Coping with Injury

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These are my thoughts and suggestions on coping with injury as a runner.

  • The mind and injury
    • Admit the Problem. To deal with an injury, you first have to admit the problem exists. It is easy to ignore a nagging injury until it becomes catastrophic. Be honest with yourself.
    • Stay Positive. There is anecdotal evidence that a positive mental attitude can help with healing. Being positive also makes it more likely that you will take reasonable steps and maintain control of your situation.
    • Rely on Friends. Get support from your social network and use their advice (with discernment). Knowing someone understand how you feel can bring comfort and help you stay positive.
    • Have Faith. There is evidence that faith is correlated with longevity, health and psychological well being. I believe that prayer for healing can be effective.
    • Battle Your Demons. If tapering tends to produces a kind of psychosis, then injury tends to be even worse. Understand and acknowledge the psychological problems you are having. It's critical you don't give in to despair. I am a big believer in counseling for many of the problems that are encountered in life.
  • Seek Heeling
    • Be Your Own Physician. I believe that you should take responsibility for your health. This does not mean ignoring professional medical advice, but rather that you do not accept that advice blindly. Others are likely to have vastly more knowledge and experience than you do, but you can spend more time focused on your particular problem. Don't be a passive participant in your healthcare, but actively engaged.
    • Research the Problem. Spend time researching your injury on the internet, reading widely, and using discernment to evaluate the value of each piece of information. Beware Confirmation Bias and Illusory superiority.
    • Seek Professional Help Early. Getting professional help will give specific advice on your problem, but choose your professional carefully. I recommend that you ask lots of other runners for their experience and recommendations. Having a professional who is themselves an athlete makes a big difference, as they are more likely to understand your problems and objectives.
  • Limit the Consequences
    • Limit Weight Gain. One of the problems of being injured is weight gain, which needs to be limited to prevent a corresponding degradation in fitness. Weight is easy to gain and hard to lose, so try to limit your calories to offset the drop in energy expenditure. Don't try to avoid any weight gain, as this could impair heeling.
    • Nutrition is Critical. Poor nutritional quality can also limit the body’s ability to heal, as can a restricted calorie intake. So nutrition becomes a balancing act, between getting the nutrition needed for heeling with restricting calorie intake to limit weight gain. The focus should be on food that is nutritionally valuable without too many calories. I would suggest focusing a higher intake of quality Protein, along with a high intake of Omega 3 oils (including fish if possible) to ensure the body has the raw materials to rebuild. A supplement of vitamins and minerals can also be appropriate as insurance. For stress fractures for instance, ensuring a high quality Magnesium and Vitamin D3 intake, along with Calcium can ensure that bones can be rebuilt.
    • Cross Train with Care. Cross training can help offset the loss of fitness that can occur with injury. However, if you do not normally cross train, then it is easy to incur another injury by overdoing an exercise you are not used to. Don't try to do a new form of exercise with the same intensity that you would apply to your running.
    • Understand Loss of Fitness. The loss in fitness that occurs when you are injured will depend on how much you reduce your exercise and for how long. Total bed rest (such as post-surgery) can produce a rapid loss in fitness, but limited exercise, even with reduced intensity and duration, can offset this loss. It seems that fitness that can be lost in a short period can be regained in a short period, so a week or two of partial rest can be recouped in a week or two. (Weight gain can harder to undo.)
    • Evaluate Your Plan. If you have a training plan for a specific event, you need to evaluate the impact of an injury. Ideally your plan should have enough slack to allow for a week or two of reduced training and still be ready for your goal. You should not try to continue a plan that has increasing load over time as if you were not injured. You should probably not even continue where you left off, but rather, you should change your plan to accommodate the time off.
    • You Can't Make Up Lost Time. If you lose a couple of weeks from your training plan, trying to work extra hard to 'make up the time' is more likely to cause another injury than to produce benefits. Instead, adjust your plan and your goal.
    • Active Care. For many injuries there are actions you can take to improve your healing. The psychological problems of being injured can make it hard to take the actions that are needed.
    • Rest Appropriately. Some injuries require complete rest, but others require either a reduction in activity or will allow cross training. There is even evidence that some injuries do not heal correctly with total rest, as a small amount of stress is needed for correct repair. This is especially true of tendon injuries, as a limited stress will align the new tendon material. Without that stress, the tendon will heel weaker.
  • Don’t let it happen again
    • Root Cause Analysis. Fixing an injury without working out what caused it is only a temporary fix. Did you do 'Too Much Too Soon"', is your Cadence too low, is there a muscle imbalance, etc.?