Running Injuries

running at sunrise

Running is a great way to burn calories, release endorphins, and improve your cardiovascular health. It can be a healthy activity to do with friends and loved ones, and many enjoy the thrill of competing in races of various lengths. While the number of benefits one can gain from running is vast, so is the number of injuries that may come along with it – especially when covering longer distances. Running injuries are the result of different factors, which include not stretching properly, insufficient footwear, or possible musculoskeletal problems. These injuries can potentially put a stop to running and cause further damage if not cared for properly. Below are some of the most common running injuries, and how you can treat and prevent them so you can get back on track.

1. Runner’s Knee
What is commonly referred to as “runner’s knee” is actually patellofemoral pain syndrome (PFPS), and it is irritation of the cartilage beneath the kneecap. This irritation may be due to biomechanical factors such as over pronation (excessive rolling in of the foot), and weak hips, quadriceps, and glute muscles. If you are experiencing this pain, it is best to decrease the amount of running, or taking a break altogether if the pain persists. While on your hiatus, work on strengthening the surrounding musculature of the hip, glutes, and quadriceps. Look into alternate forms of cardio such as the elliptical or swimming until you are ready to hit the pavement again.

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The Marathon Mulligan (and lessons learned along the way)

I should have been done. When I signed up for the 2011 Chicago Marathon – my first full marathon – I did so fully intending to take a well-deserved break afterward. I wasn’t going to stop running completely, but I was ready to hop off the marathon training-go-round after eight months of speed work, long runs, hill workouts and even longer runs. I was excited for the race, and excited for the rest.

Then I had a Chicago-style meltdown, finishing the marathon more than an hour slower than my goal, and my plan changed. Before the race, I wasn’t sure if I would run another marathon. Immediately after the race, I swore up and down that I would never run another #@*$! marathon again. A week later, I was online looking for a winter race that fit my schedule, understanding Chicago would forever haunt me if I didn’t give myself a chance at redemption. I settled on the Arizona Rock ‘n’ Roll Marathon, strapped on my running shoes and reluctantly started training again.

When I cross the finish line in Phoenix Sunday morning (hopefully in 3:30 or faster), I will have finished two marathons within three months of each other. It’s a bit unbelievable considering how intimidating the thought of running 26.2 miles seemed to me at this time last year, but things get even crazier.

I learned just before Christmas that I’ve been accepted onto the press tour for the 2012 Tokyo Marathon. One catch: Writers on the tour are required to run the race. I knew it would be a challenge to run another marathon a mere six weeks after Arizona – and still only four months after Chicago – but that’s not an opportunity you pass up. That’s what my brain said, anyway; my body was already begging for mercy.

Of course, I won’t be the first guy to run two marathons in six weeks. In fact, there are tons of runners who have run multiple marathons and/or ultramarathons in back-to-back-to-back-(-to-back-to-back…) weekends. I call those kinds of runners freaking nuts. Or maybe inspirational. Probably a little of both, come to think of it. I’m not of that caliber, however, so I’m more than a little…curious…to see how I pull this one off.

As I prepare for the start of my marathon double-header in Phoenix this weekend, I took the time to go through some of the lessons I’ve learned thus far in my training. Some of these are things I already knew but were driven home during the hundreds of miles of falling footsteps over the past year, while others were new lessons that cropped up along the way. I plan on adding to this list after the Tokyo Marathon, but for now, here are five I’ll take with me to the starting line this weekend.

Nothing new on race day. I figured I’d start with the most important lesson since I had to learn it the hard way. I’d heard this “rule” many times before but thought it was more a case of playing it safe than anything else. How much could a different type of food or sports drink really affect you on race day? I never much worried about small details like that and I didn’t want to start micromanaging now. Then I had to take Tylenol with codeine to help me sleep through my shoulder injury during the week leading up to the Chicago Marathon, which I later learned led to my disastrous finish (codeine is known to cause dehydration and electrolyte imbalance). Prior to each of my first two half marathons, I had a Peanut Butter Crunch Clif Bar for some added pre-race nutrition even though I’d never before eaten one, prior to a race or otherwise. It took me several months to realize the Clif Bar was the source of my severe stomach discomfort after both races, a situation I (thankfully) haven’t had to replay since eliminating Clif Bars from my routine.

A friend asked me about a month ago if she should try running her half marathon that weekend in compression tights. She had used compression socks after a race but had never run in any sort of compression equipment. My advice: nothing new on race day. I said it probably wouldn’t hurt her to run in the compression tights but I strongly recommended that she not test that theory during a 13-mile race. You never know how your body will react to any sort of change to your routine, and the worst possible time to experiment is on race day. If you’re trying a new type of energy gel or sports drink, breaking in some new equipment, or anything of the sort, do yourself a favor and first test it on a training run. Race day is crazy enough without throwing a bunch of unknown variables into the pot.

You only have so much control. I was healthy, confident and excited leading into the Chicago Marathon, then a freak injury to a nerve in my shoulder wrecked everything. No matter how methodically you set up your training routine, how devoutly you stick to your plan, or how great you feel during your training, some things are simply out of your control. You may roll your ankle or come down with a nasty cold a week before your race. Oh well. The only thing you can do at that point is determine whether or not you can still run, and then do your best under the circumstances. That’s precisely what I did for Chicago, and what I did in Cleveland when dealing with a knee injury (see below). I’m about as healthy as I could hope for heading into Phoenix, and I’m just hoping I stay that way for a few more days. And then six more weeks after that.

Run, then race. I went into the Cleveland Half Marathon last May with a mysterious knee injury that had me wondering if I’d even be able to finish. My training leading into the race had been erratic because of the injury, so I decided to run the first 10 miles at a relaxed pace in hopes of having enough left in the tank to finish strong. This time, the plan worked to perfection. I came through each mile at a steady 7:15 pace and after I passed the 10-mile mark, I found another gear and cruised to a PR of 1:32:51. In hindsight, I probably could have taken off a little sooner but I chose to play it conservatively and was obviously thrilled with the results. By taking the time to settle in early, I gave myself an opportunity to truly race the final quarter. The opposite approach, of course, is to go out too aggressively, face plant around the midway point and then drag your sorry carcass across the finish line. I did that in Virginia Beach a couple months later. I’ll be following Plan A this weekend.

My form is a work in progress. My high school coach told me once that I had the best form on our team. I took that to mean I didn’t need to improve in that area. Wrong. After reading (and loving) the book “Born to Run,” I picked up a pair of Saucony Kinvara (a lightweight, minimalist-type shoe with a low heel-toe drop) and began shortening my stride, quickening my turnover rate and focusing on hitting the ground with my midfoot rather than my heel. My knee almost immediately felt better. While doing a track workout with a neighbor a couple months ago, he mentioned that I should try dropping my arms a bit to help my breathing and loosen me up. Now my shoulders aren’t nearly as tight after a run as they used to be. I still catch myself striding too far or lifting my arms during runs, but I just readjust and instantly feel the benefits of my improved form. It takes a lot of research and field work to find what’s best for you, but Runner’s World is a great place to start.

I love owning a treadmill. This last one seems a little strange coming on the heels of my last post about winter running, but as a work-from-home father of three, having a reliable treadmill in my basement has been a godsend. I still try to get outside as often as possible, but I’m no longer hamstrung by poor weather conditions or other people’s schedules. Sure, it’s boring, but Netflix has been a fine running partner for me since buying our NordicTrack C900 last month, and while it will surely collect a bit of dust in the spring, summer and fall, I’ll run it ragged every winter. Using a treadmill at your local gym also works, but it’s not nearly as convenient as having one at home. Even better, I’ve done two 10-mile runs on my C900 and am pretty confident I could tack a few more miles on in a pinch.

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Be sure to check back next week for my recap of the Arizona Rock ‘n’ Roll Marathon, and in February I’ll kick off my Tokyo Marathon coverage as I learn just how well my body can handle two marathons in six weeks!

Bullz-Eye.com editor in chief Jamey Codding ran competitively in high school, took a brief 15-year breather, and then came back to run four half marathons and a full marathon in one calendar year. Read all of his Runner’s Journal posts, including his Chicago Marathon recap, and learn why he runs.

  

Training for Marathon #1: Race weekend

Ah, the curveball. The dreaded “bolt from the blue.” With just over a week to go before the Chicago Marathon, I was lounging in bed on a lazy Saturday morning, watching TV and delaying the start of my day as long as possible. I had to knock out an easy 10 miler later that afternoon — my last long run prior to the race — before coasting through the final week with two short runs on Tuesday and Thursday. I felt great about my training, confident that I’d worked hard to put myself in position to run my best race possible on October 9, and also fortunate that I’d avoided any sort of serious injury that would interrupt my training or affect me on race day.

Then, I felt a twinge in my shoulder.

I had been sitting with my right arm slung over my head, an odd yet comfortable position I often find myself in while watching TV. Only this time, when I stood up, my right shoulder felt a little sore. Nothing alarming at first, just something I figured would pass within a few minutes. Instead, it got worse…and worse…and still worse. The pain got so bad — so sharp and so deep, right behind my shoulder blade — that I was convinced I must have pinched a nerve or something. Knowing the race was approaching and growing increasingly concerned as the pain swelled to an almost unbearable level, I headed for the ER, wondering how the heck I hurt my shoulder so badly while watching TV, and just a week before my first marathon. Fantastic.

The ER doctor gave me a quick examination, ruled out any nerve issues or muscle tears, then gave me prescriptions for a muscle relaxer and pain killer to help treat a strained shoulder. Monday afternoon, still in considerable pain, I headed to my sports medicine doctor, who took one look at my swollen shoulder, noting how far my shoulder blade was “winging out” (his term), and diagnosed me with subscapular bursitis, or inflammation of the fluid-filled sac that sits between my shoulder blade and rib cage. The good news, he said, was because my injury wasn’t muscular in nature, I’d still be able to race Sunday, which was obviously my biggest concern. He gave me a cortisone shot to reduce the pain and inflammation, and my range of motion almost immediately improved. The bad news, though, was that my shoulder would most likely bother me to some degree during the race and, in my doctor’s words, my arm was going to be “extremely sore” afterward. Hey, something to look forward to, right?!

Of course, I’m just relieved I got the green light for Sunday. Then again, the only way I would have even considered skipping the race entirely would be if the doctor told me trying to run through the injury would cause further damage. With that not being the case, I’m ready to gut this out and deal with the pain on race day, to whatever degree. What choice do I have? Sure, the circumstances could be better, but it is what it is. I refuse to let something so random detract from this experience, a moment I’ve been training for since February, a moment I’ve envisioned for years. Crossing the finish line Sunday is going to be an unbelievable experience, even if my shoulder is on fire when it happens. To quote Forrest Gump: Shit happens. I need to manage the situation and adjust my expectations.

When I first started training, my pie-in-the-sky goal was to run better than 3:10 in Chicago to qualify for the Boston Marathon. As the race has gotten closer and I’ve piled up more mileage, I’ve pulled my expectations back a bit. My main priority now is to start comfortably with a reasonable pace that will allow me to cruise through the first half of the race. That may seem obvious or simplistic, but it’s easy to get caught up in the energy and excitement on race day and find yourself coming through the first mile much faster than planned. Strategy goes out the window at that point. Considering the Chicago Marathon ranks as the third largest race in the world, with more than 45,000 participants and a course filled with raucous and supportive spectators, sticking to my plan early and putting myself in position to run a strong second half will be even more challenging.

Assuming things go as scripted, however, my baseline goal is to run 3:30, an 8-minute-mile pace I handily topped on my longest training run of 21.5 miles. Setting a reasonable goal will make it easier to ignore my watch in the early stages and settle into a comfortable pace while also giving me some wiggle room in case my shoulder gives me more trouble than I’m anticipating. If, however, things break my way during the race and I feel better than I’d hoped, I could realistically break 3:20. The chances of that happening may have taken a hit with this freak shoulder injury, but I’m not abandoning my best case scenario days before the race.

Ironically, I had been fighting a cold for the past couple weeks, eating more fruits and veggies while loading up on vitamin C to stave off anything that could sap my energy and complicate things on race day. I even skipped a cold and rainy training run two weeks ago to ensure I didn’t get sick. Fortunately, those actions paid off, but while I may not have been able to avoid injury, at least my legs are healthy heading into my first marathon. For that, I’m grateful.

I expected to encounter one or two hurdles in my training, but I didn’t expect something so random to happen so close to race day. I’m hoping to get at least one run in before Sunday, but my shoulder isn’t quite ready yet. On the plus side, I have a few more days to recover, and while I could have done without the monkey wrench, I won’t be the only one on the course dealing with an injury, nor am I the only runner whose training was interrupted along the way. Rather than worrying about factors beyond my control, I’m determined to make the best of a less-than-ideal situation. It’s race weekend, a weekend I’ve had circled on my calendar all year, and I’m as ready as I can be.

When life gives you lemons, sometimes you’ve got to figure out how to make lemon-lime Gatorade.

Jamey has tracked his training for the 2011 Chicago Marathon — his first full marathon — in his Runner’s Journal. Assuming he survives, Jamey will return a week or so after the race to recap the event as he looks forward to running the Tough Mudder next March. Email jcodding@bullz-eye.com with comments, questions or your own thoughts on running, and see why Jamey runs.