Running After an Injury

​I started running again, after a two-year hiatus. I wanted to share what I learned from developing and recovering from an overuse injury.

The day I decided that "my thing" for the next year would be running, everyone was surprised, especially me. I had never run a mile in my life, and I was 35. On my first run, I couldn't make it around the block and I had to lie on the floor afterward. I'm nothing if not stubborn, though, and I kept going, running every day for the first several months. Four years later, I ran a marathon. Untrained, no coach, adapting a training plan I got out of a book, because I'm supposedly smart enough to figure everything out for myself.

While training for that marathon, I developed tendinitis of the anterior tibialis. (That's the tendon in the front of your ankle that makes your foot flop up and down). It was so painful that I would sometimes wake up in the middle of the night feeling like someone was kicking my ankle with a cowboy boot. I got two MRIs, which showed nothing, and did physical therapy for six months, after which I was still having unexplained pain.

I attributed the tendinitis to making too many changes to my routine at the same time: changing my terrain from dirt and gravel to concrete; doubling my mileage; and changing from a barefoot shoe to a minimalist shoe. I get a strong analgesic effect from running, which is the main reason I do it - for several hours after a run, I feel total relief from physical pain. I would run, feel great, get up the next morning, do it again, and thus keep passing the buck of the developing stress injury to the next day. By the time I was really feeling it, I had done some damage to myself. I would never quit, though, or postpone my marathon to a different year. I had made an internal and a public commitment to follow through, and I would do it if I ran myself to bloody stumps.

That was dumb.

What I wish I had done was, first, to not advertise my commitment. I should have simply worked on building my mileage until a marathon distance felt like a natural outgrowth of my routine. Deadlines don't have much motivating effect on me one way or the other. I run because I like it, I want to, and it feels good. (Except for when it hurts so much that I can't run another step).

The second thing I should have done was to STRETCH for at least a couple of minutes during my cool-down. I blew this off for four years. If I had taken the need to stretch seriously from the beginning, I might never have had the problem. I traded something that is free and feels great for months of intense pain that cost me hundreds of dollars in physical therapy. Whoops.

The third thing I should have done was to take seriously the concept that there are effective and ineffective ways to do things. I should have had more respect for expert opinion. There are stretches and strength-building exercises pertinent to distance runners. I knew about them, but I disregarded them because I felt like I was doing just fine on my own. I procrastinated on learning a few basic movements that even a kindergartener can do, like high knees, partly because I was always high on endorphins when I came home. Past Self, you fool!

Physical therapy and the search for relief brought me around. I learned that my orthopedist was chronically backlogged and literally never read the notes from my file until after I had my five minutes in the office with him. He wasn't oriented toward feedback from the physical therapists and thus wasn't learning more about recovery from sports injuries. I wish I hadn't gone for the second MRI, which I now see as a cash-generator for the clinic. I have huge respect for physical therapy as a healing profession; these are incredibly dedicated and educated professionals who see visible progress in their patients every day. However, there is a laser focus on the specific area of the pain, and I didn't learn enough to prevent its recurrence until further in my Fact-Finding Mission.

I wore an ankle brace. They hooked me up to some kind of electrical contraption. I ate fistfuls of anti-inflammatories. I stretched. I did PT exercises twice a day. I did heating pads. I did ice massage. I limped for months.

A year after I finished physical therapy, I started working with a trainer at the gym. He focuses on recovery and corrective exercises. When we met, I explained my injury in a few seconds, and he immediately described all the areas where I was feeling pain and weakness. I was thunderstruck. He didn't have a file on me, wasn't looking at an MRI, hadn't put me on an examination table, hadn't watched me do any exercises, and hadn't even laid a finger on me other than shaking my hand. Somehow, he already knew more about my injury than the PT did. What was he, a swami? We worked together, and he explained that I probably had referred pain from my tight calves. He referred me to a friend who does shiatsu massage.

THAT actually worked.

What I know now is that I need to continue to do strength training exercises, for the rest of my life. There is no point in avoiding it. Hip stability exercises, core, and quads. I need to stretch. I get a lot out of using the foam roller, even though I hate it. It's better if I run no more than three days a week, even though I want to do more. I have to cross-train. I need to be WIDE OPEN to constructive feedback from any and everyone who knows more than I do.

I want to do another marathon, and I want to run ultra. That won't happen if I push myself too hard. It won't happen if I ignore my body. It won't happen if I try to be all Stoic and prove points to myself. The path of wisdom here is to make my body stronger and more resilient. If I want to show off my supposed iron will, I can do it in other areas of life. I'd like to be a running machine, but alas, all I have is ordinary human flesh.

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