I am trying to run primarily on trails due to the modulation in pace from obstacles or rocky terrain. I think this is helping me avoid re-injuring my knee. (itb and patellar tendinitis) I run in different shoes and different distances on different paths. I also do a shorter, fast run on pavement weekly.

Are there other things you recommend people do when they have a knee that isn’t cooperating?

If you have a similar problem as Mike, then he is following a great plan by working in as much trail work as he can. It’s definitely a better way to stay healthy, whether you have had previous knee injuries or not. I’ve actually written a few articles on that very topic (Benefits of Trail Running, Trail Running for Road Runners, Trail Running 101.)

When it comes to knee problems, I do have one additional suggestion and one thing to watch out for based on what Mike said in his email.

First, I’d recommend working in some weight training to strengthen your muscles. You can do body weight exercises so you don’t need an expensive gym membership or to go out and buy a lot of equipment; functional movement that hits a lot of different muscles at once are best and if you do need more resistance then you can use every day objects or buy something cheap like a 50 or 60 pound sandbag at your local home improvement store.

Some exercises that are worth doing include squats (both double leg and single leg), pushups, lunges, deadlifts and pull ups. Bodyweight lunges and squats are probably the best place to start given your concerns about your knee.

One thing that you want to watch out for, especially if you have a history of knee problems, is switching out shoes that are too dissimilar.

I use a lot of different types of shoes, mostly depending upon where I’m running, but most of those shoes are pretty similar one to another; they are neutral shoes with a minimal (or non-existent) heel lift.

A few years ago, though, I was switching between heavier shoes with a lot of cushioning and ultra-light weight minimal shoes from day to day to day, and my hips started to bother me as a result because my body didn’t know what to make of the situation. (Plus, the heavy shoes just weren’t appropriate for me.) Switching back to just one general type of shoe made that problem go away within a few days and I still got the advantages of variety by using different models of shoes.

If you aren’t feeling any pain right now then you are probably fine with your current shoe choices, but I just wanted to make sure that I mentioned it.

Have you got a training question that you’d like answered? You can contact me here on the website, or ask a question right on the wall for my facebook fan page (which is probably the quickest way to get a response.)

There were 3 different stretches that they used (technically 4 since the last stretch had 2 parts.) The subjects that were going to be stretching were supplied with a detailed stretch protocol that included the photographs of the stretch, as well as images of what they were supposed to be doing.

This video demonstrates how to do the full stretching regimen:

(Download This Video)

Quadriceps

The first stretch was a quadriceps stretch. From a standing position you need to grasp your foot or ankle on the same sided leg, and then pull your foot gently up towards your butt.

You steady yourself with the opposite hand, and then you can lean back to increase the stretch if you want to. Without bouncing, hold that stretch for about 10 seconds and repeat 3 times for each leg.

Hamstring

The second stretch was for your hamstrings. From a standing position, place the leg to stretch somewhere that you can elevate your leg.

Lean forward over your thigh and try to reach your foot. Again, without bouncing you want to hold that stretch for about 10 seconds and then repeat 3 times for each leg.

Calf/Achilles

The third stretch was for your calf and achilles. From a standing position, you want to lean forward with the leg to be stretched straight out behind you, foot flat on the ground.

Keep your knee near straight for a full 10 seconds, and then flex the knee and repeat the stretch with the knee bent for 10 seconds. Again, there should be no bouncing and you want to repeat that 3 times for each leg.

(Better) Quadriceps

If you want to do this routine yourself, I would make one small change with the quadriceps stretch. Instead of using the same arm as the leg that you’re stretching, I would actually use the opposite arm.

For your right leg you would want to stretch your leg using your left arm, and for your left leg you would want to stretch it with your right arm.

The reason for that is that it puts a lot less stress on your knee because it’s a much more natural movement for your knee to be going across your body a little bit instead of having it come straight up in towards the outside. You are much less likely to strain your knee to a point where you might get hurt.

Of course, if you aren’t currently stretching before your runs, you may not want to start stretching. The results of the USATF study seem to find that for people that aren’t currently stretching, a pre-run stretch isn’t likely to improve your ability to avoid injuries.

(Stretching Study: USATF & Run to Win – Photo Credits: Humphrey the Camel & Blaine Moore)

The results of their summary can answer that question in two words:

Not really.

Here’s a video explaining the results:

(Download this Video)

The researchers weren’t able to really see a correlation between runners that stretched and runners that didn’t stretch. In fact a lot of the markers they expected to find playing a role in how likely you we’re to be injured really had no bearing on how likely you were to get injured. Some of those markers include:

• Gender
• Weekly Mileage
• Flexibility
• Level of Competition
• Age (Youth vs Masters runners)

They only found two really relevant markers that made increased your risk of injury:

• High body mass index
• Previous injury (more recent means more likely to get injured again)

No one in the study had had an injury within 6 weeks of when it started, which
is one of the controls that they used, so recent in t his case goes back about 3 months before the study had taken place.

The only other marker that they could really find an increased risk of injury in were people who were used to stretching before they went out for their runs but were assigned to the “don’t stretch before you run” control group.

The general take away from this study is that if you are used to stretching before your runs, you should definitely keep stretching. But if you aren’t used to stretching, there’s no real reason to start if what you’re concerned about is preventing injuries.

From my own personal experience I’ve found that stretching after a run does a far greater job of helping you recover from your runs and preventing injuries, as well as improving your performance in future runs, than stretching ahead of time.

The best advice that I can offer is to just get in a gentle warm up and make sure you’re not just going straight into a workout with cold muscles. Take a little bit of time afterwards to stretch out or self-massage on any of your sore parts when you are done running.

(Study Findings Available at: USATF – Photo Credits: Lululemon Athletica)

I felt myself losing my footing and tried to roll so I’d land on my side instead of my face (I’d rather break a shoulder than a neck) and while I wouldn’t have been too happy I was doing all right until my head got stopped by a tree stump.

Thankfully, no signs of concussion and a mountain biker came upon me a few minutes later and helped me bandage up my head so that I could run the 2 or 3 miles out of the woods back to the car. He followed me back up the trail until we found my wife and then she ran back with me and drove me to the ER.

So…what should you do if you fall down while you’re running, and you’ve hit your head?

The first thing you want to do is to just be very careful. You want to stay calm, and don’t panic.

Take a few moments, draw in a few deep breaths and just make sure that you don’t get yourself too worked up and wind up hurting yourself more. You might be dazed or confused and you’ll probably be in quite a bit of pain if you did hit your head.

Once you’ve had a few moments to collect yourself, do a quick self-assessment. Does your neck hurt? Do your shoulders hurt? Can you wiggle your fingers or toes? Do you know what your name is? Do you know where you are, what you’ve had for breakfast, what day it is? Are you nauseated or dizzy? These are some simple things you can do to just check and see if you might have a concussion.

What you’re going to want to do is once you manage to get up, you’re going to want to get yourself somewhere where you can get checked out, especially if you’ve got any signs of concussion or cuts on your head that will probably bleed a lot. You’ll need to get some stitches and want to make sure to get them cleaned out so you don’t get any infections.

If you have any signs of concussions, be very careful about moving around. If you have a cellphone, you may want to just call for help rather than trying to get yourself out of wherever you happen to be. And once you get to the emergency room, they’ll clean you up and they’ll give you the best advice for what you should do next.

(Bloody Photo Gallery is available on Facebook)

Last week, we got a pretty good sized snowstorm to come through our area and leave behind about 15 inches of wet, heavy snow. It was perfect for making snowmen, but not so good when you needed to get your car out to go to work. It was a beautiful and warm day, too, so the longer you waited to shovel the heavier the snow was going to get.

I figured that I had 3 options:

1. Shovel enough to get my car out, and let my wife do the rest of the driveway.
2. Shovel enough to get my car out, probably be late to work, leave early, and then spend all night shoveling the now heavier snow that’s beginning to freeze.
3. Call in to work, take a personal day, spend the morning shoveling and the afternoon running.

Tough decision, right?

My wife is in her last semester of law school and doesn’t have time to spend all day out shoveling with 2 papers and an exam coming up.

I hate shoveling in the dark, especially now that the snowbanks are higher than my outdoor lights and I have to use a headlamp to see by.

So, I called in.

Erin and I spent about 3½ hours shoveling snow, and a few hours later I got out for a quick hour on foot after the plows had pushed the snowbanks back. All in all, it was a great day.

At least, it was a great day until I went to bed. I was laying in bed, turned my head to look towards the door, and managed to pull a muscle in my neck.

It wasn’t as bad as my birthday back in 2006, when I sat up and heard a loud crack only to find myself on my back staring at the ceiling and having a few moments to think, “This can’t be good…” before the pain set in. That took me out for months; this time it was only a few days.

Now, back to the training logs.

This was the third time that this has happened to me, the second time being last Summer. I remember that first time pretty vividly, as I was pretty naive and thought that I’d broken my neck. (Erin had heard the crack my neck made from the next room.) I couldn’t quite remember when the second time was, but my training log came the rescue.

Because I record all of my workouts and the conditions I run in, and I track how often (well, how seldom) I get injured, I can usually go back over my log and see exactly what it was that led to my getting hurt. This lets me see the similarities and avoid repeating any stupid things that I might be doing so that I don’t get hurt again.

For example, it snowed again yesterday. I didn’t have to spend as much time shoveling, but since the first and third times I hurt myself I had spent a lot of time doing a shoulder workout and then ran out in the cold, I decided that a few hours of shoveling could substitute as my workout for the day.

Another nice thing about being able to look at the training log is to see exactly how long I was out.

Last week, my neck wasn’t hurting nearly as much as the first time I hurt myself, and the second time I only missed 2 days of running.

It was nice to be able to look at my history and know definitively that I could bounce back pretty quickly without being much the worse for wear.

Looking at graphs of your training volume and being able to search for specific workouts are great. The single largest benefit of keeping a training log, though, is to track how your training affects you and to look at your historical data so that you can learn from your mistakes. You can also learn from your successes; repeat what works and stop doing the things that hurt you.

The log won’t lie, and it’s memory will be much better than yours.

Do you have any stories about how you’ve looked back over a training log and learned something useful? If so, I’d love to hear about it in the comments below!

(Image & Photo Sources » Running Ahead – Blaine Moore – Martin Kingsley)

In fact, according to Running Research News, almost twice as many research studies advise against stretching compared to those that advocate stretching. A recent article of theirs listed quotes from recent studies that they had gone through, with 14 quotes advising against stretching while only 8 quotes could be construed as advising stretching. There were 4 inconclusive quotes.

I’ve included their list of quotes below, since the format from the original article is really difficult to read and follow. I’ve asked them for a list of the studies where these quotes were pulled from for future reference:

Research/Arguments in favor of Stretching for Injury Prevention

1. Improving flexibility through stretching is another important preparatory activity that has been advocated to improve physical performance.
2. Experts in the field of training and conditioning agree that good flexibility is essential to successful physical performance, although their ideas are based primarily on practical experience rather than experimental evidence.
3. Maintaining good flexibility aids in the prevention of injuries to the musculoskeletal system.
4. Current sport research shows improving flexibility or increasing joint ROM is significant in its contribution to movement efficiency, amplitude of movement, and prevention of soft tissue injury.
5. Athletic trainers and physical therapists feel that maintaining good flexibility is important in prevention of injury to the muscle and tendon.
6. Our statistical analysis indicates an association between using a static stretching program and a decreased incidence of muscle and tendon strains in Division III college football players.

Inconclusive Research for Stretching and Injury Prevention

1. No conclusive statements can be made about the relationship of flexibility to athletic injury.
2. Due to the paucity, heterogeneity and poor quality of the available studies no definitive conclusions can be drawn as to the value of stretching for reducing the risk of exercise-related injury.
3. There is not sufficient evidence to endorse or discontinue routine stretching before or after exercise to prevent injury among competitive or recreational athletes. Further research is urgently needed.
4. Static stretching decreased the incidence of muscle-related injuries but did not prevent bone or joint injuries.

Research against Stretching for Injury Prevention

1. In summary, we see no strong evidence proving that flexibility or stretching is associated with rates of strains, sprains, or overuse injuries that can be applied across all sports or levels of competition.
2. New evidence suggests that stretching immediately before exercise does not prevent overuse or acute injuries.
3. Incidence of injury was not significantly different for the experimental and control groups.
4. This intervention was not effective in reducing the number of running injuries.
5. There was no significant effect of pre-exercise stretching on injury risk rate between the stretch group and the control group.
6. A typical muscle stretching protocol performed during preexercise warm-ups does not produce clinically meaningful reductions in risk of exercise-related injury in army recruits.
7. In this study the number of lower extremity overuse injuries was significantly increased in infantry basic trainees with increased hamstring flexibility.
8. Injured runners were more likely to have stretched before running.
9. Although stretching to increase flexibility is widely recommended to prevent training injuries, data to support the practice are lacking. Our data indicate that both the most flexible and least flexible individuals are at higher risk of lower body injuries. Subjects in the least flexible and most flexible quintiles were 2.5 and 2.2 times more likely to get injured than subjects in the middle quintile.
10. The results of this review do not support the role of pre-exercise or postexercise stretching as an intervention addressing postexercise muscle soreness. In addition, the evidence presented in this review does not support the role of pre-exercise stretching in the reduction of lower extremity injury risk.

Research/Arguments in favor of Stretching for Performance Improvement

1. Our results show that stretching may favorably influence the force-velocity relationship of the trained muscle as well as the shape of the torque curve during movements at a given velocity.
2. Regular stretching improves force, jump height, and speed, although there is no evidence that it improves running economy.

Research against Stretching for Performance Improvement

1. Greater flexibility may impair performance in sports that do not require a high degree of flexibility such as running. Runners with less flexibility are actually more efficient at running.
2. Intense static stretching may reduce maximum force production. The loss of voluntary strength and muscular power may last up to one hour after the static stretch.
3. Based on these results, performing stretching before a vertical jump test would be detrimental to performance.
4. Observations by coaches and athletes have called into question the universal prescription of stretching for the purpose of enhancing sport performance, and this skepticism is being supported by the growing body of empirical data.

(More Info: Running Research News)

Her training had been going really well, she was just entering her taper, and she really didn’t want to quit running a mere week before her marathon. I told her that they’ll make another marathon and that she was better off listening to her doctor in this instance. She had a specific problem that running was going to exacerbate and the best way to get rid of the problem was rest.

She decided to follow my advice and skipped not only the Boston Marathon but also the Vermont City Marathon, which she had considered trying to jump into a month later. In fact, she took 8 full weeks away from running. What was the result? Well, I’ll let her tell you herself (emphasis mine):

Hi,

Just thought I’d give you an update, and thank you once again for all your advice this past spring. Instead of pushing it, I ended up taking 8 weeks off from running to allow the foot to start healing. I then set my sights on a fall marathon, and ran Philadelphia this past weekend. I ended up with a PR, 3:55 (first time I ever broke 4 hours) and qualified for Boston with 20 minutes to spare!

So thank you again for your advice about Boston, I’m glad I took it – even though I didn’t like it at the time! But it did pay off!

Thank you!

I have no problem with you doing a follow up or using my comments, especially if it can help someone else see that taking time off is not the end of the world, and in the long run can actually help. I read on RA all the time about people dealing with PF for months, and even years. My doctor had warned me it could be up to year especially if I kept trying to run thru the pain.

Instead, I dealt with the problem, then came back stronger then ever. After 2 months off, I was only able to get 5 months of training in before the marathon, but still PR’d by 7 minutes.

Great race, very well run. Little cold at the start, 26 degrees! This was my 13th marathon, and my favorite course. I was running with my training partner, and friend. She ran this course 2 years ago, so she knew where the historic sites were and pointed them out as we went along. It was flat enough to be a fast course, but with enough hills thrown in to give your legs a little break. I also enjoyed the out and back so that you could watch the front runners. Of course the crowds weren’t as large as in Boston, but they certainly were enthusiastic.

I did take the first mile a little fast, then settled down to a good pace, and never fluctuated more then 6 seconds each mile. Even though it was cold, I made sure to hydrate at each water stop, plus with all the ice on the road from the thrown cups, you really did have to slow down as you went thru each stop. I’ve never felt better during a marathon, I even picked it up for the last half mile passing quite a few runners.

I was surprised when I checked the results today and found out I placed 4th in my age group! The finisher pictures in front of an American flag at the end were a nice touch, and the hot chicken broth really hit the spot! It was a painful 1.2 mile walk back to the hotel, but 2 days later I feel fine and ready to run again!

– Jane

Congratulations on a great race in Philadelphia, Jane, and I’m glad that you were able to rest up from your over training and use that as a base to start a new (injury free) season.

Sometimes we push our bodies so hard and for so long that the best thing that we can do is to just step away for a little while and let some recovery happen, and then to allow ourselves enough time to build our base back up while we train for our next goal event.

I’m glad that it worked out well for Jane and that she ran such a great time in Philly, and I hope that if you ever get a serious injury that you can also have such great success.

If you have any stories about your own injuries and how you overcame them (or they overcame you) then I’d love to hear them, either in the comments below or in an email.

(Photo Credit: Ed Yourdon)

Table of contents for 2nd Maine Cross Country Clinic

1. 2^nd Annual Maine Coach & Athlete Cross Country Clinic (Part I: Injury Prevention and Treatment)
2. 2^nd Annual Maine Coach & Athlete Cross Country Clinic (Part II: Nutrition Basics & Fueling for Performance)
3. 2^nd Annual Maine Coach & Athlete Cross Country Clinic (Part III: Biomechanics & Footwear)
4. 2^nd Annual Maine Coach & Athlete Cross Country Clinic (Part IV: Meet the Athletes)
5. 2^nd Annual Maine Coach & Athlete Cross Country Clinic (Part V: The Athlete’s Panel)

The 2^nd annual Maine Coach and Athlete Cross Country Clinic was on August 18th, 2008 at the University of Southern Maine. The clinic lasted for about 2 hours, although most of the speakers and coaches were available before and after the clinic for questions.

The clinic was sponsored by John Rogers of the Maine Running Company. The panel brought together some of the best local experts and some native-Mainer professional runners and their teammates to talk on various topics relating to a high school cross country athlete. This year’s clinic did not touch on the coaching aspect nearly as much as it did last year, and just about the entire clinic is relevant not only to high school cross country runners but also to anybody that enjoys getting out to train and race.

I took a lot of notes, so I am going to be splitting up them up into functional parts which will be published throughout the week.

Injury Prevention and Treatment

Starting the night off was a discussion from a physical therapist. His talk focused on 2 key areas, training consistency and common traits amongst injured runners. He only sees the injured athletes, so his advice is geared towards making sure that he never has to meet you.

The most important thing to training is that you have a consistent schedule year round and that you don’t take significant stretches of time off from getting at least some sort of exercise, preferably sport-specific such as running. Cross country is a short season that is only 8 to 10 weeks long, so if you take the Summer off from running then you aren’t going to have the conditioning that you need in order to get into shape to race during the season.

Be up front and honest with your coaches and trainers. Let them know what kind of conditioning you have when you show up for preseason to help them develop a training plan for you. If you tell them that you have gotten in all of your base training and they start having you do speed work, then you are more likely to get injured because your body isn’t ready for that level of stress. If you are injured, you won’t be able to compete or train. It is far better to let your coach know if you need some time to get conditioned so that you can still race well at the end of the season and avoid overtaxing your body too early.

If you do start to feel some aches and pains, then let the coach and your trainers know. They can help you assess whether you are coming down with an injury that can be prevented with some rest or whether your aches and pains are just a normal byproduct of your training.

The most important way to avoid injuries is to be consistent throughout the year. Mixing in some cross training in your off seasons can give you a needed break to recover from your track season and help you keep your fitness levels up. You will stay in shape and you’ll have some fun.

Some of the best cross training that you can do is strength training and core training. A strong core allows your muscles to pull off of a firm surface, which is analogous to running on a track. A weak core is inefficient and is more like running on a sandy beach at high tide.

You will still need to spend time running over the Summer. With a short cross country season, you don’t really have time to get all of your base training in during the season. Base training can take as long as 10 weeks.

If you do get hurt or injured, then let your coaches know as soon as you notice a problem. Your mentality (and that of your coach’s) should be to get back to your sport as soon as possible, but not at the expense of getting back safely. Spend your recovery time doing non-impact cross training such as the elliptical machine or pool running.

If you are injured, then chances are good that you have at least some of the following traits:

1. You don’t like to stretch.
2. You tend to have weaknesses in your butt or your hip, or weakness in your core.
3. You suffer from a lack of flexibility.
4. You don’t pay attention to things from the bottom up and have improper shoes.

He spends a lot of time teaching injured athletes about some basic concepts to help prevent them from coming back and having to use his services again.

The biggest thing you need to learn is the difference between dynamic and static stretching, and when they are appropriate to use. Before workouts, concentrate on dynamic stretching such as doing butt kicks, high knees, or high knee walks. Focus on your large muscles such as the hip flexors or your glutes to work on your balance, warm up your muscle tissues, and prepare your body for doing the workout.

After the workout, do static stretching during or immediately following your cool down within the first 10 minutes. You don’t need to try to stretch as far as possible; you’ll never actually stretch that much during a race. Just stretch out enough to feel the pull and hold it for a brief moment.

Another concept to embrace is using a foam roller or massage stick. These tools will allow you to get in deep and break down your muscle tissue between workouts, which can help affect the density of the tissue.

“My Anterior Tibialas is tweaking. It’s swollen and unrunnable right now. Needless to say, the record will remain in AT’s (Andrew Thompson) hands.”

Apparently, he got a bad case of poison ivy on his left foot, which caused him to change his running gait enough to cause unnatural stresses on his body that led to tweaking his muscle. He still plans to continue running after taking a little rest and drugging himself up, but he is no longer to make an attempt (this year at least) at breaking the trail record.

While I applaud what he has done so far, 538 miles in 14 days for an average of over 38 miles per day, I have to disagree with his self-medication regimen that he is embarking on. I would avoid Prednisone unless I was in dire circumstances as a general rule, and taking it just to reduce inflammation so you can continue a feat like this doesn’t strike me as the best of ideas. At least he has conceded the attempt at the record and won’t try to push himself too far beyond his limits in continuing the record attempt.

I hope that Karl gets another opportunity to make the record attempt in a year or two, and I’m sorry that he had to take time off after 2 weeks of running. If you’d like to track Karl’s latest updates, he is keeping all of his relevant info at his website, Where’s Karl.com.

(More Info: KarlMeltzer.com – Photo Credit: Matt Hart)

That meant that it was time to try running again this afternoon. I ran a few miles easy with my wife, then picked up the pace when we got to a place in the road where we couldn’t run next to one another safely anyway. I wound up adding 4 loops to the normal route that we were on, which turned an 8 miler into a 12.5 miler. My neck actually felt much better after the run than it did beforehand, which is a definite relief.

I didn’t make my weekly distance quota (95.5km ran of a minimum 100km in store and a preferred 110km penciled in,) but I came close enough and I was so exhausted all weekend that I’m sure the multiple naps helped me heal. This evening’s run leads me to believe that I can get back to my normal running routine tomorrow, although I am going to take a week off from any weight training.

I don’t feel that my training plan has been impacted at all by this minor injury, and I am looking forward to moving closer to my sub-16:00 5k goal for this Summer. I have also made some plans for my next goal race after the 5k races throughout the Summer and Autumn, a 50 miler on January 3^rd.

“He’s OK, but he felt his groin cramp up and stopped running as a precaution,” said Powell’s manager, Paul Doyle. “He’s not going to take any chances. It’s an Olympic year.”

(More Info: Golden Gala – ESPN)

I didn’t hear any cracks today, and it isn’t nearly as painful, but I managed to tweak or pull something when I started my run today. I was all of about 22 seconds into the run. Now that it is 10 or 11 hours later, it hurts just as much so I don’t expect to run much this weekend, but hopefully it will have improved to the point where I can resume training again next week.

Even so, he is stronger in the 200 meter distance than in the 100 meter distance, and was one of the favorites to challenge Usain Bolt and Asafa Powell at the Olympics. Unfortunately, he pulled his hamstring during the Trials and so he won’t be competing.

“Before I went out on the track I felt a little tightness in my hamstring. So I had kind of a bad feeling. When I came off the curve the first two steps were fine, and then I felt it, sort of a pull, about 40 meters in. Once I was on the ground it didn’t hurt as much as when it happened.”

If you haven’t seen Tyson Gay’s fall yet, here’s a video:

Both Gay and his trainers and coaches are confident that he will be ready to race in Beijing this August. He is still scheduled to compete Aviva London Grand Prix on July 25, and his cramps should not affect him past his 12-14 days of active rest to rehab it.

Gay went through an MRI to determine the extent of the damage he has only suffered a mild strain. He should make a full recovery and still be competitive next month. The fall looked much worse than it actually was, thankfully.

I am looking forward to watching him compete in Beijing. It is too bad that he’ll only be able to run in the 100 meters, but as they said in the video, America’s motto is “What can you do for me today?” and not “What have you done for me in the past?”

(Press Releases: 1 – 2 – 3)

I’m a 54 year old female training for my 7^th Boston. I peaked 3 weeks ago at 60 miles, and ran 45 miles 2 weeks ago, but last week I was diagnosed with plantar fascitis and a heel spur. I was told no running, I’ve been biking for 1 1/2 weeks, anti-inflammatories, lots of stretching & ice, and my PT has been doing iontophoresis treatments on my heel to help reduce the swelling.

I know I probably won’t be able to do another BG on Monday, but do you think I have a chance of running the whole thing? How much endurance have I lost by biking instead of running during my taper? Should I just wait and go for an easy run this weekend and see how it feels? I really hate to miss a Boston Marathon, but I also don’t want to do more damage.

Has something like this ever happened to you? It certainly has for me. Jane emailed me to ask me to be the voice of reason, so I unfortunately had to give her an opinion that I knew she did not really want to hear but probably knew that she should.

Runners can be very stubborn. When I was in high school, I tried talking my coach into letting me race with a broken ankle once. I even purposefully didn’t get it x-rayed for a week so that I’d have a chance to race. The fact is, though, that sometimes racing is just going to do more damage and when you weigh the risks versus the rewards it just doesn’t make sense.

Janet Hamilton, one of the instructors in the RRCA coaching certification class that I attended a few weeks ago, summed up the appropriate response really well. She said that the next time somebody asks you a question similar to what Jane asked me, I should tell them, “They’ll make another marathon.”

The marathon is a distance that you need to respect. Jane was diagnosed with plantar fascitis barely a week ago, so chances are pretty low that she is going to be in any shape to run for that sort of a distance or for that long on her feet without damaging herself further. My wife got plantar fascitis a week or two before she was going to run her first marathon, and she had to scratch the race back when we first met. She had the exact same thoughts going through her head as are going through Jane’s right now.

Right now, I don’t believe that Jane really needs to worry about any loss in her level of fitness. She is an experienced marathoner, and has peaked at 60 miles, so presumably she has been averaging 45+ miles per week for at least the last few months. While Jane may have deconditioned a little compared to a normal taper, she still has a pretty high level of fitness and if she were uninjured but still taking a similar layoff from running she would still be able to run.

I had some very minor plantar fascitis issues a couple of years back, though, and I basically had to take 5 weeks off before I was able to even consider running more than a few miles per week. If Jane’s doctor is saying no running then I would be inclined to agree with him.

Further evidence that Jane needs rest comes from the excessive swelling that she is experiencing. I am not a doctor and have never pretended to be one, but reducing the swelling from an injury may not necessarily be a good idea. Swelling is a necessary evil in order to heal, so constantly eliminating the swelling may prolong the healing process. Since Jane has been seeing her doctor and a physical therapist, they probably have the best idea for what is appropriate for her, but it is something that you may want to keep in mind if you are self-diagnosing your own injuries.

Here is part of Jane’s response after I told her as much (emphasis mine):

Not exactly what I wanted to hear, but it is what expected! I guess I just needed another experienced runner to tell me. I’ve had too many doctors tell me I should give up running at my age so I don’t have a lot of faith in their opinions. [...] I hate to think that my training will go to waste, so was wondering if I would be ready to do Vermont City in 6 weeks. Any thoughts on that idea?

I cringe when I hear of doctors that discourage exercise. I can think of nothing better for somebody at Jane’s age than to run, but then again I can’t think of anything better for anybody of any age. It especially boggles my mind given Jane’s experience of running at least 7 marathons. If your doctor ever suggests that you quit running without a really good reason, you may want to consider finding a new one or at least questioning the doctor pretty closely before following through on his “advice.”

The biggest problem of course comes when you are hurt. As runners, we tend to be pretty set with our tunnel vision and don’t want to skip runs, but sometimes the choice literally might be between a month off or a year off depending upon whether we take the rest our body is telling us we need or if we keep running anyway and wind up doing further damage.

There are two things to bear in mind when you are overcoming an injury. First, you need to give your body the rest that it needs in order to recover. That may or may not involve a complete stop to your daily or weekly runs depending upon the injury, but it will almost certainly require that you at least decrease the duration and intensity of your workouts.

The second trick to overcoming your injury is to determine what caused the injury in the first place. If you do not know what caused your injury, then you are very likely to just get injured again as soon as you restart your training regimen. Any time that I start to feel any aches or pains, I look immediately at my shoes to determine if they are at fault. Are the shoes that I’ve been wearing appropriate to the kind of shape that I am in and the sort of workouts that I am doing? How many miles do they have on them, and are they ready to be replaced? Often times, you can solve most of your problems by replacing old shoes or shoes that are not appropriate for your body type. Problems with your feet can manifest themselves in your legs or even in your hips.

If the shoes are not what is at fault, then the next likely cause will be the way that you are training. If you increase the duration or the intensity of your training before your body has had an opportunity to adapt itself to a level that can handle those sorts of workouts, then you are almost always going to hurt yourself. Especially going into an endurance race like the marathon, it is almost better to be a little undertrained than a little overtrained.

Getting back to Jane’s questions, I do not think that the Vermont City Marathon is necessarily out of her reach as an alternative race to Boston. Then again, I do not think that it is necessarily within her reach either. Looking forward to it as a goal may be worthwhile, but Jane’s first priority should be towards recovering from her injuries. After that, she needs to get back to her training in such a way that she does not reaggravate anything that still may not be at 100% or even cause new injuries. Compensation injuries are not uncommon when you try running on something that is already hurt and you adjust your style of running as a result.

Whether Jane is ready or not will depend upon the severity of her injuries and on how fast she manages to recover. The wiser course may be to start considering a late Summer or Autumn marathon instead, but assuming that she is as addicted to running as most of the runners that I know (including myself) I would not be surprised if she kept Vermont in mind for her next Marathon. Hopefully she will recover well enough to be able to safely run the marathon, and if not then hopefully she will be smart enough to recognize that she is better off skipping it.

If you are fine when you are running, but get numb legs or feet when you finish, then take note of what you do when you finish your run. When I was in high school, I would often head straight to the rest room when I got done running. The toilets were a little lower than they needed to be, and I was cutting off the circulation in my legs. My problem went away as soon as I started standing around for a few minutes after my run before sitting down anywhere, especially somewhere that involved creating less than a 90 degree angle with my legs.

Photo by CAZASCOIf your legs or feet go numb when you are running, then 90% of the time you will have one of two problems. The first cause for numb feet or legs is that you have your shoes laced too tightly. While it is possible that you are cutting off circulation at the ankle, the more likely problem comes from having the laces pulled too tightly near your toes. There is a blood vessel on the top of your foot that can be easily compressed.

Do not make your shoelaces too loose, though, because you will be more likely to trip or give yourselves blisters. What might be too tight one day may make for a perfect fit the next day, depending upon how swollen your feet are before and during your run. It is normal for your feet to swell up to a slightly larger size throughout the day, especially if you spend a lot of time on your feet. They can also swell up a little during a run.

The second cause for numb feet or legs has to do with your shoes. Do your shoes fit properly? Are they a half size or full size too small or too large? Are they new shoes or do they have a few miles on them? When you bought your shoes, did you have running socks with you and wait until later in the day to try the shoes on? Did you seek the help of an expert at a specialty running store?

Improperly fitting shoes can easily lead to numbness. They can cut off circulation and/or apply pressure at points on your foot that does not really work well with your specific biomechanics. You may not even feel any problems with your feet; biomechanical problems caused by your shoes can travel up your leg and manifest in your ankles, calves, or knees. Your biomechanics can change as you get into better (or worse) shape throughout an exercise program, especially if you experience a large weight change or change in body composition.

A third problem with numb legs may be related to trauma, but these reasons are far less likely than tight shoelaces or improperly fitting shoes. Jim Manatel had to stop running after he damaged a nerve during a run after overtraining his body and not stretching enough after his runs.

If numbness persists anywhere in your body for any length of time, you should visit your doctor and get the problem diagnosed. Like many illnesses or injuries, early treatment (or prevention) can save you a lot of pain and grief in the future.

Have you ever had any problems with numbness during your workouts? Has it only happened in isolated incidents, or have you had recurring problems? How did you solve your problems with numbness, or are you still suffering from them? Share your stories in the comments.

This should probably go thru the website, but here it is anyway:

I had a member ask me today about pain in his legs and based on what he described and showed me, I think he has posterior shin splints. I suspect flat-footedness, but he also squats heavy and lifts heavy in general. He says the pain backs off after about a mile, but comes back. I think he said he ran about 8.5 on Sunday…

I told him ice for sure, which he is doing, and maybe some over the counter anti-inflammatory drugs and maybe 7-10 days of no running.

Any thoughts? Have you run into this before with any runners you know? Have you ever tried “arch-strapping”? I noticed that is a some-times cure for pain associated with flat-footedness.

I do think the guy is somewhat flat-footed.

What are posterior shin splints?

Posterior shin splits are a very common running injury. The most common culprits are excessively worn running shoes and doing too much hill or speed work before preparing your body for that sort of workout. He is probably suffering from tight calf muscles which is exacerbating the problem.

Posterior shin splints are an inflammation of the tendons that attach to the inner side of the shin bone and causes pain in the inner surface of your shin bone extending down to the arches in your feet. They can often mask an underlying stress fracture, especially when there is acute pain and swelling. If he does have a stress fracture, then the best advice is to take time off from running for at least a few weeks or even a few months.

How do I treat posterior shin splints?

Assuming that he does not have a stress fracture, then I would say that taking a few days off from running and getting some swimming or biking in should help a lot while maintaining his level of fitness. I would also cut back on speed work for at least a week or two. The first thing to do when nagging pains start to appear is to follow the RID or RICE methods of injury treatment. It is important to try and determine what is causing the pain in the first place, though, so that it will not return once he starts running full weekly mileage again.

He should start stretching his calf muscles after every run, whether his shins are hurting or not. Icing immediately after a run will help to reduce any swelling, as will ibuprofen. After icing to reduce the swelling, applying heat will bring fresh blood into the area which can aid in repairing any damage, but will also cause the swelling to come back. I don’t recommend heat when there is already swelling. My theory is to ice early and ice often. My favorite method of icing from the ease of use standpoint and the use of time standpoint would have to be giving myself a short ice massage in any tender areas. He should plan on icing for at least a few weeks after the pain has subsided.

How can I prevent shin splints from returning?

How many miles does he have on his running shoes? One of the first things that I do when I begin getting pains like that is to determine which pair of shoes have too many miles and retire them. I rotate between 4 and 5 different pairs of shoes at a time – they last longer both in a calendar sense and in a miles sense.

He may also want to make sure that he is wearing shoes that are appropriate for his particular gait. Different shoes are designed for different styles of running and account for different body types. He might want to go to a local running specialty stop and seek the help of an expert when replacing his shoes.

Does he wear his running shoes when he squats or does deadlifts? If so, he might want to consider doing those types of exercises in flat shoes or in his socks. Running shoes have a small lift at the heel which throws off your center of gravity and makes those types of exercises less effective and more dangerous. I am not so sure that they could be causing the problems in his shins, though.

What about my arches?

When I had some issues with plantar fascitis last year, I got a boot that I wear that stretches out my arch, and that helped a lot. I would wear it whenever I was sitting in one place for any length of time and when I went to bed. The last time that I had shin pains, though, was when I was in college and I had a stress fracture; I didn’t even know about those boots at that point. I am not sure whether something like that would help or not, but it is unlikely to hurt. I have never strapped my arches in preparation for a workout, though, so I can not really offer any advice on the effectiveness of that. Any time that I would have needed to, I opted to cross train instead.

Disclaimer

I hope that this general advice is helpful, but if the pain doesn’t go away then he should go see his doctor or a sports therapist. I also want to point out that I am not a doctor and do not pretend to be one, and that the advice above is just how I would treat myself in a similar situation and what I have done in the past before resorting to professional help.

Unfortunately, it is not the most uncommon injury. Asafa Powell, who is currently the world record holder at 100 meters (pending Justin Gatlin‘s appeal regarding steroid use), is out for the early season races this year. He has run 9.77 seconds a few times now, but he may not be able to race for another month or two. He is training at a low intensity, though.

“To put a time frame on it, it’s very difficult,” Asafa’s manager Paul Doyle said on Wednesday. “It could be in a matter of a week, or it could take five weeks.”

(Source: Asafa Powell News)

Good morning,

I came across your website this morning and am interested in asking your advice. I have been out of running for a couple of years due to injury and am looking to get back into it. My goal is to go sub 16 minutes for a 5k, hopefully this fall. Do you think this is realistic and what would your training advice be? My last 5k was about a year ago with no training I ran just over 19 minutes.

Thanks!

I can not say off hand whether Ima is likely to run a sub 16 5k this Autumn, since I do not really have enough information and have never met Ima. As such, I will approach this in very general terms and extrapolate whether I think that I could do it under similar circumstances.

For most people, I would say that it is unlikely that somebody will run under 16 minutes in a 5 kilometer race with just 6 months of training after a few years off. Chances are pretty good that if you have taken a few years off due to an injury than you are probably in your mid- to late twenties at the youngest. It is possible that you could be younger than that, but I would tend to think that if somebody could run under 16 minutes and got hurt, they would be unlikely to take two or more years off of running while they are still in school and eligible to compete at the NCAA level. I know that I certainly didn’t take that much time off when I had a stress fracture and tendonitis. As we get older, it takes us longer to bounce back from injuries and to regain our former levels of fitness. This is not necessarily a bad thing, as long as you do not allow yourself to become frustrated with expectations that are set too high.

A big factor in how well your training and racing can progress in 6 months is how much of a base your body has. My guess is that if you have run a sub-16 minute 5k as recently as 2 or 3 years ago, then your body probably has a pretty good base even with a few years of inactivity. How well that base has been maintained over the few years will be directly related to how active you were in other physical activities besides running. If you did not have a high mileage base with a lot of quality speed work behind you, then I am doubly impressed that you managed a sub-16 minute 5k. If you do not have the base or have not actually gone under 16 minutes, then I think that going under 16 minutes in 6 months is probably unrealistic. Even with a solid baseline of 70-100 miles per week a few years ago, it may take a while to get that level of fitness back if you have not kept active with other sports or cross training.

An untrained 19 minute 5k is a great starting point. I have taken layoffs of over 3 months, and quickly gotten my 5k times from 19 minutes down to 18 minutes one week to the next at the start of a racing season as I begin to run again. I do not really recommend the racing your way into fitness method, though, unless you have a deep wallet and have trouble getting yourself out to do speed work. Whether you do practice races or manage to find some time for repeats and fartleks, I recommend taking it slow to get back into it and to build up your fitness for at least a month or two before getting into any kind of speed work. Running at a slow pace for 20-30 miles per week for a month or two will get your body used to running again, hopefully without reaggravating whatever the injury was that sidelined you in the first place.

Without any real details about your running history or current levels of fitness and activity, I can not really say whether you would be able to run under 16 minutes with only 6 months of training. I can say that for myself, I doubt that I could do it. I also doubt whether I would necessarily try. My first priorities are my marathons, and the 16 minute goal is one that I hope to break this year but not at the expense of my longer races. If I did take a few years off, though, then my gut instinct is that if I started training in the Spring for a 5k race in the Autumn, then I would probably only manage around 17 minutes. I would definately be in the 17:30 range by mid-Summer, and might break into the high-16′s in the Fall, but most likely I would not get much faster than that.

The trick to attempt something like that is to make sure that you get a solid base in, that you eat very well, stay hydrated, get plenty of sleep, and have a solid training and racing plan to take you through the Summer and early Autumn. Any hints of pain, especially around whatever was previously injured, will need to be treated immiediately. My motto is to ice early and ice often. I think that some hard workouts while cross training would be necessary, if only to be able to give your heart an aerobic workout without further stresses on your legs. Swimming and weight lifting would be mandatory, and a bike would probably help things out as well.

If you go for it, Ima, then I would certainly be interested to see what your training is like and to see how you do.

Photo by Ian Hampton

When you play chicken with an automobile, you will lose. If there is a collision, the passengers in the automobile have a thousand pounds or more of metal and plastic in which to cocoon themselves. You do not. If you and the car run into one another, you might dent it (or you might not) but the car will definitely dent you. If you swerve, then you wind up off of the road and you have lost. Try not to twist an ankle. If the car swerves, then they will hopefully avoid colliding with anything else. In my experience, though, the car will rarely swerve.

You may not have intentionally wanted to play chicken with the car. Maybe you just weren’t paying attention, and ran a little too far into the road. Or maybe visibility was poor, or the driver wasn’t paying attention. Just remember that no matter who is at fault, the runner will always lose.

At lunch time today, I played chicken with an automobile. Visibility was poor, but if you ignored the law requiring headlights with windshield wiper use then it was not so poor that headlights were required to see. None of the other drivers had any trouble picking out my bright yellow reflective jacket. The driver quite obviously had no idea that I was there, though. Between not paying attention to me, and tailgating the person in front of them, they did not see me until I jumped off of the road into the snow. They also decided to swerve, but had I not jumped they would have still hit me anyway. Thankfully, nobody was coming in the other direction at the time.

Nobody believes that they can get hit by a car until it has happened to them. This is one of the reasons that I never wear headphones when I run on public roads. I just can not afford the distraction and I am always going under the assumption that every car that I come upon is going to hit me. If you were smart, you would also operate under the same assumption. It could help you to save your life.

One of my newsletter articles specifically describes how I avoid getting hit by a car and the steps that I take when I go out for every run.

Table of contents for Injuries (November)

1. Strains vs Sprains
2. Should you see a doctor about your injuries?
3. Common Weight Lifting Injuries
4. Common Running Injuries

In a collaborative effort with Scott over at Straight to the Bar, we wrote about injuries for the month of November. This is the final article in the series. I will first explore why runners get injured, and then I will share some of the most common running injuries that you are likely to hear about or suffer.

Causes of Running Injuries

The vast majority of running related injuries are due to one of 3 things:

1. Poor biomechanics
2. Over training
3. Trauma

Poor biomechanics is caused by adopting a running gait that does not agree with your body. You can do this by trying to improperly emulate somebody else’s running style, or by wearing the wrong kind of shoes. Most people can wear most running shoes without hurting themselves too badly, but if you plan on running regularly you should first visit a specialty running store. I highly recommend that you seek the help of an expert when choosing your running shoes. Poor biomechanics can be exacerbated by inadequate flexibility or strength, even in muscles that do not seem to be related to running. While you can use different muscles to perform different actions, your body is really just one big, well-connected machine.

Over training can be broken out a little bit. Over training can be caused by increasing your mileage too fast and running more than your body is ready to handle. A safe way to increase your mileage is to try not to go up more than 10-15% or so each week from the week before, and to cut back at least 5% every 3 or 4 weeks. Over training can also be caused by running the same mileage, but increasing some other physical activity that can tire you out or make it easier to pull a muscle that will sideline you. And finally, the surface that you run on can lead to over training if you take too much of a pounding (or too little) no matter how much you increase or decrease your mileage.

Trauma is the sort of thing that can injure anybody at any time, whether they are running or not. It is caused by an external factor that causes you to hurt yourself such as falling down and breaking a bone, or twisting an ankle in a pot hole, or getting hit by a car. Injuries of this sort are usually pretty self evident and are outside of the scope of this article.

Common Running Injuries

These are the top 5 running injuries that you will hopefully manage to avoid:

1. Stress Fractures
2. Tendonitis
3. Plantar Fascitis
4. Runner’s Knee
5. Shin Splints

Stress Fractures
Stress fractures are cracks in the outer layer of a bone from repititive stress. It is most often caused through over training by increasing mileage at too rapid a rate. Stress fractures can be exacerbated by excessive pronation or supination, which is usually caused by wearing innapropriate shoes. Stress fractures will usually hurt in a very localized place and will begin as a dull ache that can easily be misinterpreted as a sore muscle. Rest is the best way to cure a stress fracture, although you may want to consider taking supplements with calcium and cutting back on diet soft drinks. They can inhibit your body from absorbing calcium. Be sure to keep adequate rest in your training plans and to follow a gradual schedule of increased mileage. If you suffer from frequent stress fractures, then you are either not allowing yourself enough time to heal (1 to 3 months) or else you may require custom orthotics in your shoes. Stress fractures can be easy to miss with a common x-ray and may require a bone scan to detect.

Tendonitis
Tendonitis is excessive inflammation in your tendons. The most common for runners is achilles tendonitis. It begins with a dull aching after you finish running, which gets worse if left untreated. The tendon will begin to ache first thing in the morning after getting out of bed, and then while you are in the act of running. The dull aching will become more acute, until you always feel at least the original dull pain even when you are not working out. Tendonitis is usually caused by running too far and too fast when your muscles are not flexible enough to support such a workout. The problem can be exacerbated by shoes that have worn out and cause excessive pronation. To avoid getting tendonitis, be sure to warm up before doing any speed work, do not raise your mileage too fast, and try to stretch when you are done with your workouts. You can treat tendonitis by icing after your workouts, taking small amounts of ibuprofen to reduce swelling, and taking time off from running. This is a perfect time to practice RID or RICE. Achilles tendonitis can be treated specifically by using small heel lifts until the pain subsides. Any acute pain, however, really needs to be checked out by a competent doctor.

Plantar Fascitis
Plantar fascitis is inflammation of the plantar fascia, or the bottom of your foot. This tendon is very hard, like a ligament, and connects the heel of your foot to the ball of your foot. Every stride that you take, whether walking or running, involves the stretching out of this tendon to absorb the impact of hitting the ground. Tight calf muscles can increase the stress on the tendon and cause increased microtrauma that can lead to inflammation. The first symptom of plantar fascitis is the feeling of a bruise on the bottom of your foot. Left untreated, it can become painful any time you walk or run about or stand for a long period of time. It will often hurt a lot first thing in the morning. Plantar fascitis is caused by over training and poor biomechanics. Icing, stretching, and replacing any worn shoes is very important in aiding the recovery process. Stretching should concentrate on the calves and on the foot. A hard, round ball with a bit of give can be rolled beneath your foot to stretch it out. You will need to decrease hill and speed work or take time off completely to allow plantar fascitis to heal. If it is left untreated for too long, you may require custom orthotics in order to do any serious training in the future.

Runner’s Knee
Runner’s knee refers to any pain in the knee cap and is usually the direct cause of over training and poor biomechanics. The two most common forms of runner’s knee are patellar tendonitis (the pain is localized to the tendon in your knee cap) and chondromalacia patella (scarring has occurred because the knee cap does not sit properly in its femoral groove, and the underside has worn down and become rough and deteriorated). This can be caused by a lack of flexibility in any or all of the quadriceps, hamstrings, or calves. Most often, however, it is caused by a problem with the foot or ankle, usually due to excessively worn shoes and over training. The problem can be exacerbated by excessive hill work. Runner’s knee begins (like most running injuries) as a dull pain after the run that gets worse over time. Treating it early is very important to prevent permanent damage. Stretching tight muscles after your workouts and icing frequently helps. I have found that an ice massage is especially effective.

Shin Splints
Shin splints are any pain in the shins and is usually tibial stress syndrome. There are two types of shin splits, anterior and posterior. Anterior shin splints are really an inflammation of the tendons that attach to the front of the shin bone to the outside. It begins as a dull ache on the outside of your shin bone as you run and can get worse until it is painful to walk. Posterior shin splints are an inflammation of the tendons that attach to the inner side of the shin bone and causes pain in the inner surface of your shin bone extending down to the arches in your feet. Shin splints can often mask an underlying stress fracture, especially when there is acute pain and swelling. Shin splints are rarely caused by too much mileage (unless it is really a stress fracture) but can be caused by too much hill work or speed work before you are ready for it. Tight calf muscles and excessively worn shoes are often the culprit. Stretching your calves several times a day and laying off of the speed work can usually make your shin splints go away in short order, and I recommend icing after every run while your shins hurt and for a few weeks after the pain has gone away.

Preventing Injuries

The reason that I explained the common reasons that runners get injured before describing some common injuries is that there are common themes amongst and between the different injuries. Diligence in identifying and treating an oncoming injury and some simple precautions can go a long way towards preventing the worst of the injuries from ever bothering you.

1. Replace worn shoes quickly. Better yet, use more than one pair of running shoes and rotate them often.
2. Ice Early, Ice Often.
3. Be careful about how fast you increase your mileage, as well as the duration and intensity and prevelance of any hill or speed work.
4. Warm up before workouts, and stretch your calves and any tight muscles after workouts.

Table of contents for Injuries (November)

1. Strains vs Sprains
2. Should you see a doctor about your injuries?
3. Common Weight Lifting Injuries
4. Common Running Injuries

In a collaborative effort with Scott over at Straight to the Bar, we we will be writing all about injuries for the month of November. You can expect a new article on the matter every week.

This week, Scott discusses common weight lifting injuries and provides links to places you can go to determine the best way to treat them.

Next week we will conclude the series with a run down of common running injuries.

The website is in its infancy, but it certainly shows promise. There are still a few kinks to be worked out, and there are (as of this writing) only 13 articles available. The site will grow, however, and it has only been around for a few weeks.

Injuries are categoriezed in two ways. You can find injuries specific to your sport, and you can find injuries specific to a part of your body that happens to be hurting. There is also an alphabetized list of injuries that have articles written, but I imagine that this list will quickly grow to be unmanageable and might be moved to its own page rather than appearing on every page.

There is also the standard Google search bar, but because the website is so new it is not very useful. Google has not yet indexed many of the pages. You can follow updates to the site automatically by subscribing to the RSS Feed.

Table of contents for Injuries (November)

1. Strains vs Sprains
2. Should you see a doctor about your injuries?
3. Common Weight Lifting Injuries
4. Common Running Injuries

In a collaborative effort with Scott over at Straight to the Bar, we we will be writing all about injuries for the month of November. You can expect a new article on the matter every week.

This week I would like to explore whether or not you should self-diagnose your injuries, or whether you should go to visit a doctor. The largest determining factor are going to be what resources are available to you, followed by the perceived severity of your injury.

There are many different resources that you may have available to you that will determine whether going to a doctor is even a viable option. Are there any competent sports physicians in your area, or are you going to have to go to a general practitioner? Do you have insurance, and would your visit be covered by your insurance? Can you afford the visit out of pocket? Do you have any sort of medical staff available in a different setting, such as an athletic trainer? Do you have a coach or experienced teammates that can offer you any advice? In my experience, a doctor that has studied sports medicine or an athletic trainer are both good options when available, but a general practitioner may not know enough to be more helpful than to recommend time off.

Money may not be very important in the scheme of things when you are trying to decide whether to get an injury looked at, but it can often be the difference between winging it and missing a few months of training or seeing somebody competent and missing only a few weeks. Of course, if there is nobody competent in your area, then you are going to have to spend not only a large amount of money but also a large amount of your time in travelling to somebody that can really help.

Once you know what resources are available to you, the next most important thing that you need to consider is how severe you perceive your injury to be. Be sure to note that what you perceive and how severe an injury actually is may have little correlation with one another. Experience will be your friend here, and if you have any coaches, teammates, or friends that have more experience than yourself then you would be wise to ask their opinion.

Sometimes you can tell that something is very severe, such as when you break a bone and a piece is sticking through your skin. Chances are pretty good that even if you are a physician yourself that you are going to need some competent help. Other times, you can tell that something really is not very serious, such as when you stub your toe and it stops hurting after 10 or 15 minutes. In those cases, you generally will know whether you need to go see a doctor or not.

The problem with sports injuries, especially non-contact sports such as running or weight lifting, is that you may not even notice the more severe problems while minor problems may seem like they really hurt. For example, an oncoming stress fracture might seem like a minor shin splint, and tendonitis may begin by feeling like a sore joint. If you do not adjust your training appropriately, then you may wind up having to sideline yourself for a season or more. Then again, if you do not properly cool down after a marathon or other really difficult workout then you may find yourself unable to move the next day. Realistically, even though you are in a lot of pain, there is not that much wrong with you and you will be fine within a day or 3.

The more that you exercise and the more that you compete competitively, the more that you will get to know your body. Once you have had a sports injury or three, you will start to notice a trend when you begin overtraining. If you keep accurate training logs and track your weight or your resting heart rate on a daily basis, then you will often be able to prevent the worst injuries in their early stages just by becoming familiar with your own body and its needs.

After considering your resources and trying to figure out how much pain you are in or are likely to be in if a change is not made, should you go to see a doctor or not? In general, I recommend going to the doctor if possible. In my experience, most recreational athletes are not comfortable enough with their bodies and do not have a frame of reference to accurately judge how serious an injury is.

That being said, I very rarely go to the doctor. Most of the times that I have, I have been disappointed with what they have to say. I have kept pretty accurate training logs for most of my adult life, and have had more than my share of injuries. I also know exactly how much pain I am willing to put up with, and how much training I need to do, in order to attain my goals.

Table of contents for Injuries (November)

1. Strains vs Sprains
2. Should you see a doctor about your injuries?
3. Common Weight Lifting Injuries
4. Common Running Injuries

In a collaborative effort with Scott over at Straight to the Bar, we we will be writing all about injuries for the month of November. You can expect a new article on the matter every week.

This week, Scott describes the difference between strains and sprains. He also discusses the most common causes of strains and sprains and the best ways to recover from them.

Although the terms strain and sprain are often used interchangeably, just remember that strain=tendon and sprain=ligament.

After you have taken a look at what he has to say about RICE and HI-RICE as a way to speed recovery, you should read my thoughts on how to get R.I.D. of injuries.

Table of contents for Icing Your Woes

1. Icing Your Woes: Ice Early, Ice Often
2. How to ice your muscles using an ice bag
3. How to ice your muscles using an ice massage
4. How to ice your muscles in an ice bath
5. How to ice sensitive areas

Knowing how to ice is important, but there are a few places on your body where you have to be a little more careful about how you go about icing yourself. Specifically, you never want to apply ice directly to your eyeballs or to testicles. You also do not want to follow the 20 minute rule for either; you should never ice your eyes or jewels for more than 10 minutes tops.

When you are icing your testicles, wrap the ice in a towel. Swelling can happen very fast down there, so getting the ice applied quickly (when necessary) is important. You should never allow the ice to come in direct contact with your testicles, and you should allow at least 20 minutes between icing sessions.

When you need to ice your eyeball, you will never apply ice directly to it. Instead, ice the bone above or below your eye instead. As with icing your testicles, be sure to ice for no more than 10 minutes at a time and to allow for 20 minutes between icing sessions. Icing for longer than that or more frequently can damage sensitive tissues.

On the team, we had a way to deal with injuries. The process that we preferred was to get “RID” of injuries, where RID stood for Rest, Ice, and Drugs. For most of us, we skipped the rest and went straight to the ice. Others skipped the rest and the ice and went straight to the drugs; they have the ulcers now to prove it. Another popular acronym in running communities is the “RICE” method: Rest, Ice, Compression, and Elevation. I will expand upon each element below.

Rest
There are three basic types of rest.

1. Passive Rest: Passive rest is cutting back your mileage and/or your intensity in your workouts. You run less or you run less hard or both. This gives your body a chance to recover. Any fitness program should incorporate some sort of passive rest well before you get injured, because your body needs time to repair the muscle tears that training causes. It is the whole point of doing the work in the first place.
2. Active Rest: Active rest is doing the same activity at a much lower intensity. Recovery runs and morning runs tend to be active rest. For example, in the evening, you might do a speed workout on a track. The next morning, you might run a few junk miles just to stretch out and prepare yourself for another workout that evening. Your only run the day after a hard workout might be a few easy miles. This allows you to stretch your legs out, void any nasty toxins that are still lingering from the day before, and generally just gives your mind a chance to do the activity without having to focus on it. Done properly, recovery runs keep you from burning out. Done improperly, they bring you some huge performance gains followed very swiftly by injuries and burn out.
3. Cross Training: Cross training is basically the same thing as active rest except that it is a different sport. If you are a runner, good cross training activities include bicycling, swimming, rowing, and weight lifting. You get a cardiovascular benefit, but you use different muscles and in most cases reduce the impact on your joints during the activity. Instead of running junk miles for a half hour, you could go out and get a pretty intense swimming workout in without negatively impacting your next workout on the roads or track. A proper weight lifting routine should be a part of your regular training to make sure that you have a good balance in your body and that every major muscle group gets a good workout. If you are a beginner weight lifter, I recommend that you check out The New Rules of Lifting.

Ice
The theory behind the icing your muscles is that your muscles constrict and the bloodflow is diverted to your deeper muscles close to the bone to keep them safe against the extreme temperatures that you are applying to the outside of the muscle. When you take cold away from your body, fresh blood rushes through the muscles that does not have any of the chemicals released by your muscles as you ripped and tore them during exercise. This speeds up the healing process.

In general, any time that you feel even the least bit more sore than normal, I recommend that you ice early and ice often. I wrote a series about a month ago that describes different ways to ice your muscles:

1. Using an ice bag
2. Using an ice massage
3. Using an ice bath

Drugs
Drugs could easily be a twenty article series, but I will give a brief overview here. First, different drugs are going to cause your body to do different things during a workout than you are used to, whether it is a drug that you are taking because of an injury or because of something completely unrelated to your athletic pursuits. Be careful about side effects, especially drugs that cause a sensitivity to the sun.

The only drug that I have ever really used to help treat or prevent an injury was ibuprofen. Ibuprofen does a good job of reducing swelling, which allows fresh blood to get into inflamed areas and encourage the healing process. A few ibuprofen with your icing early on can prevent you from getting a season ending injury. You need to make sure that you do not take it on an empty stomach, though, and I recommend limiting it to only when you really need it. Ibuprofen can thin your blood a little, which is not really something that you want as an athlete. That being said, you will probably need to ignore the recommend dosages. Talk to your doctor about what is appropriate for you before you do, however. He or she will have a much better idea about what is appropriate for you.

The general consensus in my locker room was to take two to four pills at a time after each run. For myself, the most I ever took at a time was two pills after each run, and that was right before I came down with a stress fracture and tendonitis. Obviously, drugs alone are not enough to prevent an injury. In general, when I felt a need to take ibuprofen, I usually only took one pill or two pills after a morning run and nothing after the evening run. I recommend caution and better advice from somebody that knows more about the subject.

Compression
I never really subscribed to the RICE method, but wrapping your muscles accomplishes two things. First, when you wrap a muscle before exercise, it restricts your movement. This can be good if you need to prevent yourself from doing further damage, which can happen if you have a full range of motion or an injury caused by a hyperextension. Second, compressing an injury after exercise can accomplish some of the same things as icing your injury. It limits blood flow to the muscle, so that when you remove the compression fresh blood can move in and flush out any toxins you need removed.

Elevation
Elevation is another method for encouraging fresh blood to a muscle by denying it as much blood as you can for a short time. I have used elevation as a preventative measure even less than I have used compression. The only times I have felt a need to elevate an injury was when I had severe swelling and wanted to prevent any sort of fluids from accumulating in the broken or sprained area in an effort to reduce the swelling.

As a quick overview, I hope you found this guide helpful. Not subscribing to the RICE method, I am sorry that I do not have a lot to say from my own experiences about compression or elevation. In general, especially now that I train myself, I try to stick to using rest and ice to control injuries and to perform preventative maintenance on my body. For the most part, it works out pretty well for me.

Table of contents for Icing Your Woes

1. Icing Your Woes: Ice Early, Ice Often
2. How to ice your muscles using an ice bag
3. How to ice your muscles using an ice massage
4. How to ice your muscles in an ice bath
5. How to ice sensitive areas

Whenever your muscles are feeling a bit sore or overworked, you should remember my motto, “Ice Early, Ice Often.” Arguably the most effective way to do that is to immerse your muscles in an ice bath.

An ice bath can consist of using a full sized whirlpool type contraption, or by dumping a bag of ice into a bucket of water. With a bucket, you can immerse your feet. With a full whirlpool, you can immerse as much of your body as you want to. In general, you should not immerse more of your body than you have to in order to completely cover the sore muscles in water.

Somebody that is new to using an ice bath will probably not be able to stay immersed for more than a minute or two. As you get used to it, though, you will be able to increase your immersion up to 5 or 10 minutes. You should never stay immersed for more than 10 minutes at a time.

The theory behind the ice bath is that your muscles constrict and the bloodflow is diverted to your deeper muscles close to the bone to keep them safe in the extreme temperature. When you take your leg or body out of the ice bath, fresh blood rushes through that does not have any of the chemicals released by your muscles as you ripped and tore them during exercise, such as lactic acid. This speeds up the healing process.

In general, using an ice bath is a one time event that should be done as soon after your workout as possible. Once you get out, you should do some gentle stretching and warm your muscles back up. You do not want to get back into your ice bath until after the next time that you exercise.

There are a few ways to stretch your arch. If you are doing a “Figure 4″ stretch and you can reach your toes, you can pull them back towards you and do a combination stretch. The easiest way does not involve that kind of flexibility, though. You just roll your foot over a tennis ball along the floor with your shoe off. You can also use some other ball of the same general size. I use a wooden juggling ball. The next method is not technically the safest way for you to stretch out your arch, but it is very effective. First, a little background:

As I have been picking up my mileage, I have also been picking up some minor aches and pains. Over the past few weeks, my left arch has been hurting throughout the day. It is usually not too painful (if painful at all) while I am running, but sitting around later it can hurt quite a bit. I have also been getting a few other aches and pains for the last few days, so I decided to take the day off from running yesterday.

I find that mowing my lawn relaxes me and I enjoy doing it. I have a small lawn with a push mower, and it takes me on average a little over an hour to complete. It is mostly flat, but there are a few steep parts leading into my back yard, and there is a very steep drop off along the back of the property that leads into a brook.

What I did to stretch out my arch was mow the lawn barefoot. I feel the need to add a disclaimer that if your lawn mower’s manual does not tell you to always wear shoes when mowing your lawn, then it should. It is not the safest way to mow your lawn. A shoe may not protect your foot much if you get it caught beneath the mower, but it can prevent your foot from getting there in the first place. It will also protect your foot from anything discharged out the back of the lawn mower.

So with that disclaimer being said, why would I want to mow my lawn barefoot?

1. Walking around barefoot will naturally stretch your arch as you move along.
2. Pushing the lawn mower provided more resistance than merely stepping forward, which gave me a better stretch.
3. Pushing the lawn mower up and down the steeper parts of my lawn provided a little bit of strength exercises as I supported my foot off of the balls of my feet.
4. Mowing the lawn kept me walking around barefoot on grass for over an hour, which probably would not have happened if I was just walking back and forth randomly.
5. My feet got really dirty, and the process of scrubbing them clean gave the arches a good massage in the shower afterwards. And this morning. And probably tonight and tomorrow. My feet got really dirty.

So, while I can not recommend that you do something as potentially dangerous as mowing your lawn barefoot, I can relate a positive experience that I had with it. My foot that has been hurting over the last few weeks felt great when I went to bed last night. I do not expect that to last very long, but hopefully a day off from running combined with the stretching will mean I am that much farther from actually getting injured.

Table of contents for Icing Your Woes

1. Icing Your Woes: Ice Early, Ice Often
2. How to ice your muscles using an ice bag
3. How to ice your muscles using an ice massage
4. How to ice your muscles in an ice bath
5. How to ice sensitive areas

Whenever your muscles are feeling a bit sore or overworked, you should remember my motto, “Ice Early, Ice Often.” The second and my favorite way to do that is to give yourself an ice massage.

In general, you do not want to ice for more than 20 minutes at a time using any method. When giving yourself an ice massage, you generally do not want to ice for more than 10 minutes at a time, and can often get by with about 5 to 7 minutes of icing. You should still give yourself 20 minutes between icing sessions, and may want to do up to 3 icing sessions in a row. An ice massage is simply massaging the sore places with an ice cube of some sort. There are a few different methods for getting the ice cube ready for an ice massage.

1. Take an ice cube out of a normal ice cube tray. Rub that along your sore muscles. You may want to wrap the back side in a paper towel to keep your fingers from getting too cold while you hold it. On a warm or hot day, the ice cube will probably only last a few minutes before it has melted.
2. Freeze water in a small paper cup. This is the best and easiest way to go about it. Fill a small paper cup with water and freeze it. When you finish your run (or other workout) just pull the cup out of the freezer and peel the paper back. As the ice melts you peel more paper, so that the majority of the ice isn’t exposed directly to the hot air or your warm fingers. Depending upon the size of the cup you can get 5 minutes to 15 minutes before ice melts. Sometimes you can even use the same cup for multiple sessions, although I prefer using a smaller cup.
3. You can use a freezer pack. I am not a big fan of using the freezer packs that you use in coolers to keep your food cold, but they work as well. I prefer something smaller and easier to manage, but they are certainly the most economical method of icing yourself. They also make less of a mess.

Remember that unlike when you ice yourself with an ice bag or use a freezer pack, the water will not be trapped and will make a small puddle on or beneath you. If you sit on an easy to clean floor or a towel, then it is no big deal. Just hang up the towel or mop up the puddle when you are done.

Table of contents for Icing Your Woes

1. Icing Your Woes: Ice Early, Ice Often
2. How to ice your muscles using an ice bag
3. How to ice your muscles using an ice massage
4. How to ice your muscles in an ice bath
5. How to ice sensitive areas

Whenever your muscles are feeling a bit sore or overworked, you should remember my motto, “Ice Early, Ice Often.” The first and easiest way to do that is to just grab a bag of ice and slap it on your sore spots. Leave the bag of ice on your leg or joint for 20 minutes, and then take it off for 20 minutes. Put a new bag of ice back on for another 20 minutes if necessary.

In general, you do not want to ice for more than 20 minutes at a time. When using the bag of ice method, you generally do not want to use full ice cubes, since there will not be a lot of surface area for you to use in the ice bag. Crush the ice into smaller pieces first, or else use the old bag of peas method. Take an old bag of frozen peas, and slap them onto your body where you are sore in lieu of ice. They will need to be refrozen after each use, and I recommend labelling the peas so that you do not accidently eat them later. Frozen peas that have been thawed a few dozen times really do not taste very good. The size of the peas is perfect for conforming the bag of ice around your muscle, and they do not require any work other than pulling them right out of the freezer.

The nice thing about using a bag of ice is that you do not need to do anything other than position the bag and then wait. There is no thought needed, there is no effort needed, and you can easily multitask. If you are using a plastic bag, then you generally do not need to worry about frostbite. If it is too cold for you, you can just place a paper towel under the bag to get most of the cold but not all of it concentrated on your skin.

Table of contents for Icing Your Woes

1. Icing Your Woes: Ice Early, Ice Often
2. How to ice your muscles using an ice bag
3. How to ice your muscles using an ice massage
4. How to ice your muscles in an ice bath
5. How to ice sensitive areas

One of the biggest mistakes that you can make is to ignore aches and pains when they are minor. Your body is very good at telling you things; the trick is learning how to distinguish between minor tears that are getting repaired and major tears that could lead to an injury. The easiest thing to remember is to ice early and ice often. When you finish a workout, your muscles have been torn. This signals your body to repair the muscles, and if the tear is bad enough and you have properly fueled yourself it will repair the muscle in such a way that the same workout will not cause as much damage. This is how we get better at any physical activity.

When you do too much too fast, or you twist something in a way that your body doesn’t want it to twist, you risk pulling a muscle or bruising a bone or causing a fracture. There are countless ways that you can hurt yourself. As you get more experienced in working out and you begin running more miles and doing more speed workouts, you have to be mindful of how you feel. In general, you should be able to tell the difference between being sore because of a good workout and being in pain because you have injured yourself. Any time that you are not sure, then ice the sore spots after your workouts.

There are different ways to ice your muscles, and I will get into them later. In general, you want to apply the ice to the sore spot directly after your cool down and stretching. When you are done icing, you will generally want to wait for 20 minutes and then ice again.

Icing your sore muscles will not heal an injury, but it could help to prevent one. When in doubt, apply a little ice. If you are just a little sore, then one round is probably enough. If it gets worse from workout to workout, then you should ice more and even consider taking an extra rest day or two. Icing your muscles can help you keep yourself on your training schedule, but pushing your schedule back a day or three now and again may help prevent you from pushing your schedule back a month or three.

I went back to the gym this morning. My finger is mostly recovered; it is still sore and aches, but most of the swelling and just about all of the visible bruising is gone already. Granted, I probably did not really break the finger, or if I did it was really minor. But it was nice to be able to lift and not worry about dropping a heavy barbell because of the finger.

The lifting itself was no trouble at all. After I finished the sets, though, the finger definately ached. Stretching and flexing it made it worse briefly but better in the long run. I did not have any trouble with the snatch grip deadlifts or the romanian deadlifts, and the bulgarian split squats burned like normal but didn’t even make my finger take note. The same goes for the bridge exercise with a knee tuck on a swiss ball that Bud Gibson had turned me onto.

Speaking of which, he has a new exercise, BOSU Jackknifes, at his site that is fairly similar. I haven’t tried them yet, but plan on playing around with them at some point in the near future.

Yesterday, I got up and went about my morning all the way up to the point where I leave for the gym, when I realized that my swollen and bruised finger was not going to do very well trying to support a barbell. As the morning progressed, the bruising kept spreading from the base of the finger until it had gotten about a third of the way past my last knuckle. It is still discolored today, but it is not nearly as purple and is starting to look more fleshy. It is still swollen though. If my wedding band comes in again this week, then I will not be able to try it on.

My workout plans are flexible enough to account for minor setbacks like this. I took Monday off from lifting, and very well may take the rest of the week off and let my finger heal. In the meantime, I will get plenty of running done, which can be held without having to support weights that are heavier than myself.

How much would your training be derailed by something as silly as a broken finger?

Some of you may remember the bonehead move by Kellen Winslow who has yet to have any sort of worthwhile professional career because he keeps doing stupid things, such as doing stunts on a motorcycle without strapping on his helmet.

Ben Roethlisberger, whom I had assumed to be a much more intelligent person and who has been undeniably more successful as the quarterback of the Pittsburgh Steelers, has proven he is even dumber than Kellen Winslow. This is a shame, since I have enjoyed watching the start of Roethlisberger’s career over the last two years.

This morning, Roethlisberger was out on his motorcycle and got in an accident. Eyewitness reports state that he was not wearing a helmet and that he was ejected from his bike and hit the windshield of a car. He is in the hospital for a head injury that is not supposed to be life threatening, but the team has not made an official announcement yet.

These players are idiots. I recognize that folks who enjoy their motorcycles tend to be fanatics, and there is nothing wrong with this. The problem, though, is that riding a motorcycle is an inherantly risky behavior no matter how good of a driver you are and no matter how careful or experienced you are. When you are Bob from Accounting, a broken leg is an inconveniance and an expense. When you are a starting quarterback or other professional athlete, however, it can end your career. Many professional contracts prohibit unnecessary risky behavior in the off season, and with good reason. Teams invest a lot of money into these players, and it just seems silly to jump on a bike without wearing a helmet and cruise around risking your career.