So, How Many Hats Do You Wear?

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Pensacola, Florida, United States
Husband. *Dog Dad* Training Specialist. Runner. Triathlete (on hiatus). USATF LDR Surveyor. USAT (Elite Rules) Certified Official, Category 2. RRCA Representative, Florida (North). Observer Of The Human Condition.

Thursday, April 25, 2013

Put A Different RICE In Your "Diet"

"Achilles tendonitis..."

I turned in the direction of the voice.  Valentino, in a voice which seemed almost a laugh, said again, "Achilles tendonitis!" 

"You?"  I asked.

"Yeah, me.  I suspected that's what was wrong.  I could feel it when I got out of bed the past couple of mornings; all the popping noises and such."

"It's a sign we're getting old, man.  Our breakfast cereal is supposed to make noise, not our body," I replied. 

I'm not into schadenfreude, the concept of having joy at the misfortune of someone else, but it did seem a little bit ironic.  Val's also a running coach; he specializes in sprints at the high school and Junior Olympic level.  During my autumn of pain, he would shout angrily when I would limp into the office the day after my own track workouts -- workouts which had intensities or distances too much for my fifty-year-old (still-injured) tendons to endure.

So, Val has appointments with the base medical clinic, the physical therapist, base pharmacy and the like.  But he's going to keep running because he's stubborn...and he hates cross-training.

When runners think about injuries and their treatment, most of them have heard of the mnemonic RICE: Rest, Ice, Compression, Elevation.  While this treatment method works well for the discomfort of soft tissue injuries, it's not a cure, and isn't as effective when we begin to talk about the more common overuse injuries from which runners suffer.

The same mnemonic, RICE, can be used to treat the cause of injuries like achilles tendinosis, plantar fasciitis, iliotibial band syndrome, patellar tendinosis, and the like.  Unlike the soft tissue RICE, this RICE stands for: Reflect, Identify, Correct, Evaluate.

Reflect - stop and think:  Has there been a sudden change in the run/workout routine?  Have I added distance, changed terrain, altered surface, or increased intensity?  When did I purchase this pair of running shoes?

Identify - what are the most-likely causes for the damage?  In the case of overuse injuries the culprit usually begins with "too:"  Too much speed work.  Too much added distance.  Too little recovery.  Too old shoes.  Too many hills.  Too many crowned or bad surfaces.

Also, take the time to identify what sort of exercise you can do to replace running for the next few weeks; you might lose some cardiovascular fitness during this period, but exercise which does not aggravate the present damage will allow blood to continue to flow to the injured area, continuing the healing process.  Anti-inflammatory drugs can be taken to ease swelling but shouldn't be taken to mask pain just so you can go out and run...remember the discomfort/pain is a message that something is injured and needs to heal.

Correct - what can you do to keep this injury from reoccurring?  A lot of overuse injuries are the result of a musculoskeletal imbalance or a muscular weakness, leading to compensation by a connecting part of the body which was unable to handle, or recover from, the increased strain.

Evaluate - is there really a need to train at the level which caused the injury in the first place?  If the root cause of the injury is strictly to do with poor equipment then I would recommend a gradual return to the training regimen where no pain existed.  If terrain, mileage, intensity or surface changes were the cause, then consider very conservative changes or increases, giving the body sufficient time to recover and adjust to the new stress.  If the cause is too little recovery, then you'll have to figure out a way to assist the recovery process either by taking a day off, engaging in "active rest," or implementing modalities like self-massage, massage therapy, compression garments, stretching and so on.

So, when it comes to injuries, you still need to remember the RICE mnemonic, but it's a completely different form of RICE.  Reflect.  Identify.  Correct.  Evaluate.

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