Got up at oh-dark-thirty a couple of mornings ago to run a ten-mile race simulation workout. If that statement coming from me does not provide a deep sense of foreboding, then stick around; the sense progresses from ankle-to-knee depth in nothing flat. Even on the most-industrious of training days, save for the ones when I visit my New Orleans friends (I have to justify my dietary indiscretion!) I don't get out the door any earlier than 7 a.m. Yes, race days are a different story, hence the simulation workout being so darn early. So, I began my early morning ritual: Feed the dog, fire up the coffee pot & await the, er, signs which tell me my body is completely awake. After dressing & stepping out the door it was time to start; why stand around thinking about what needs to be done? The sooner I start the run the sooner I can get on with breakfast & the rest of the day.I figured the first two miles would be a bit of a slog; my body is usually in a state of denial, or shock, at the thought of running. After two miles my heart & lungs figure out what is happening & join in on the "fun." However, at two miles I began to feel some sharp pains in both of my heels. I decided to see if I could continue through the discomfort; perhaps the plantar tendons would loosen up enough to let me finish the run. At two-and-a-half miles my gut decided to join in on the chorus of complaints. Game over. Shut it down. Walk it home. Call it a day.
The law of cause-and-effect rings true in running: For every action we take, there is the opportunity for the body to exert an equal & sometimes opposite reaction...which it will if certain laws are not followed. Running places stress on our body, which it learns to adapt to over time. After a while, the stress which caused us to lay on the couch all afternoon only tires us for an hour or so; eventually we get stronger because of the stuff we first thought would kill us. See? Nietzsche was right! This is essence of training - we throw our body little curveballs to make it stronger.The problem when we start running is, we feel too good about the first stresses & overestimate how much the body can take. That's why new runners eventually get dinged up, & old runners (like me) occasionally nurse overuse injuries - plantar fasciitis, achilles tendonitis, iliotibial band syndrome & patellofemoral joint pain, just to name a few - when we make a few too many changes in our training plan before thinking about the effect. Add some hill repeats or bridge running when you're used to training on the flats, or increase the intensity or mileage beyond the level your body can stand, & the next thing you know you are gobbling ibuprofen like it's candy.
Here's a list of some of the most common running-related (overuse) injuries, causes & treatments:
Symptom: Swelling & pain around joint (i.e., ankle).
Possible Diagnosis: Sprain.
Possible Cause: Applying weight to foot in a rolled position, while running or jumping on an uneven surface.
Treatment: Rest, ice, compression & elevation for 7-10 days. Anti-inflammatories to reduce pain and inflammation. Gradual progress to weight-bearing exercise as tolerated. See a doctor if injury does not respond to treatment in two weeks.
Symptom: Pain at back of ankle.
Possible Diagnosis: Achilles tendinosis.
Possible Cause: Tight or weak calf muscles. Too much training, hill running or speedwork. Excess stretching can aggravate the problem.
Treatment: Reduce/stop hill/speed work. Gently stretch calves after exercise, & ice the tendon area. Strengthen the calf muscles (toe raises, balancing on your toes, wall stretching). Cross train on some “easy” days.
Symptom: Muscle pain, soreness or stiffness.
Possible Diagnosis: Delayed onset muscle soreness.
Possible Cause: Microscopic tearing of the muscle fibers from exercise. Eccentric muscle contractions, like downhill running, going down stairs, and squats cause this most.
Treatment: Rest, ice, compression and elevation for 7-10 days. Anti-inflammatories to reduce pain and inflammation. Drink more fluids.
Symptom: Pain along the outside of the knee and lower thigh, especially when going down stairs or getting up from a seat.
Possible Diagnosis: Iliotibial (IT) band syndrome.
Possible Cause: Common in runners who run only on one side of a crowned road. Biomechanical abnormalities, muscle tightness or lack of flexibility in the gluteal (buttock) or quadriceps (thigh) muscles.
Treatment: Rest, ice, compression and elevation. Anti-inflammatories to reduce pain. Decrease mileage. Consider a physical therapy visit for leg strengthening exercises.
Symptom: Pain under or around kneecap, worsening with activity, while descending stairs, etc.
Possible Diagnosis: Patellofemoral pain syndrome.
Possible Cause: Likely the way the patella tracks along the groove of the femur, depending on muscle strength and balance, use, & tracking. This means the cause may be from a variety of different factors, to include muscle imbalance & shoe breakdown.
Treatment: Rest. Non-impact exercise, like swimming. You may want a physician or physical therapist to coordinate your treatment with additional strengthening & stretching.
Symptom: Pain under the glute/buttocks.
Possible Diagnosis: Piriformis syndrome
Possible Cause: Shortening of the muscle and compression of the nerve. Overuse of glutes & other hip muscles can also cause piriformis muscle spasms. Other factors include gait problems, poor body mechanics & posture.
Treatment: Stretching & strengthening of the core and glutes & the best treatment for piriformis syndrome.
Symptom: Pain in the heel, especially during the first steps in the morning/of a run.
Possible Diagnosis: Plantar fasciitis
Possible Cause: Flat feet, high arches, excess pronation, weight gain, tight achilles’ tendons, sudden changes in workout intensity/time/type/surface, poor shoes.
Treatment: Nonsteroidal anti-inflammatory drugs. Stretch the achilles’ tendon. Massage the sole, achilles’ tendon & calf with a roller. Walk/run in proper footwear – no barefoot walking or running.
Symptom: Pain at front of lower leg, along shin bone.
Possible Diagnosis: Shin splints.
Possible Cause: Improper stretching, lack of warm-up, hard surfaces, improper footwear, biomechanical problems.
Treatment: Rest, ice, compression & elevation for 7-10 days. An anti-inflammatory can help reduce pain & inflammation. Gradual progress to pain-free weight-bearing exercise. See a doctor if injury does not respond to treatment in three weeks.
So when it comes to increasing the amount of mileage or time you spend running, the best rule is to not increase by more than ten percent; and that ten percent should be stretched across the week as much as possible. When looking at pace and effort, the percentage of maximum heart rate multiplied by time can provide a training stress score which can be tracked over time. Lastly, when dealing with hill/bridge repeats, err on the side of caution; easy paces and cautious increase in volume.
If at first you don't succeed in learning how to wisely increase your workout volume, don't worry. Your body will let you know it's time to try, try again.
Here's a list of some of the most common running-related (overuse) injuries, causes & treatments:Symptom: Swelling & pain around joint (i.e., ankle).
Possible Diagnosis: Sprain.
Possible Cause: Applying weight to foot in a rolled position, while running or jumping on an uneven surface.
Treatment: Rest, ice, compression & elevation for 7-10 days. Anti-inflammatories to reduce pain and inflammation. Gradual progress to weight-bearing exercise as tolerated. See a doctor if injury does not respond to treatment in two weeks.
Symptom: Pain at back of ankle.
Possible Diagnosis: Achilles tendinosis.
Possible Cause: Tight or weak calf muscles. Too much training, hill running or speedwork. Excess stretching can aggravate the problem.
Treatment: Reduce/stop hill/speed work. Gently stretch calves after exercise, & ice the tendon area. Strengthen the calf muscles (toe raises, balancing on your toes, wall stretching). Cross train on some “easy” days.
Symptom: Muscle pain, soreness or stiffness.
Possible Diagnosis: Delayed onset muscle soreness.
Possible Cause: Microscopic tearing of the muscle fibers from exercise. Eccentric muscle contractions, like downhill running, going down stairs, and squats cause this most.
Treatment: Rest, ice, compression and elevation for 7-10 days. Anti-inflammatories to reduce pain and inflammation. Drink more fluids.
Symptom: Pain along the outside of the knee and lower thigh, especially when going down stairs or getting up from a seat.Possible Diagnosis: Iliotibial (IT) band syndrome.
Possible Cause: Common in runners who run only on one side of a crowned road. Biomechanical abnormalities, muscle tightness or lack of flexibility in the gluteal (buttock) or quadriceps (thigh) muscles.
Treatment: Rest, ice, compression and elevation. Anti-inflammatories to reduce pain. Decrease mileage. Consider a physical therapy visit for leg strengthening exercises.
Symptom: Pain under or around kneecap, worsening with activity, while descending stairs, etc.
Possible Diagnosis: Patellofemoral pain syndrome.
Possible Cause: Likely the way the patella tracks along the groove of the femur, depending on muscle strength and balance, use, & tracking. This means the cause may be from a variety of different factors, to include muscle imbalance & shoe breakdown.
Treatment: Rest. Non-impact exercise, like swimming. You may want a physician or physical therapist to coordinate your treatment with additional strengthening & stretching.
Symptom: Pain under the glute/buttocks.
Possible Diagnosis: Piriformis syndrome
Possible Cause: Shortening of the muscle and compression of the nerve. Overuse of glutes & other hip muscles can also cause piriformis muscle spasms. Other factors include gait problems, poor body mechanics & posture.
Treatment: Stretching & strengthening of the core and glutes & the best treatment for piriformis syndrome.
Symptom: Pain in the heel, especially during the first steps in the morning/of a run.Possible Diagnosis: Plantar fasciitis
Possible Cause: Flat feet, high arches, excess pronation, weight gain, tight achilles’ tendons, sudden changes in workout intensity/time/type/surface, poor shoes.
Treatment: Nonsteroidal anti-inflammatory drugs. Stretch the achilles’ tendon. Massage the sole, achilles’ tendon & calf with a roller. Walk/run in proper footwear – no barefoot walking or running.
Symptom: Pain at front of lower leg, along shin bone.
Possible Diagnosis: Shin splints.
Possible Cause: Improper stretching, lack of warm-up, hard surfaces, improper footwear, biomechanical problems.
Treatment: Rest, ice, compression & elevation for 7-10 days. An anti-inflammatory can help reduce pain & inflammation. Gradual progress to pain-free weight-bearing exercise. See a doctor if injury does not respond to treatment in three weeks.
So when it comes to increasing the amount of mileage or time you spend running, the best rule is to not increase by more than ten percent; and that ten percent should be stretched across the week as much as possible. When looking at pace and effort, the percentage of maximum heart rate multiplied by time can provide a training stress score which can be tracked over time. Lastly, when dealing with hill/bridge repeats, err on the side of caution; easy paces and cautious increase in volume.
If at first you don't succeed in learning how to wisely increase your workout volume, don't worry. Your body will let you know it's time to try, try again.
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