Grasshopper

I knew it had to happen. As a clinician, the statistics on running injuries are pretty ugly. Even still, I have been injury free for years. Of course, there is the little stuff that you can train through like a sore achilles. I had not been forced to stop running since I had torn my meniscus 3 or 4 years ago. All this changed a couple weeks ago.

At the end of a typical loop leaving from the gym, I suddenly had crazy sharp pain in my right calf. Basically, continuing to run was simply not an option. I walked a half mile back to work sort of scratching my head about what was going on. My focus was on what had been different in my training. My experience in the clinic tells me that most injuries occur in a transitional period: increases in miles, intensity, or frequency are typical culprits. The strange thing was that I was not in such a period. I had gently returned to running after the Grindstone 100. I thought about my shoes, which that day were my Newtons. I am new to Newtons but they had really treated me well to date. It was not as if the shoe was new to me. Then I thought about the recent training. I had just done a 19 miler with Team Jackass at a steady clip, marathon pace plus 20 seconds. I felt good most of the way. Thinking back another couple weeks I recalled an ankle sprain on the same leg while on the Rock Creek trails. It was a good sprain, the type where you feel the bones clunk. It hurt, but not horribly. I iced immediately and took a break from running for a few days. Without swelling or pain I took back to running. In hindsight, this might have been my first mistake. The best I could do as far as my leg strain goes was that I was compensating for the twisted ankle which caused me to overtax the muscles of my lower leg.

Second mistake for grasshopper was trying to get back to running too soon. I felt the sharp pain on a Thursday, and tried to run two days later. It was such an amateur mistake. I am embarrassed that the PT in me did not smack down the runner in me. It is a testament to the passion of running in us. So I tried to run too soon and made it significantly worse. I felt a pop in the muscle as I gimped back to the car with my buddy Mike Yuengling. The posterior tibialis was in complete rebellion/ shut down mode. I was done for a few weeks at least.

There are a variety of lessons to be learned here. I should know better how to manage these things because I do it every day. Learn from the clinician Doctor G, not the runner Bobby G!

One quick lesson, with more to follow, relates to listening to your body. I frequently help athletes recover from injury. I ask them to rate their pain on a 0 to 10 scale.

If the pain is in the 0 to 3 range, I am ok with resuming normal activity. For a runner, I ask that if the pain is causing them to limp then all bets are off. Otherwise they can gently try to run.

If the pain is in the 4 to 6 range, it is most appropriate to switch gears to cross training. For a runner, as with most other athletes, I like the stationary bike, elliptical, or the pool. Depending on the injury, one might be better than the other. You want to cross train until the pain drops back into the 0-3 range.

If the pain is in the 7 to 10 range, it is time to just shut it down. Focus on letting things calm down. Go back to the basics: ice, compression, elevation, and relative rest. Do this until the pain subsides so you can begin to gently train again.

A key element with the above recommendations is that the athlete is honest with how they assess their pain. No cheating in other words. It is an accurate assessment of the pain. If your pain is a 5/10 but you really want to meet your training buddies for a run then it does not become a 3/10. Recovery from an injury should be about changing training such that you can stay active and heal at the same time. More to follow on that.....