Running Through Injury: When You Can/ Can’t and How I Did It
It is the nature of most runners to ignore at least some level of pain and continue training until the situation becomes dire. Although it is best not to let the situation come to that, there are some injuries you can run through and some that you either can’t or shouldn’t. Read on to see which is which and what I did when faced with them.
I’ve suffered three major injuries that have kept me from running—a severe iliotibial band strain, a tibia/fibula fracture requiring plates and screws to repair and a torn meniscus.
Everything else, I trained through and although it was sometimes painful when I paid extra attention to them at the beginning instead of ignoring them and hoping they would go away, my injuries were relatively brief.
And even when running is not recommended, there are other training methods you can use to maintain your level of fitness so that when you are cleared to run, the transition back is a smooth one.
When you shouldn’t run
Obviously, any traumatic injury such as a fracture or ligament or tendon tear or damage will sideline the toughest runners. Depending on the severity of the injury, you will probably have difficulty walking, let alone running.
But just because you are sidelined from running, it doesn’t mean that you can work out in some other way. For instance, while my IT band healed, I was confined to the pool—long before the advent of aqua vests—literally running in the shallow end of the pool for my workouts. Of course, if you are a good swimmer (I am not!) you could aqua jog and swim.
After surgery to repair my broken leg, and because I was in a removable boot, I was able to ride a stationary bike, starting with little resistance and then increasing resistance as I was allowed. Through biking, I was able to maintain my aerobic capacity and regain some of the muscle mass lost due to atrophy.
After I tore my meniscus and opted not to have surgery, I returned to the stationary bike but continued to do modified HIIT workouts, skipping lateral movements like side lunges as well as plyometrics like tuck-knee jumps, etc. Because I continued to train with modifications, my orthopedist agreed I could skip the usual course of physical therapy.
Stress fractures, although they don’t seem traumatic, can become displaced with continued pounding and force. Stress fractures require time off from running to heal properly. I have seen cases in which the athlete and his/her doctor believed the stress fracture has healed, the athlete is cleared and returns to running, and the stress fracture recurs.
Compartment syndrome also requires time off and in its acute form can require surgery to repair. Swelling and bleeding in the compartments (groups of muscles, nerves and blood vessels) of the arms or legs increases pressure which restricts blood flow to the compartment causing muscle and nerve cell damage. Acute compartment syndrome is most often caused by a traumatic injury such as a fracture; chronic compartment syndrome is caused by exercise. The most common symptoms of chronic compartment syndrome are pain and cramping while exercising which can be easily mistaken for regular pain and muscle cramps. Other symptoms include muscle bulging, trouble moving the foot and numbness.
When you can run (if you want to)
Of course, everyone’s tolerance for pain and discomfort ranges widely. Although there are some injuries you can train through, you might find that the pain is too great for you to tolerate. And if the injury is causing you to alter your gait in any way, continuing to run could make you susceptible to other issues and injuries to your uninjured leg.
Soft tissue injuries such as ankle sprains, plantar fasciitis, tendinitis, runner’s knee, shin splints, iliotibial band syndrome, piriformis syndrome, may not have to sideline you completely and may only require some modifications in your training.
The modifications I found most successful were a longer than usual warm-up; a greater amount of post-workout stretching and supplemental stretching throughout the day specifically geared to the injury; icing throughout the day, especially following a run/workout; injury-specific strengthening exercises and a regular course of NSAIDs. My minor injuries all occurred before the boon of elastic therapeutic tape, which I would probably use now to aid in recovery in the short-term.
For instance, when I had Achilles tendinitis, I spent extra time stretching before my run and considered the first couple miles part of my warm-up, running them extremely slowly. When the tendon loosened up sufficiently, the pain was such that I could run without altering my gait. After running, I spent a lot of time stretching my Achilles and calf on a foot rocker and then followed with a period of icing. I also took NSAIDs regularly but not a crazy amount. Two every four to six hours to start and then two every six to eight hours. I slowly weaned myself off them once the pain and inflammation were under control.
I used this same method when running through plantar fasciitis, swapping stretching on a foot rocker to rolling my arches on a golf ball. And the same method again for hip flexor tendinitis, but foam rolling instead of the golf ball and foot rocker.
In addition to these recovery methods, I dropped my mileage and my running intensity until the injuries were under control. And, I also started treating the injuries in their early stages, before they could hamper not only my running but my daily activities as well.
The bottom line
This is my own personal experience with training through injury and may not suit others. If the injuries hadn’t responded positively to what I was doing, I would have taken time off and seek medical advice if it was warranted.
Medical advice is necessary for an acute injury and often necessary even for minor ones. For instance, it is sometimes hard to tell the difference between pain from a stress fracture and that of shin splints. And although stress fractures don’t often show up on x-rays, an orthopedist can tell the difference. Don’t attempt to train through an injury unless you are fairly certain what the injury is; you may need to consult a doctor to figure that out.