Saturday, October 26, 2019
You’ve put in almost all the miles already. You’ve done the hard work leading up to your big race. Virtually every runner has a goal race in the Fall. This could be one of the major marathons. It could be a shorter race in our hometown, Baltimore. It could even be your first 5K. No matter the distance or the level you run at, performing your best in that goal race is important for everyone.
Unfortunately for some, this is the time of the year where I meet many a stressed out runner in my job as a Physical Therapist. While distance running has so many benefits for health and well-being, injuries are common. The good thing is that running injuries usually give us a warning sign. Those shins start to ache a little before they are a full-blown stress fracture. Your Achilles tendon is tight and sore the morning after a hard speed workout before it progresses to the point of preventing those workouts.
Another good thing is that when I see runners who are getting “nagging” injuries checked out, even if it is just weeks prior to the big race, there are almost always treatments that can help and you don’t have to be shut down completely. There are obvious exceptions, like stress fractures. But if problems are addressed early, prior to structural damage, we can usually come up with a way to have you make it to that goal race.
For those of you with some pain right now and hoping to avoid having to defer your entry, here are some tips:
If the pain is severe or sharp, do not try to run through it. These are the smaller percentage of injuries that you can’t ignore no matter how much you would like to. Seeing a running specialist physician or PT should be your first step. I do stress that you should seek out medical professionals who specialize in treating runners. I’ve seen too many runners who found a “quick fix” in a second opinion after a doctor had told them that they should give up running. There are very very few cases where that is necessary.
Assess your warm-up. Muscular injuries are more susceptible to being aggravated if you jump straight into higher intensity efforts without warming the muscles. A basic dynamic warm-up should include things like skipping, carioca, butt-kickers, Frankensteins. This is much more important than static stretching prior to a run.
Assess whether the pain improves, gets worse or stays the same as you run. Tendon issues actually tend to feel better after warming up, and the best was to tell if you over-did it is actually how you feel later. Pain from a bone stress injury will worsen with cumulative impact through your run. And you can usually poke right on a specific spot of the bone to aggravate the pain. Do not try to train through this, get it checked out. If there is a low level of discomfort that really doesn’t worsen with more mileage, you may be OK to work through that and delay getting it checked until after your goal Race.
Hopefully these little guidelines can help you navigate the problems that can pop up near raceday and help you get through. Part of getting through is to re-assess how that painful area is feeling afterward. Be sure to take a few days of complete rest, only gentle stretching, if we’re talking about a race of 13.1 miles or more. This is especially important if it was your first race of that distance. If you’ve run a marathon or ultra, your immune system is generally suppressed for up to 72 hours, so be cautious with jumping back to training with almost no break at all.
If you have a muscle injury, it can be difficult to differentiate it from what is “normal” post-race soreness. The general rule is that after day two, any muscle soreness should be improving day by day. If soreness with general activity is not improving, or pain has become sharp or severe, it’s time to get it checked out.
If you train with a Heart Rate monitor and notice that your resting HR is 10+ beats per minute greater than it was pre-race, then you are not fully recovered and ready to resume your running training. Light cross-training is helpful at this point.
As you do resume running, have the first week or two involve simply running comfortable miles. Make sure you gradually get back to a comfortable volume of running before ramping up the intensity again with speedwork, hill repeats, lactate threshold runs, etc.
With these little tips you should be set up well to get to the starting line of your goal race, crush it, and get back to the running you love after an all-out effort.
Written by: Josh Billings, Physical Therapist and Running Program Coordinator for MedStar Sports Medicine. Learn more about MedStar Sports Medicine and make an appointment by clicking here.