Last night I received an email from Jane, one of my readers who is training for this weekend’s Boston Marathon. Jane’s training was going really well, she felt as though she were peaking at just the right time, she had just started her taper…and then she got injured. Sound familiar to you? It certainly does to me. Here is a part of her email:

Question MarkI’m a 54 year old female training for my 7th 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):

Question MarkNot 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.