to get the activity to ramp up keeping your pain line as flat as possible.
And that’s what I mean when I talk about comparing the slope of two lines.
You want a lot of slope in the activity line. You want activity to keep going up and up and up.
If you notice any increase in pain, all you have to do is look at your activity journal and back off that one particular activity that you most recently added.
If you’re only adding one new activity, or one new level of intensity to a particular activity, then you can always can identify the one activity that is stressing your tissue and putting you at risk of a re-injury as you ramp up your fitness.
Right now you may be thinking that all this tracking seems like a tedious process. Well, it is.
But if you want to serve your own advocate, and you want to beat the conventional medical wisdom of the standard “sit still treatment” you have to do something different.
Don’t ever forget, if you’re just sitting still you’re losing your running fitness.
You don’t have to let your runner body waste away just so you can let one part recover.
You have only injured one structure. You have one metatarsal stress fracture. You have one tendon which is inflamed. You have only one anatomic part which is injured and needs to recover.
Keep your body moving. Keep building strength and everything that will support and protect that healing injured part.
Pay attention to the slope of the two lines that help you map out your progress and guide you along the way.
And if you do, you will get back to running sooner.
Pain is the best tool to help an injured runner decide when run. You don’t have to figure out what to write down. We made a simple Pain Journal PDF for you.
If you have a question that you would like answered as a future edition 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. Thanks again for listening!