OUCH?!?! Injuries: Prevention, Recovery, & Maintenance, Just the Basics

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Injuries…more specifically, sports injuries…suck. No sugar coating that fact here. Sure,
no injury is “fun”. Many injuries are accidental. Not saying that a sports injury can’t be
accidental, but many are preventable.

If you fall down when running and bang your knee, sure your knee is likely going to hurt.
What happens if you go out for a run, and your knee starts to hurt, and I mean like really
bad, out of nowhere? Chances are, you go home, ice, roll, ask all of your fiends on your
Social media running group. Try six other things that were suggested, and maybe it
feels a little better, here and there. The problem…even if it feels great, did you unlock
the “why” or the “how”? Hey maybe you got the “sports massage” that was being
offered on the daily deal, and they asked you when it hurts and you said it starting
bothering you when you were running. Surmising that it must be from running! Nope.
(Disclaimer: There is nothing wrong with deal sites, massage chains etc; just be aware
not all practitioners are the same. Everyone has their own set of skills and knowledge)
As an athlete, we want to be “pain free”. What does this mean? And what about that “no
pain, no gain” stuff people like to bark?

I will explain. First, understand that pain is a nervous system response indicating
something is not right. Sometimes it may start as discomfort and progressively increase.
There are even different pain descriptions, like sharp, shooting, intense. Some
descriptions are subjective, and are specific to the individual; while others are more
about the pain itself. Eventually this “not right” feeling may be this is a “not good”
feeling, and then even “STOP!” Pain is warning you, telling you, and then making a
demand on you to knock it off! Pain is a survival mechanism. It is also basic common
sense, something us humans do not seem to want to embrace. So we create phrases
like “no pain, no gain”, “pain, is temporary…” Typically this is not referring to the “real
pain” but the discomfort, or soreness from a workout. Our body testing it’s limits, and
moving further. If you are training for a marathon, for example, you will experience some
pain, but it should not be injury or hurt pain so to speak. Even after the race with much
training, you may feel pain. Your body went out and pushed, and tested its limits. You
need to recognize your body’s signals and the information it is attempting to
communicate. This is why a training plan, recovery days, tapering, good nutrition, warm
up/cool down, and many other things are so important. This is allowing your body time
to heal, it is communicating back to your body that you understand and recognize what
it needs, and you are willing to work with it accomplish great things together. Create
balance for your body. I like to say “Balance in your body. Wellness in your life”.

That being said…tell me what “it’s a good pain” means?!?! Ok…truly it means that
something is working itself out. Personally, as a massage therapist, I really dislike this
phrase. Someone should not have to jump up and down on your shoulders or hips to
make the muscles feel better. This has potential for even a greater response from the
nervous system. Also don’t forget, just because it hurts here, does not mean that is the
starting point, source, cause, or whatever. The relief felt upon massage, or other work in
an area that has pain, but not source, may be temporary. Get to the source.
Pain-free. This is a goal. One does the work, without shortcuts, to become pain free.
Whether it be when training; or in recovery from back surgery. Do the time, put in the
work, listen to your body, get it what it needs. This is your first and only real “home” you
will ever live in. Take care of it. It may not just be “getting older”. If something persists,
get it checked out.

The main components for injury prevention (or if too late for that…rehabilitation) are
proper form, strength training, and what’s on your feet! I like to throw in self-care as a
piece of this as well. Self care (the rolling, the stretching, the warm-up, the cool down,
even nutrition) helps to keep you on target with your goals by helping to maintain the
body’s health and to help you recognize potential warning signs of over use.

Form is huge. No one is likely going to have “perfect form” but everyone should aim for
more efficient form. Why put extra stress on the body? When I speak of form, this also
is for walking, standing, sitting….now I sound like a nag! With regards to running, a gait
analysis can be helpful, but what happens later in your run when you are tired and your
posture is collapsing. Or when cycling it is important to have a great bike fit, but what
happens when you are tired and your body no longer “fitting” with the fit. I often refer to
this as false advertising. What the form looks like at the beginning of an activity (or day
even), is not likely what it will look like at the end, or even halfway through. An athlete
needs to understand what efficient form looks like and work on their own form bit by bit.

I will be addressing form more in another post.

Shoes. Just because they fit and are comfortable, does not mean they are the
appropriate shoe for you. Just because you have run 12 marathons in that style shoe,
does not mean they are still the right shoe for you. Purchase shoes for the runner you
are, not the runner you were, or want to be. Get a proper fit. Actually go to a specialty
running store and have a fitter size you and explore the options for you. If you go to a
brand name shop, those will be the only shoes you will see. If you go to a massive
sporting goods store, and handle a box on your own…you may think you will save a
couple dollars, but really you are over paying for self-service, as usually the price is the
same. Let someone take care of you and spend time with you picking out something;
and if they are not the right shoe, many stores have a fabulous return policy so you can
check out something else. Go to some sponsored fun runs and try different shoes even
at your local running store! Inserts often can help with form and foot fatigue. Rigid
orthotics however, have not been proven to prevent injury. I am not telling you to forgo
wearing them if you do, just explore.

Strength training. Strong muscles, tendons, and ligaments, help the body to provide a
strong defense against athletic injuries. Strength training will help the “support team” of
the body. This team consists of muscles, tendons, and ligaments that help stabilize the
joints of the body as well as supporting the movement for more balanced and fluid flow.
The support team will also help as the main movers begin to fatigue, allowing for more
endurance.

What about self care? There is much to do here! Rolling, stretching, ice, compression,
recovery boots, meditation, massage therapy, sufficient rest and more. Self-care, no
matter what you are training for (or not even training!) is important daily. Self-care will
help recovery and aid with efficient body movement. This topic will be discussed further
in another post.

The most common injuries that runners and other athletes suffer from can be prevented.
Injuries happen. After rehabilitation from an injury, it is also important to make some
changes. Discover the cause of the injury. A doctor, a physical therapist, a movement
specialist, or a coach, can all assist with this. Not all of them will have the same abilities,
or knowledge…or even time. Each of the following injuries will be discussed further.

1. Patellofemoral Pain Syndrome sometimes referred to as Runner’s Knee.
2. Iliotibial Band Syndrome
3. Shin Splints
4. Achilles Tendonitis
5. Hamstring Issues
6. Plantar Fasciitis
7. Stress Fractures

When a client of mine has a potential injury complaint when they are training for
something I ask them (or interrogate them!) I am not a doctor so I am unable to actually
diagnose, but I can assess and work with injuries. I help athletes return to activity, and
help to determine the cause of issues, or potential overuse injuries. An injury does not
have to be caused by the sport but can be several contributing factors. Injuries also can
be related to each other. Tight calves (gastrocnemius and soleus muscles) can lead to
Achilles tendon tightness, and then in turn lead to Plantar Fasciitis issues. All of which
can have contributing factors such as how one walks up the stairs (and how many),
driving position, how one sits at their desk, hip placement, and more!

Some examples of questions:
1. Are you following a training plan
2. What are you doing in addition to your training plan
3. Work atmosphere (or life activities when not running or training)
4. Are you doing any other cross training?
5. What is your nutrition like?
6. Missed workouts/miles; are you making them up? How are you altering plan?
7. Are you increasing speed?
8. Shoes
9. Trauma/prior damage
10. Running/activity surface

What can YOU do?
Stop activity if you are experiencing inflammation. If pain is present, and does not go
away after you warm up, try walking, if it persists, stop activity. If the area is not
functioning normally, stop activity.

The longer you continue activity, the longer it may take to recover completely and return
to activity. You can take time off of running without losing a significant amount of your
conditioning. Just be sure not to pick up where you left off, but ease into it.
Try to decrease your risk of injury by inserting walking breaks from the beginning. Allow
for plenty of recovery by spacing out your training plan and not loading it with intense
workouts everyday. Account for other outside of training activities that will also affect
your body (moving, a day on your feet at an amusement park, etc). Ease your way into
faster running, with shorter speed workouts, and eventually add into your longer runs (make sure form stays consistent, as the lower body may be moving fast, but the hips may not be), be careful with your stretching. Don’t overstretch, or stretch too much. A warm up and a cool down is different from stretching and often even more important.

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Terri was not an athlete growing up. Maybe a bit “athletic” and definitely awkward. Now she is not only a runner and triathlete, but a Coach as well! She has been a part of the Chicago “sport” community for 25 years as a Licensed Massage Therapist and Movement Specialist. She has her own business, Urban Wellness Chicago, in the city, works with the Northwestern University Athletic Department. As a Coach with Chicago Athlete Coaching and the Chicago Manager for Running Tours USA, she does now consider herself an athlete, and regularly competes in races of multiple distances. Oh and yes, still a bit awkward!

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