You might not believe it when your IT band is giving you trouble or your plantar fasciitis is flaring up or even if you sprained your ankle, but there’s good news about being injured.
“The number of times I actually advise injured runners to stop running is very, very few,” says Colleen Brough, director of the RunLab at Columbia University in New York. “If you’re dealing with a bony stress injury, then you’re going to need to sit it out.”
But when most of the other common running injures rear their ugly heads and threaten your next race, try using these approaches to fight back and stay on track.
When your doctor says “rest,” ask what that looks like. Because it probably doesn’t mean sit on the sofa and binge on Netflix for the next six to eight weeks. It usually means rest the injured body part, but keep up your cardiovascular fitness. “Within two weeks of no running, there’s a significant decline in your VO2 max [or aerobic capacity],” says Jason Karp, exercise physiologist and creator of the Revo2lution Running certification program.
Know what “keep running” means to doctors:
That’s not code for “stick to your training program and just hope the pain goes away.” Many injuries crop up due to less-than-ideal running form, which is often amplified when you get tired. Suppose you have a biomechanical problem that’s causing plantar fasciitis. Even if you take time off, the problem will come back once you start running again, explains physical therapist Michael Conlon, owner of Finish Line Physical Therapy in New York City. “Unless you’re addressing the biomechanical issues, the idea of rest and nothing else isn’t that effective,” he says. Make an appointment with someone who can help you correct the underlying problem that’s causing the injury. And do it now. It’s much easier to address acute issues than ones that started months ago, says Conlon.
Add and subtract:
When you’re forced to subtract some miles from running, add another type of exercise to the mix. If you had a two-hour run scheduled and you can only do 60 minutes until you hit the pain wall, then do 50 minutes of physical training and finish up on a different piece of equipment. “I’m not preoccupied with what exercise you choose,” says Jonathan Cane, co-founder of City Coach Multisport, “as long as it’s intense enough to elicit a training effect.” So if swimming isn’t your strong point, then pick something else, as long as what you choose doesn’t aggravate your injury. (It should be a linear sport, Brough points out. Basketball and tennis involve a lot of lateral cutting, which can create new injuries.)
Create new patterns:
Even if part of your run trouble is that your glutes are weak, strengthening those muscles with isolated gym exercises might not be enough to get you pain-free again. You need to learn how to use that strength while you run, says Brough. “I often give running homework—cues you can use while you’re running to correct your mechanics,” she says. For instance, if someone’s knee drifts inward and contributes to knee pain, she might tell them to squeeze their butt as the foot hits the ground to better align the knee. Or maybe for the next 100 feet, they cue up a lower abdominal exercise or experiment with placing their foot flat on the ground rather than striking it with their heel first. It’s called real-time gait training, she says, and it teaches you to create new movement pathways that help you run strong, not just be strong. You can strengthen a troublesome muscle, but if you don’t learn to engage it while running, it can’t help you out.
Vary your intensity:
Mimic the original training plan’s intensity, Cane says. If it should be a hill day, do hill repeats on the bike. Tempo? Do that. Since heart rates can vary on different pieces of equipment, train by perceived exertion. True, nothing exactly mimics running—“You can’t train for a marathon solely on the bike,” Conlon says. “But even when you’re injured, you can do quality exercise and still maintain your fitness for whatever it is you’re training for.”
Be honest with yourself:
Tempted to do your race even though you probably shouldn’t? Karp suggests asking yourself: “What is the purpose of running the race when injured? What do you hope to get out of the race that’s worth the increased risk of making the injury worse?”