As a runner, injuries sure do suck! It can feel like a pretty dark time when you’re no longer able to do the thing you love and stop something that makes up so much of your identity!
Injuries also seem to pop up just as you are starting to feel on top of your game! sometimes the body can skip the recovery when the physiological stress is a little too much and recovery time is too little, leading you down that scared road to injury.
A small niggle appeared in my hamstring post threshold session back in June. I knew this was not just going to go away with a simple recovery day, a bit of ice and compression! My first point of call was reaching out to our amazing team physios at the Running Room, Luke my physio has assisted me every step of the way on my rehab journey dealing with ‘Proximal Hamstring Tendinopathy’. I would absolutely recommend Luke to anyone with a injury, he has been incredibly supportive and the most amazing problem solver. It's been small baby steps but everyday we are getting closer to becoming injury free.
Below I am going to share a few things that I have learnt along the way of recovering from injury and hopefully I can share with you some tips and advice for whenever life throws an injury at you!
1. Comparison
Firstly comparison! With the huge platform of social media it is so hard to get away from seeing what everyone else out there is doing! You open Strava and Instagram and all that catches your attention is all the runners/athletes training hard and injury free!
Comparison is always the theft of joy and in a world driven by social media having regular checks in moments with myself has been so powerful. I spend 5 minutes every evening just before I head off to dream land journaling and reflecting on:
What went well today in my training?
What did I enjoy?
What did I learn from today to make tomorrow even better?
The key messages that have helped my recovery is control the controllables and focus on those things you can do and not what you can’t.
2. Cross Training
Cross Training has played a massive part in my recovery journey, to maintain my cardiovascular fitness, aerobic base and keep my sanity when not being able to run as much as I’d like too.
Over the last 5 months I have been experimenting with the best combination of exercise modalities to not aggravate my injury whilst keeping up my aerobic fitness and hopefully get stronger in the process. There are so many options of Cross Training out there - You can bike, swim, spin, row, use the elliptical and aqua-jog and even anti-gravity treadmills.
A key question for me was - are any cross training options better than others? And most importantly which form of cross training will least aggravate my hamstring? This is when I delved into the research.
Cycling and treadmill running are both beneficial in developing your aerobic system. Yet maintaining your aerobic base is only one part of the picture. Another important factor is specificity, which means how similar is the form of cross training to running. This is when the elliptical started to call my name!
Research has shown that training using an elliptical can elicit similar VO2max values, heart rate measure and substrate oxidation to treadmill running, whilst performing an action similar to running (1). The only downside to me with the elliptical was being confined to the four walls of the gym. Thankfully the recent development of spotify audiobooks and all my well loved running and triathlon podcasts has gotten me through these sessions.
I have been using the turbo to replicate the training response of my track based sessions to remove the impact and time adventuring the roads - cycling is great for the cardiovascular system however not so specific to running. I have fallen in love with cycling and it has been great to replace all my running, meeting new people and trying something new!
When choosing your form of cross training when facing an injury it is important to consider the type of injury you have. Some forms of cross training can put a little too much strain on the site of injury preventing the healing process thus being counter productive. For me to avoid repeated extension of my hip I have been swimming with a pull buoy. If you're not too sure on which type of cross training to do with your specific injury - contact your local physio or doctor.
3. Strength Training
The gym has been my best friend over the last few months and although I was already an avid gym goer I have spent a lot more time focusing on my strength, personal imbalances and overall technique. The last few months have been a great window of opportunity to work on my weaknesses and become stronger. My rehab exercises have been specific to my posterior chain (hamstrings, erector spinae, glutes and calves). Alongside this I have been focused on strengthening my trunk and core key for stabilisation during running to develop good form and posture and thus reduce risk of injury and enhance our running economy (3).
To keep motivation levels for training high instead of purchasing a new pair of wheels for running I decided to invest in some new gym shoes - The Nike Metcons 9 which I absolutely love!
4. Running during an injury.
Although I have been doing lots of cross training I haven’t completely stopped running. I have kept 2-3 easy runs in my training week with the addition of mini tempo sessions (starting at 5 x 1 minute efforts at target marathon pace). Running during recovery from a soft tissue injury has shown to be safe and effective as long as the pain is kept at moderate levels thus allowing tendon healing to occur. During all of my running based sessions I have made sure my pain level has not exceeded 4/10..
Overall, research suggests that as long as the pain is below 5 on a scale of 0-10 it may be safe to run during rehabilitation. This is based on the ‘Pain Monitoring Model’ although most of the research in this area is on Achilles Tendinopathy and Patellar Tendonitis (2). Again I would recommend seeing your local physiotherapist or doctor before running with your own injury.
It is super important when you return to running you perform this safely! It can be super exciting when you can finally run again however it is important to remember how far you have come and not to jump straight back to the volume of running you were doing pre-injury as this will result in the potential flare up of the injury or even another niggle.
It is also reassuring to know you come back to previous fitness levels a lot faster than it took to build the first time round! It’ll take a couple of weeks but soon week by week, day by day you will be back to where you were. You’ll be back running in those threshold zones feeling fitter, faster and stronger than ever.
I hope this blog post was of help for any of you out there with an injury and shows to you cross training can bring you back to running stronger, efficient and faster than before.
Thanks so much for reading my first blog post, the next one will be based on my nutrition approach during my recovery from injury!
Ams x
References:
Bosch AN, Flanagan KC, Eken MM, Withers A, Burger J, Lamberts RP. Physiological and Metabolic Responses to Exercise on Treadmill, Elliptical Trainer, and Stepper: Practical Implications for Training. Int J Sport Nutr Exerc Metab. 2021 Mar 1;31(2):135-142. doi: 10.1123/ijsnem.2020-0155. Epub 2021 Jan 20. PMID: 33477112.
Silbernagel, Karin & Thomee, Roland & Eriksson, Bengt & Karlsson, Jon. (2007). Continued Sports Activity, Using a Pain-Monitoring Model, During Rehabilitation in Patients With Achilles Tendinopathy A Randomized Controlled Study. The American journal of sports medicine. 35. 897-906. 10.1177/0363546506298279.
Šuc, A., Šarko, P., Pleša, J. and Kozinc, Ž., 2022. Resistance exercise for improving running economy and running biomechanics and decreasing running-related injury risk: A narrative review. Sports, 10(7), p.98.