Today on the Doc On The Run Podcast we’re talking about why you should question every timeline of how long it’s going to take to get back to running after an injury.
I was recently doing a webinar entitled “Am I ready to run?” And what I wanted to do is try to explain to people about when you’re actually ready to make that transition from being in a fracture, walking boot, to moving out of the boot and starting to move back to activity, then actually starting to run again.
A lot of the people who are on the webinar actually sent in their questions. And one of the first questions came from a runner who had a stress fracture and was told, “you should come back in three weeks to take another x-ray.”
And in that case, the runner said, the doctor had said that you have to come back in three weeks to do another X Ray, take another look….and then they could decide whether or not it was okay to run.
Here’s what you really have to think about when you think about that specific scenario.
If your doctor says, “I think it’s going to be three weeks, we’ll take another x-ray then,” you have to really think about that timeline.
You have to question the timelines. I’m not saying the doctor is wrong. What I’m saying is you have to question it.
If the doctor guesses that in three weeks, you’re going to have something appear on an X Ray that assumes the bone is going to be stronger at that time. Right?
So what that really means also is that from today, till three weeks from today, every single day, healing happens. Tissues are getting stronger. More collagen is forming. The osteoblasts and osteoclasts are working in conjunction to remodel the bone, more bone is getting laid down. Tissue is getting stronger. But every single day, if you get stronger, then in theory, every single day, you could do a little bit more activity.
You know, you wouldn’t have to wait three weeks, right?
You wouldn’t sign up for an event and then just wait for three weeks and expect to be stronger because you signed up for the event. You know that you have to do something to get your strength back. You also have to let the tissue heal, but that’s a different issue. But I’m just saying you have to really think carefully about these timelines.
Any standard timeline is for standard patients.
General timelines don’t work for people who are more aggressive, more athletic and more competitive. That’s been my experience, but there is no formula that works for everybody. If you think about that, it’s ridiculous.
If you take a high school cross country runner, will they get stronger and heal faster than somebody who’s a 65 year old diabetic patient who’s overweight?…for sure. That’s not a criticism. That’s a fact.
Will that person who is a high school athlete, recovering from an injury, get better and stronger, faster than someone who is a professional athlete. Probably not. Why?
Well, the younger athlete actually has the propensity to heal faster, but the professional athlete has more help. They have teams of trainers and coaches and doctors. I see professional athletes who have professional personal physicians that travel with them. And then they call me in to actually consult on a very specific part of whatever’s going on with them, but they have more advice.
Every healing runner’s timeline is different depending upon who you are, your physiology and what you do.
I got an interesting email yesterday from a woman who just had surgery. And she said, “I am so lucky that my surgeon told me that I can run after six months.”
Okay, first of all, I want to say that it’s awesome! If you have a positive attitude in a way that when you hear “I will not run for six months,” you think you’re lucky.
When your surgeon does surgery on you and tells you that it’s going to be six months for you to run again, then you have to think about this…
What has to be true that it’s really going to take six months for you to run again?
If it’s going to be that long, what has to be true? Well, first of all, your surgeon has to be right, and your surgeon has to know what you’re going to do or what you’re not going to do in order for you to run in six months. So the surgeon has base assumptions about what you’re going to do and assumes that you will do all those things and assume you will not do anything that would slow that timeline down.
Then you have to think about, what has to be true for you to never run again? So what would be true? Well, you might get worse, you might have to have surgery again, you might lose your leg. Something terrible happens. You don’t heal from the surgery. Your foot hurts, hurts every time you walk. Something would have to be true for you to never run again, right? Something would have to be true for you to never get better.
What would have to be true for you to run and only three months instead?
What would have to change? What would you have to do differently?
Well, first of all, you have to follow all the doctor’s instructions, but then you have to do something for extra credit.
If you do things for extra credit, you get back to running faster.
That’s the bottom line, but that’s the deal is you have to realize that you can actually change all this. You can heal faster depending upon what you do. You can reduce your risk of recurrence and getting another injury later, depending upon what you do.
It’s not about timelines. It’s about your goals and expectations.
You have to decide what you’re willing to do and what you’re not willing to do and what actions you take. If you want to get better, faster. So there are some things you cannot change. And we think of those as intrinsic factors. Like if you’re a man, you know, you’re a woman, those are different risks.
If you’re a woman, you actually have a much higher risk of a recurrent tibial stress fracture. If you’re a man, you actually have a much higher risk of getting an over-training injury in the first place. You can’t change that, but you can change all these other things: muscular imbalances, a lack of balance. If you’re a heel striker versus a forefoot striker. If you actually take the bull by the horns and you do exercises to figure out how you can get better, all of those things matter
Then you need to act with a progressive return not running. This is most of what a teach to physicians about actually figuring out how to ramp up activity slowly and deliberately. So you strengthen everything that’s not injured first, and strengthen the thing that is injured last.
Most people do that backwards.
They get an Achilles tendon injury. They want to strengthen the Achilles tendon. You can’t strengthen it while it’s injured. It just keeps it injured!
Let’;s go back to this high school cross country runner. He is different. He’s a high school athlete. He’s going to heal faster than me. He has a potential to heal way faster than me. So if some doctor says, “okay, Chris, you got a stress fracture. It’s going to take you six weeks to get better.” Maybe so.
And then he also says to this high school cross country runner, “you’ve got a stress fracture. It’s gonna take you six weeks.” How is it possible that that’s true? It doesn’t seem like it’s possible. Cause that kid heals faster than me.
The most important thing is to figure out what your goal is.
The way that I usually like to think about it is that think about if you think you’re better than a normal patient or not better than a normal patient. Let’s say you have endocrine dysfunction, you have diabetes, and you have heart disease. You have a whole bunch of bad medical problems. Well, you’re probably going to heal slower than a normal patient.
So if the doctor says, “most of my patients with this problem, it takes six weeks.”
Well, if you’re a really unhealthy patient, it’s probably going to take you longer. If you’re a lazy patient, if you know, for a fact, you just won’t do anything the doctor tells you, it’s going to take you longer to heal.
If you’re an active athlete and you’re somebody that’s used to training use to taking initiative, use to following directions, you’re probably going to heal faster.
But then you have to figure out what has to be true for you to heal faster than that timeline. Same seems like you have to do the right stuff, right? And you have to do more of the right stuff. And you have to figure out how to reduce more of the stress to that piece of tissue.
You have to do more of this stuff to build those other pieces of tissue that are not injured. So they can better support that one to prevent it from getting re-injured. And you have to figure out your plan. Figure out where you need help. You have to do something and you have to execute. You’ve got to, you’ve got to work your plan. You got to plan your work, but you got to work your plan. If you don’t do both those things, it will not help.
You have to do something different. You cannot just sit and wait for things to heal, and you have to figure out what you can do that will maintain any fitness of any type without stressing the injured healing tissue. You actually do have the power to change lots of factors that alter your healing timeline. Really think about what you have control over what you can change.
The first thing is your rate of recovery. You, nobody should be stuck with any specific timeline.
So if a doctor tells me that it will take six weeks to heal a stress fracture, (which happened to me when I was in medical school) and he tells the same patient, who’s a 400 pound, 70 year old, uncontrolled, diabetic patient that is going to take him six weeks to heal. And he tells a high school cross country runner with the same stress fracture it can take six weeks for him to heal. At least two of those have to be wrong. There’s no way it can be six weeks for all of us. It might be six weeks for one of us, but there’s no way it can be six weeks for all of us.
So if I’m told that this is normally the time it takes to get back to running, but you know professional athletes and some other athletes will heal much faster than that, what is true for them, that’s not true for you on your timeline.
What is it that you can do differently that is really going to affect your timeline? What will change that rate of recovery?
This is usually the small stuff. It’s usually the stuff you do in training. That makes the biggest difference, like resting, like nutrition. It’s not generally a PRP injection, or a STEM cell injection or a bone stimulator or those kinds of things. It’s usually much simpler things.
Then of course you can change your goals. I’m not telling you to become a swimmer swimmer. If you’re a runner, I’m not even telling you to start running half marathons, if you like running marathons.
But what you have to look at is your goals. And you need to really think about is the goal that I’ve been given by the doctor as a timeline, of how long it takes to heal Achilles pair of tendonitis. Is that realistic for me? Or is it not, is in and it could be either direction. It could, you could think it’s going to take longer because you know, you’re busy at work. It could take less time because you decide you’re going to do a whole bunch of things to really sort of eke out every possibility of healing the tissue faster, no matter what the timeline, just remember, depending upon what you do, depending upon how frequently you follow up, depending upon how frequently you track your improvements or pay attention to your pain, all these things really matter. So you’ve got to do something!
You gotta take action! The people who actually get better, the fastest are the ones who follow up more frequently, check in often or track all of their own stuff on their own. That’s why created the Runner’s Rapid Recovery Journal. It actually helps you take a look at what you did in training and apply it to your healing. Take what you know, that works in training, apply that to your recovery.
You’ve got to really track everything. You’ve got to figure out what you’re missing, what you’re not doing. All of those little things matter. So if you want to change your timeline, do something, take action, start tracking it, start monitoring it. Get theRunner’s Rapid Recovery Journal. Start doing those exercises, develop some goals and then work toward those goals every single day.
That’s really the key!
Right now the Runner’s Rapid Recovery Journal is on sale and you can get it at discount. You can get an instant download version today. You can find a link in the show notes at the bottom of this episode at docontherun.com under the podcast tab.
Go check it out!
Get the Runner’s Rapid Recovery Journal…
