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Runner's injuries

Those who enjoy running have different viewpoints on training, nutrition, sports gear, and other running-related issues. However, if you ask them about their greatest fear, the answer will be the same – injury. It is every runner's nightmare, because it calls for training volume decrease and in some cases even taking a break from training altogether, which leads to abstinence crisis. We get nervous because of the kilometers missed – the ones we would usually do with a smile, adding them later in our notebook. The impatience telling us to start training too early can be fatal – it can lead to chronic injuries and long-term treatments. It is very important to have patience in time of injury, since it will save us time needed to get back on track and after a certain amount of rehabilitation procedures, gradually enhance training intensity enjoying it injury-free. Generally speaking, lighter injuries can be dealt with in a matter of days. But if we don't take them seriously, a more complex injury can occur, leading to rehabilitation lasting for several weeks or even months.

How do injuries happen?

Most of the injuries occur due to overtraining. It is important to keep the weekly progression gradual – around 10-15% in reference to previous week (if you ran 50 km last week, then the next week you can run around 55 km). „Instant marathoners“ will definitely not recognize themselves in this, their progressions being around 50% (sometimes even 100%), crushing personal bests over and over again, and lasting for about a year or two – later they are nowhere to be found, due to injuries which no not allow them any further training. Enormous increase in mileage (50-100 %) will almost always result in injury. Stress fractures are the best example, when overtraining leads to tired muscles which can no longer absorb complete stress, which is being transferred to the bone, causing a tiny fracture.

Other than overtraining, some injuries can be caused by monotonous training, exposing some muscles to the load more than others. This is why variability in training matters so much. One training cycle should contain hills, speed, distance, and some light continuous running, cycling, or swimming in between. Also, one day per week should be used as a rest day.

If we do most of the training on hard surfaces, it is very likely that we will sustain an injury. Remember all those kilometers on a monthly basis and calculate how many times our feet hit the surface, then it is wise to conclude that surface choice has a great role. Other than track fields, woods (a slightly wavy tracks) are a great choice for training. Macadam is also a good choice. Two of the worst surfaces for running are tarmac and concrete, so they should be reserved only for race day. It is a very important precondition for life-long running career with no greater injuries.

Another important factor are the shoes. Generally speaking, good quality running shoes can hold their own for about 1000 kilometers (± 200), and should be replaced afterwards. Before you buy any shoes for their good looks, ask around about their qualities. It is rather simple to educate ourselves today reading advertisements and magazines, which describe characteristics of every shoe model (flexibility, stress absorption). Flexibility is one of the most important features, because of the equal weight load on the foot. Stiff shoes carry the load to the same spots on the foot which then become sore (and this can lead to injury). Running shoe size must be slightly bigger than the regular shoe (one size for flat surfaces, two sizes for hill tracks). Also, you should buy them in the evening, when the foot is bigger.  

A very segment which must not be avoided when speaking about injuries is stretching. Insufficient or incorrect stretching (or lack of it) will bring injuries sooner or later. The worst thing you can do is to drive to your favorite training spot, lock the car, and start running with no stretching or warm-up. After this kind of training beginning, you will most likely end it with limping. Injury has already occurred and it will be too late. You need to walk for at least 500-1000 meters, and stretch afterwards. Stretching must be controlled; otherwise it might also lead to an injury because muscles and tendons are still stiff. When you realize the caution needed for stretching, you will understand how bad it is to start your training unprepared. Stretching should last from 10 to 20 minutes – the shorter (more intense) the training, the longer this combination of warm-up and stretching. If your training lasts long and is low on intensity, the warm-up can be shorter (around 10 minutes). Stretching must include all body parts, especially legs. Everything can be found in MARATONAC magazine, No.3, pp.32-35. You should begin with hamstrings, hips, quads, and then lower back, shoulders, and calves.

I would add one more thing that you should not forget – abs. These muscles are also under huge strain during running and are simple to warm up, doing crunches (lie on the floor, bend your knees, hands behind the head, and lift the trunk to 30 degrees off the floor). This warm-up regime will keep you away from injuries and the movement will be easier and softer. You should also stretch after running, to enhance the muscle recovery.

Also, keep a running diary. Because this is the only way to keep track of training intensity.

How can you recognize early stages of injury?

There are six alarming signs to recognize an injury in a runner.

  • JOINT PAIN -  if while running you experience any joint pain, you must not ignore it. pain usually occurs in the ankle, knee, or hips, while the wrist, elbow, and shoulder are not so commonly affected. Since joints aren't covered with muscles, it is obvious that this is not muscle soreness. Causes of it are rather complex and joint-specific, but the pain usually fades away after 48 hours – if it does not, you must see a doctor.  
  • PAINFUL SENSITIVITY OF MUSCLES – if you feel pain in a particular point in the muscle which enhances on touch, and you do not feel the same on the other side of the body and the pain does not subside after 48 hours, you should see a doctor. This is usually a sign of sprainage, and sometimes even rupture.
  • JOINT SWELLING – rarely occurs by itself but is often combined with pain, stiffness, and grinding sounds due to tendon movement because of the swelling. You must immediately see a doctor.
  • REDUCED RANGE OF MOTION IN THE JOINT – usually occurs along with the swelling, but not necessarily. To establish this condition, you must compare joints on both sides of the body and see a doctor immediately.  
  • PARESTHESIA (TINGLES) – are a nerve compression consequence and can be dangerous. You can wait up to ten days and if the condition does not improve, see a doctor.
  • COMPARATIVE WEAKNESS OF SOME PART OF EXTREMITY – if you notice that one of your extremities is weaker than its counterpart, it might signify a serious injury. A doctor will diagnose the condition after certain tests.
What should I do once I have established signs of an injury?

You must not let it get worse by continuing with the activity. But also, it is not necessary to visit the doctor right away. You can also help yourself.

Treating the injury:
  • Stop the running immediately
  • Apply bandages and compression bands to the injured part
  • Put ice to it, but no longer than 15 minutes. Before you apply it again, make sure that the injured part has properly warmed again, in order to avoid cold burns. Never put hot bandages on an injury – they enhance the blood flow and make swelling and pain worse
  • Elevate the injured part

If this does not help, see a doctor. If your physician concludes that the injury is serious, he or she will advise you to see a specialist (orthopedist, surgeon, physical therapist). This way you will have the diagnosis in no time and will be able to start therapy, which is crucial if you want to get back on track as soon as possible.

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