Tuesday, January 15, 2013

Injuries, niggles, and tweaks, oh my!

More questions and answers! :)

Another question that I was asked was about injuries, and if (and how) I have really stayed injury free with all of my running miles.

The short answer is yes, I have avoided any major injuries (knock, knock, knock on wood) as a runner, even with consistent 80-100 mile weeks. I have missed a day or scaled back for a couple of days a few times because of a minor tweak, but there has not been anything that has taken me out of the running (pun intended) for longer than that.

I know that a lot of it is probably luck, genetics, etc, (although there are no other runners on either side of my family as far as I know), however I would like to think that all of the extra that I do contributes at least a little to avoiding injury. I know there are amazing runners who do everything "right" and still end up injured so there are no guarantees, but I do think there are things we can all do to stay as healthy and strong as possible.

Here are some of the things I have done and do on a regular basis in an attempt to keep this body running strong -

- I built my mileage slowly. It is great to want to run 100 mile weeks, but it takes time to slowly and carefully build your mileage base to be able to handle higher mileage. Also, what is "high" for some runners is low mileage for others. I read somewhere that every runner has a sweet spot - the highest amount of mileage they can handle without getting injured. And the way to find that spot is to continue to slowly (did I mention slowly?) add to your mileage until you hit the point that it is too much, and then back off just a tiny bit. I would say err on the side of caution and one more time, build slowly. I recommend never more than a 10% increase in mileage a week, and always having a scale back week every 3-4 weeks. Patience is a virtue in mileage building. :)

- Consistency! I am a believer in running consistently. That is not to say that you should not have scale back weeks, recovery days, rest days, rest periods after marathons, etc. because you should definitely do all of those things, however running lots for a few weeks and then running very little or not at all for a few weeks, on and off and on and off, or taking an extended break and trying to jump back in where you were at, is tough on the body and can increase injury risk. Try to be consistent most of the time (with rest and recovery when appropriate), whether for you that is running two days a week or seven.

- Rest and Recover. These are important and often overlooked aspects of training. You HAVE to give your body time to recover from your hard efforts to improve. For some people that means three days of rest or cross training a week. For some people that means easier runs in between hard efforts. I do run every day, sometimes twice, however my easy days are run SLOWLY and at a very easy effort (and often without a Garmin).  My hard days are HARD, and my recovery days are EASY.

- Cross/strength train - I do a core routine three times a week (abs, back, hips, etc.) and a strength routine twice a week (arms, shoulders, legs, etc.). Having your whole body strong and fit helps you maintain your form in a long run/race when you are tired, and does lots of good in avoiding injury. It means I have to get up half an hour earlier than I normally would. I hate doing it. But I believe it is worth it, so I make it a priority. And who doesn't want toned arms and abs? :)

- Listen to your body. Runners get very good at running through pain and ignoring pain. We are often very determined, dedicated, and dare I say even stubborn. One of the keys to staying free from injury is listening to your body. Is it telling you that you need extra rest? Better nutrition? More stretching? A new foam roller? A day off? A week off? New shoes? A massage? Ignoring the warning signals from your body rarely ends well. Just as important as listening to your body is finding and doing what works for YOU. Everyone is different. Don't compare. Get advice from others, but do what works for you.

- Get the right shoes. There are SO many different types of running shoes out there. There are everything from barefoot shoes to the giant Hoka's. How much support do you need? What amount of heel to toe drop works best for you? Light weight shoe or standard trainer? GET FITTED. Go to a running store, have them look at your feet and watch you run, and have them recommend a type of shoe. Try several out and find what feels best. Then keep track of how many miles are on your shoes and replace when necessary (before you end up achy or injured). Buying shoes solely based on color or price is a BIG no-no. Of course I think Brooks are best! :)

- Hard/easy. I often have three "hard" workouts a week, but there is always at least one, usually two, and sometimes three easy runs in between my hard efforts. Give yourself time to recover after long runs, speedwork, tempo runs, etc. and follow the hard/easy rule. Back to back hard efforts are very rarely a good idea.

- Stretch and Stick (or roll). I know that there are some people who are anti-stretching, but I am a believer. I do a thorough stretching/flexibility routine after every run, and I also work my legs over with a Stick (foam rollers are great too. Whatever works best for you). When I first started running doubles (two runs in a day) I skipped stretching/rolling after my second run a few times and every time I could feel a difference, and not a good one. For me, stretching and rolling not only keeps my muscles loose and flexible, but it also helps me find any tender/sore/tight spots that I might otherwise overlook or not notice. When I find a "spot" when I am stretching and rolling, I can give it some extra attention and scale back my speed for a day or two if necessary so it doesn't evolve into anything bigger.

- Eat a healthy diet. I wrote a lot about what I eat in my last post so I won't go over it again. But shortly after I started taking my running seriously, I realized that if I was going to ask so much of my body, I needed to treat it better. I had already lost a lot of weight and was in decent shape, but when I took a truthful look, I wasn't eating like an athlete and wasn't putting the best fuel in myself. I am far from perfect in my diet, but I try really hard to make sure that I am fueling my body well and giving it what it needs to be healthy and strong, and perform in the way I am asking it to.

- Sleep. Ok, in this area you are going to have to do as I say, not as I do. I absolutely believe that sleep is super important. I would certainly sleep more if it was an option. Right now, 6.5 hours is the most I can regularly get in a night and still get my training in (and unfortunately, sometimes it is less). A girl has to do what a girl has to do. I do try to lay down during the day sometimes. I never get to nap, but if I am working on my computer while laying down I know I am at least resting. And as soon as the little kids are in bed for the night, I lay down on the couch with my big kids and Penny (and Josh if he is home!) and rest/watch tv/read/cat nap. :)

- Compression. Again, there are skeptics, but I am a believer. I run in calf sleeves and wear compression tights after my races, long runs, and some of my hardest workouts. 

Now I do think it is unrealistic to expect to be a distance runner (or athlete of any kind) and always feel perfect. If you are running regularly and working hard, reality is that at times you are going to have aches and pains. And if you are going to train regularly, you are going to have to run sometimes even when you aren't 100%. I have days where I am up with Noah in the night and am extra tired. I have days where I have a little niggle or tweak here or there. I have days where I have a cold. A few months ago I biffed it in the dark and twisted my ankle. I have a hamstring that tends to tighten up a little after a hard work out. 99% of the time I catch a problem early, take steps to fix the issue, and am able to keep running comfortably through it.

My rules to decide to run or not when I have a niggle/tweak/sore spot are that I won't run if -
- pain is more than a 3 on a scale of 1-10
- pain progressively gets worse throughout the run
- pain gets progressively worse from one day/run to the next
- the niggle/tweak/sore spot forces me to change my form in any way

If none of those things are true, then I just pay a little extra attention to the spot with the stick/foam roller, stretching, icing, and self massage, and possibly scale back intensity for a short period, and it resolves in anywhere from a day to several days. If any of the above are true, then I take off a day or two and then reevaluate. Again, I have been very lucky (and have done all of the above) and have only once had to take off more than a day or two (after upsetting my Achilles doing back to back speedwork days when I first started training hard and  I didn't know better. Lesson learned.)

I loved reading Chrissie Wellington's book, "A Life Without Limits" as she frequently discusses the little "niggles" that she experiences as an athlete and how she deals with them. Love her and her spirit!

Sometimes, unfortunately, runners do everything right and still end up injured. Everyone knows that an injured runner is not a good thing. When true injury strikes, the best you can do is get evaluated and treated by a professional experienced with runners/athletes, take the rest time that you need to heal fully, cross train as advised, try to figure out the cause of the injury so it can be avoided in the future, and try to stay as positive as you can until you can get back to it.

Ok, now share your best advice! What do you do to avoid injury and stay healthy? What works for you? Any lessons learned the hard way? What do you do when you have a niggle?

14 comments:

Amanda@runninghood said...

Wow Erin! Good stuff here. Thanks for this. Would love more details on what you do for strength (specifics) and core. That would be a great post...or have you done that? I'm awful at this. I cut a lot of corners and when I eventually get to a place where I'm ready to focus on some big big goals again (if that day comes), I know that these corners can't be cut. And I really must get this book because I hear great things. That's a book I should give my friend who was asking about books!

Jen Binns said...

What do I do to keep my running in the right direction, and for advice on injury prevention? Have the most awesome coach around in my corner. Successfully crossed the finish line after 26.2+ thanks to this lady, and followed her exact numbered scale for working my way out of a mid-training injury. It works, people!

Gracie said...

Ugh. Learned a lot the hard way! I just run through pain - and I cannot do that! I will have to be vigilant about stopping and thinking about how I feel and whether or not to stop or rest.

coach dion said...

My old body is falling to pieces and i know it's time to rest, I think I need a week or 4 off, but I don't know when I'm going to get round to doing that...

Adrienne said...

Scaling back one week every 3 build weeks. Cross training (obviously b/c of tris!) strengthens those needed muscles to stabilize your stride.

Also-on a mental recovery side, staying out of the scuttlebutt that makes me want to go longer, harder, and farther and start doing stupid stuff. It's taken 5 years, but I've learned to keep some goals to myself to protect what I'm aiming for.

Yes, Chrissie rocks!

{lifeasa}RunningMom said...

I don't think I have anything to add to your awesome list but will reiterate the things that work for me.

1. Build up mileage slowly. I have found more aches occur after a jump in mileage so don't do it.

2. Stretch/Yoga. I do a simple stretch post run for my hamstrings and have recently added in a brief yoga session at night. It isn't surprising that my peskier left side is tighter in all the yoga poses but I am already seeing improvement in less than a week. GREAT NEWS!

3. Don't get too focused on numbers. Yes, we all have training plans to run x miles and that is okay to push to achieve that but sometimes those x miles can be slower. Run slower. Do it. Your body and running performance will thank you in the long run. It took me a long time to learn this. It is fine to run minutes slower than your race pace especially if you are running daily.

4. Do run hard. Yep, run hard too. I aim for 1-3 sessions of harder runs each week but if I am focusing a bit more on building miles, I cut back the number of hard runs. Think of it this way - I go through base building and speed building training cycles but don't try to increase base and speed necessarily at the same time.

5. Eat your fruits and veggies. They have so many antioxidants in them that help you stay healthy so your body can focus on recovery not fighting germs.

Beth @ Miles and Trials said...

Really great advice. I have lost much running time over the past few years with injury after injury. I know I could be a better/faster runner if I was just able to run more consistently without taking months off for injury every year. Fortunately I have gotten a little smarter and have been able to run for about a year and a half now without major injury, but I am always a little bit in fear of the next big injury. It's hard to know what is just a niggle vs. the start of an injury. Thanks for the tips!

Amy N. said...

Great post! Thanks for all the advice!

I love that you mentioned the Chrissie Wellington post, as soon as I saw the word niggles in your post I thought of her book! It was such a fantastic book!

Christina Williams said...

So many good tips and I think the best approach. I too am a believer in stretching, as is my sports chiro too. He has me working on a very specific after-run stretch for my ITB and I am religious about it. I've never had ITB problems in over a year since (knock on wood!) I like to do yoga leg-up-on-the-wall pose after runs too for about 5 minutes. Feels so good :) Tonight I am in some compression socks/sleeves after my 3 back to back runs and I can tell it is doing a world of good. Thanks for such a great and useful post! :)

Annie Crow said...

Thanks for all this. I'm planning to use the Hanson method for my next marathon and I know I'm going to need extra attention to not getting injured since it will be more mileage than I've ever done. And thanks for being honest about the sleep. We do what we can, huh?

I would also appreciate hearing your core/strength routine. I've relying on my cross-training (and some exercises) for that, but will need to scale back my cross-training soon.

Love this week of answering questions!

Mommy Run Fast said...

So many great tips! You're so right that sometimes, despite doing everything right, injury still strikes. Be thankful for your amazing genetics! And I've been wanting to read Chrissie's book, too... glad to hear you liked it.

Lisa said...

I love this blog! After doing several halfs, I am finally doing my first full this May. Because of that, I've been doing lots of reading, mostly interested in preventing injury.

Love your heart for adoption. We do foster care and are being faced with our first possible adoption, a 10 year old.

Anyway, just wanted to say I'm new and I'm following!

Holly Parker said...

What qualifies as a store capable of evaluating what shoes I need for running?

LUCY GILBORT said...

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