I see quite a few running injuries in clinic. They basically boil down to overload – either in the short term or long term.
Short term overload/ trauma:
Fall over and hit a rock, twist an ankle, tweak a knee – that tends to be a short term overload. You know you’ve done something specific to a particular thing because you remember the thing that happened. Trauma is a bit of a dramatic word to associate with it, but it is the one that we tend to use.
Long term overload/ training error
The other end of the scale is the insidious pain that comes on through weeks and months of training. You’re not sure quite when it began to hurt, or there wasn’t a particular set of circumstances that led up to it hurting, but, by jove, it hurts now. This is a Chronic overload. An overload that has taken time to occur, but the tissues in your body (wherever it hurts, feet, knees, hips etc) have not been able to cope with the forces that you have been exerting on them.
This is easy to see with an acute overload. You twist an ankle and it is immediately apparent that your ligaments around the ankle haven’t been up to the job. They need to heal. You have overloaded in a very sharp and acute way.
What to do? Importantly, you need to modify the load.
Easy to do in an acute situation. You twisted your ankle, it hurts as soon as you put weight on it. The pain is self modifiying to a point, so you don’t run on it and it begins to get better.
However, if there is a slow burning insidious problem that gets worse and worse, but you can still kind of run, then you keep running holding on to blind faith that it will get better. The last thing you want to hear from a health professional is that you can’t, or indeed, shouldn’t run.
As a runner, I fully appreciate this and try my damndest to ensure that anyone who comes to see me doesn’t get fobbed off with the classic “well, you’ve simply got to stop running”.
In the same way as the acute injury, we need to look at this in perspective. If we can modify the load, then a long term issue doesn’t necessarily mean *not* running. Yes, it might stop you from running at the level at which you want to run for a time, but it isn’t necessarily a big red STOP light.
It might mean short walk/runs. It might mean walking a lot with a brief bit of jogging. What it definitely means is modifying the load – but probably/hopefully not reducing to no running at all.
The minor issue with this is actually ensuring there is compliance… runners are notorious for thinking “well, if I can run for a short time, well, I can run more, and if there isn’t an issue, I can continue!”. Fine. But the only time people seem to stop is, somewhat crucially, *after* the pain comes back, which is too late. Stop while it is still comfortable – don’t push it too far and you’ll be bouncing back a lot faster.
The main point:
If your issue has occurred through running, it doesn’t mean that you now can’t run – but you might need to accept that there needs to be a modification of load in order for you to get back to the speed/distance that you want to do. If you ignore it and just hope that it will go away, you’re essentially doing the same thing over and over and expecting a different result, which, as we all know, is a sign of madness.
We all know about being smart in terms of training. Be smart- modify your load.