Well, it’s been a number of weeks since my
last post and there is a reason for it. Unfortunately, I have forced myself to
take a few weeks off due to my nagging knee and now I am now slowly making a return
to my usual training program. What started as typical soreness slowly
progressed into more serious pain, affecting my ability to walk and run.
Despite the absence of swelling, the possibility of a serious tendon tear still
worried me. Initially, a few days of rest provided no relief and I decided a
full week off was necessary. Still, no progress. The following week, I forced
myself to ride my stationary bike for at least an hour every day. However, this
was incredibly boring because I've seen all the movies in my collection too
many times. My knee slowly began to make progress, but was still far from
feeling normal. By the first week of March, it had improved enough for me to do
easy runs of twenty minutes every other day with cycling in between.
Fortunately, on March 10th I was able to see an athletic trainer at LSU for free. I was shocked to hear that
my flexibility was what he would expect from a sedentary person. He suggested I
start stretching once per day at a minimum. He believed that my pain was
originated from an aggravated pes anserine. The pes anserine is an area where all the muscles of
the hamstring group form a long tendon and wrap around the front of the lower
medial knee and attaches to the tibia. Lack of proper post run care had led to
stiffness in my quads, hamstring complex, and calves, causing other muscle
groups to overcompensate leading to injury. The trainer used a combination of pulsating
ultrasound and massage immediately followed by a stretching routine. Since my
initial visit, there has been significant improvement. Over the past two weeks,
I have progressively increased the duration and frequency of running. Most
importantly, however, I have increased my post-run activities. Immediately
after running, I stretch before getting in the car while my legs are still
warmed up. Once home, I use a massage ball to break up muscle stiffness
followed with a more intense stretching routine. Since the tenth, I haven’t experienced
any knee pain during workouts and the pain associated with stretching has greatly
reduced. With this injury, I have realized it’s important to maintain a positive
attitude and to use time accordingly. I recommend identifying the cause of the
injury, being proactive with treatment, and preventing future
occurrences.
Taking time to
identify the cause of the injury is very important. I believe there are two
types of injuries. The first is an immediate injury which is caused by a one-time
event. These injuries typically have symptoms that immediately express
themselves and the source can be pinpointed. For example, a fall or a misstep.
The second type is a long-term injury, which results from continual overuse or
muscle imbalance. These injuries typically begin as soreness and escalate into
a serious pain if left unchecked. Some muscle soreness is expected from hard
training; however, if it doesn't disappear after a period of lowered intensity,
something else may be wrong. Long-term injuries are harder to identify. When
diagnosing the source of an injury it’s important for us to be honest with
ourselves since different types of injuries have different methods of treatment.
After identifying the cause of the injury, we need to be proactive
in treating it. The most important aspect is to take sufficient time off and
slowly build back into a training program. If it is an immediate injury such as
an ankle sprain, a few days off and some icing may do the trick. However, a
long-term injury may require more than just time off and ice. In the case of my
knee injury, I had to seek professional treatment. The combination of ultra-sound,
massage therapy, the addition of stretching into my routine, and icing have
been successful so far. Obviously, everyone is different and so are the
injuries we sustain; if it’s something serious, get professional help. If the injury
is a long-term one due to poor bio-mechanics or muscle imbalances, it’s
important that we try to minimize future occurrences. This can be achieved by
simply doing a proper warm-up before exercise and a proper cool-down with
static stretching after running. Previously, I was never a fan of stretching.
Now, however, I think it is more important, especially important for trail
runners. Stretching increases the range of motion our muscles and tendons are
able to withstand. Flexible muscles and tendons are better able to absorb the
twisting and bending that we subject them to while running trails. Conversely,
a tight muscle or tendon with poor flexibility, decreased range of motion, is
more likely to break or tear when it twists further than it can sustain. In
addition, core strength is essential for every runner. I have always done core
strengthening routines in my weekly workouts but since this injury I have been
giving them greater focus. I recently picked up a book by Jeff Horowitz called Quick Strength for Runners: 8 Weeks
to a Better Runner's Body. What
I like about the book is that it offers an eight week program including over
forty exercises with explanations on each workout and how they affect the
performance of our running. Currently, I'm halfway through the eight week
program, doing the prescribed exercises three times a week, and sometimes
modifying the amount of repetitions for each workout. Trail runners deal with a
variety of terrain that is constantly changing and challenging so I personally
believe that a combination of flexibility and strength will improve our ability
to run trails efficiently and minimize injury.
While this is a personal
testimony, I do feel qualified to speak about long-term injuries because I have
dealt with several related to over-training throughout the years. However,
professional help is usually always the best and is the most advisable. With that
said, I do hope that you implement proper warm-ups and cool downs, stretching,
and core strengthening into your
training plan so that you can get the most out of your running and hopefully
prevent avoidable injuries in future. Hopefully I will see you all on the
trails soon!
