Thoughts About Running Injuries

If you’re looking for a resouce on how to cure a nagging running injury, this is not it.  For a great resource on learning how run injury-free, pick up a copy of Running Strong & Injury-Free, by Janet Hamilton.  You’ll learn there are five main causes of running injuries–training errors, inappropriate footwear, inadequate flexibility, inadequate strength, and poor biomechanics.  The trick of course, is learning how to train while preventing injuries.  Triathlon is the best thing I’ve ever done to prevent running injuries.  The cross-training helps prevent overuse and repetitive use injuries.

Most Common
I’ve had plantar faciitis and it sucks.  It feels like the bottom of your foot is being ripped off.  It’s one of those injuries you can try to run through until it cripples you.  If you don’t recognize it, you’ll easily spend lots of time and money with a battery of doctors, podiatrists, accupuncturists, chiropractors, and other gurus.  My physical therapist used massage, ultrasound, stretching, heat/ice, and then taped my foot in a manner I would never be able to do myself.  Then after an extended break from running, I started with a 2-mile run and added a 1/4-mile each day until I was back to my normal training regimen.  I bought a calf stretching device which I should really use more often.

Runner’s Knee is very common.  I’ve had it on and off this year.  When my PT diagnosed it as patellar tendinitis–the technical term–I figured it was the result of running 60 – 100 miles a week on trails.  Knee injuries comprise about 55% of all sports injuries and approximately one-fourth of all problems treated by orthopedic surgeons.  A bad knee convinces lots of couch potatoes to stay on the couch.  Don’t do that.

I haven’t had shin splints since high school but it’s very common with new runners.  I sort of think of shin splints as a rite of passage.  Lots of rookies get it.  If you can get past this annoying injury, you can probably train for a lot of different things.

Everyone calls it ITB Syndrome.  That’s Iliotibial Band Friction Syndrome.  Sounds like a world of hurt and I’ve never had it.  Now I’ll probably get it.  I’ve always dreaded this one, partly because it seems unavoidable.  The iliotibial band starts on the outer hip, runs down to the outer knee, then attaches to the lower leg bone.  It spans so much of the leg it’s a miracle I’ve avoided this one.  I even have an ITB strap for running but I’ve never used it.  I’ve also had the good fortune never to have had blisters.  I think it’s because I have a good foot strike and I take great care with shoe selection.  I’m not sure blisters are really injuries, although the ones you see at Badwater or other ultras look far worse than most injuries.

Most Painful
The worst injury of all may be a torn Achilles tendon.  The few people I’ve met with this injury have never quite returned to their former running condition.  This can be a career ending injury.  I watched Brad Pitt go down in the movie Troy when they shot him in his Achilles.  It looked like it really hurt.  Crashing my bike into a rock wall was more painful than any running injury, resulting in a deep gash in my right hand and plenty of road rash. I’ve also broken my back in seven places while tree skiing and separated my shoulder in a separate incident at Lake Tahoe, but that’s a story for another time.  Suffice it to say I understand pain.  What I have learned is that recovery and rehab from a serious injury requires more mental toughness than physical effort.

Hard To Diagnose
Chronic Exertional Compartment Syndrome
is not easily diagnosed.  Lots of runners have never heard of it.  It’s a lower leg injury that occurs when muscle groups outgrow their normal “compartment” size.  I’ve never had this one and hope I never get it.  Maybe I should train less to avoid it.

Plica Syndrome or Plicae Band, also known as synovitis, is an irritation of the synovial membrane in the knee.  It’s a thin, slippery material that lines all joints.  There are four plica folds in the knee, but only one of them seems to cause trouble.  It won’t show up in x-rays or an MRI so it’s hard to diagnose correctly.  My physical therapist thought I had a pinched miniscus.  I had to see sports medicine doc who specialized in running injuries to get this one treated.  I opted for an immediate shot of cortisone in my knee, which allowed me to run a marathon five days later.

The Shoe Conundrum
There’s been a lot of hysteria and hoopla this year about running barefoot or wearing the glove-like Vibram Five Fingers after the launch of the wildly popular book, Born To Run, by Christopher McDougall.  I thoroughly enjoyed the book, and I’m amused by Tweets from Barefoot Ted and Caballo Blanco, but I’m not at all interested in taking off my perfectly comfortable runnning shoes.  You can do what you want, but I’m pretty sure I was born to run with shoes.

I’ve been watching my left big toe change form and color since I nearly destroyed it in July doing the Tahoe Rim 50K.  I had inserted my road shoe orthotics into my trail shoes which are a half size bigger.  Tha’ts not a good thing when you’re tearing down a hill 25 miles into a 50K.  Haven’t we all calculated how long it would take for a toenail to grow back?  Will it grow back in time for this or that race?  What if it falls off in the middle of a long run or race?  Will it hurt?  A black toe generally doesn’t even hurt, but the sight of it makes it look like an injury and so we look at it every day as if we’re injured.

I’d like to think my experience has taught me to be a smarter runner and triathlete, but I think it’s more a case of trying to do fewer really stupid things.  If training, racing and working out is a lifestyle thing for you like it is for me, you’ll probably get injured.  Unless you are Dean Karnazes, who claims he has never had a running injury and credits his perfect biomechanics.  Dean is a baffling example of staying injury free, but that’s not to say he has never been injured. He fell and cracked three ribs at the Transrockies Run this year and could not finish the event.  It’s possible to have perfect biomechanics but it’s extremely rare.  It’s like saying you’ve never had the common cold.