The riddle of strecthing for runners

This article confirms my suspicion that as runners we need to:

• stretch the hips and front of the leg, especially from the knee up
• avoid stretching the back of the leg (i.e. hamstring and calves but excluding the glutes), or at least not go hard on these area

Why not stretch the calves?

A little bit of stretching might be OK, but I have found it's easy to go overboard and cause injury by stretching the calves too much. Rolling seems OK. But again, gently.

The massage gun also feels good on the calves, at least the sides of them in the thinly-muscled areas.

Stretching the calves in the deep squat position (either by doing deep squats or just squatting down on purpose to stretch) is a good way to keep it within a safe range.

Holding a front squat is also a great isometric exercise for the tibialis anterior. 

I've actually found isometrics to be a far better way to deal with calf niggles and pains: it gets rid of the pain and coupled with isotonic lifts (calf raises) it seems to help make the calves more injury resistant.

Because there is a riddle of stretching for runners.

You know you don't want to too tight in places, but you can't just become a yoga fiend. And it's not just about doing the right stretches; it's about avoiding the harmful ones.

Getting good at getting over niggles

They come up, and I get over them in a few days with no fuss.

Last week, I got heel pain after a longer flat run in Z2. Probably from doing this workout too soon after a trail race.

How did I get over it?

• reduced but did not stop running
• did isometrics (ground squeezes with the feet and static calf raises)
• kept doing strength work as usual (heavy leg work at the moment)
• applied KT taping
  
• massaged lower calf and anterior tibialis

Barely a bump in the road.

I think it's not only the approach but the fact that I'm always doing strength training that helps me get over these things so quickly.

My calf/Achilles rehab plan

Luckily, I've had a steep recovery from what I thought might have been a long-term niggle. I'm just about back to normal training.

The only things I don't think I'm quite ready for right now are long runs with lots of elevation gain and high intensity running.

From what I've been reading and hearing about tendons (this video is excellent), the isometric exercises I've been doing and continuing to run have probably been the key.

I'm even rethinking my weekly day off from running (again!). Apparently tendons need an almost daily load to stay strong and functional. I think this is even more important as you age because the signal from training is weaker.

So it might make sense to run every day, even if just for 20 minutes on what might otherwise have been a weekly day off.

Of course, it's vital to be ready to take a rest day at the drop of a hat and rest upfront when you do get something more than a niggle you can run through.

Anyway, this time I'm not going to stop at just getting back to where I was before. My calves are obviously a weak point, so I'm going to make them and my Achilles stronger.

Calf/Achilles plan

1. Calf raises and holds a few times a day (already doing)
   
2. Keep running and get back to normal training (the Big Vert plan)
   
3. Heavy lifts a few times a week (e.g. 4x8 single-leg calf raises) with other leg training (e.g. squats and deadlifts) (start next week)
   
4. Skipping and other plyometrics, building up to the single leg jumps as explained here (maybe start this week)
   

 

Recovering faster than I thought, and happy I've discoved a weakness

Running didn't feel that great yesterday morning --- probably due to the physio session the day before. But my Achilles felt good later yesterday. And today it was heaps better. I barely noticed anything on my run this morning.

Calves: my weak link

According to my physio, the calves work hard when going uphill. It's basically the glutes and calves going up and the quads coming down.

Out of these muscles, my calves are surely the weak link. So once I get over this injury, I'm going to work though the progressions on this page to make my calves stronger.

I've always avoided calf exercises because they seemed to cause niggles. But precisely for this reason I probably should have focused on them.

I've started doing static calf holds four times a day (5x45" with a 15" break) in line the progression outlined here. I think it is already helping.

Rehab for increasing pain threshold

In this podcast, the researcher/physio interviewed explains why exercises help rehab.

It's not just to make the muscles stronger and hence more resilient to injury. Apparently doing exercises also increases your threshold for pain in the area worked, and this also makes you more robust. 

Fascinating!

It makes sense from my experience.

Oftentimes, calf niggles and tweaks seem to be from oversensitivity --- an overreaction to a brusque movement that no way could have caused damage and obviously doesn't most of the time because the pain's gone the next day.

So calf raises and skipping, here I come!

Reactive Achilles tendinopathy, apparently

That's what my physio told me today. Probably from the change in training to doing more climbing.

His instructions were to cut volume and elevation for a week or so and then start building slowly. Also to do isometric calf holds. I found some good resources online for progressing these. This page, for instance And this podcast is really good on tendon injuries in general.

So I can still run.

I'll keep to the flat for a while, but I may take some time off. I really don't want to make this any worse. Although apparently I should do what I can to make sure the area doesn't get weaker.

My physio and the Internet tell me pain should be my guide: do what doesn't hurt too much or makes it worse within 24 hours. Then build from there.

I'll swim and cycle, too.

Just when I thought I was feeling good...

Oh look! An Achilles or calf injury!

Which is why I wrote this running injury protocol post.

What injury?

Left Achilles, but fairly high up, so it might be a muscle.

There is a painful-to-touch lump on the side of my Achilles, though. Not sure if it has been there since I did the injury on Thursday or if it's from today's hike.

What now? Throw the kitchen sink at it:

• See if I can run on the flat (tomorrow or Tuesday)
• Rehab exercises from today (calf raise holds to start with)
• Lots of leg and other strength training now that I'll be running less if it all
  
• Cross-training (swim, hike, bike and kettlebells)
• Physio if I can get an appointment soon
• Patience. At least I get to start again!
  

Running injury recovery protocol

For everything from:

• niggles you get over in a week to serious injuries that drag on for months
• relapse injuries to unfamiliar pain

Not for things you know are nothing.

Disclaimer: this advice is for me. It's based on my experience and what I've read, heard and seen. I'm not an expert of any kind.

1. Rest up front

• One to three days (straight after the injury)
  
• Light cross-training only, if anything. Resist the urge to jump into heavy cross-training. Let your body direct all its resource to healing. Also, cross-training may confuse pain messages
• Up or maintain usual protein intake
• Apply ice (even if just to reduce pain)
  
• Possibly tape (if it doesn't confuse the signal)
  

2. Find a starting point for activity

 Running or endurance cross-training

• Find a relatively pain free starting point for the most running-similar activity possible that you can do nearly every day (i.e. running, run/walk, hiking or walking; e.g. 20' running with breaks every 5', 60' hiking or 45' easy running on the flat)
  
• Two indicators for this point:
• Pain not worse or better at end of run
  
• Pain not worse or better 24 hours later
• Supplement the running or running-like activity with cross-training if necessary (i.e. you're doing hardly anything)
• If you can't do a running-like activity, cross train until you can
  
• If you can't cross train, rest until you can
• Tape as necessary
• Train consistently (every day if possible)
  
• Build up training to normal running

Lower-body strength training

• Find a starting point for general, running-specific and rehab strength training
• Rehab exercises probably won't be necessary for niggles
  
• Train consistently (every day for the rehab exercises)
  
• Build up to normal strength (for serious injuries or weaknesses you discover through niggles)
  

Other training

• Right from the start (in the first three days), turn up the volume on body weight and kettlebell training: pullups, dips, snatches, Turkish get-ups, swings, cleans and presses. This will give you another focus
  
• Strength training and exercise in general may trigger protein synthesis. So training another body part may help heal your leg or foot injury
  

Tendon versus muscle injuries

• Muscle injuries can cause more pain in the beginning but will heal quicker. So pain can be a good guide as to when to restart activity
• Tendon injuries may hurt less early on, but the pain can last longer and will often still be there when you can run again. So don't pay as much attention to pain with tendon injuries once you are training consistently and building up sensibly

Niggles and light injuries 

You may discover after a few days rest that you don't have anything serious. This should be the case most of the time if you take days off whenever new, sudden and unfamiliar pain occurs.

If you only have a niggle, still follow the above protocol. The manageable starting points will just be toned down or adapted versions of usual training until most signs of weakness have gone. This may only be one day.

The problem with recovery weeks

They're in just about every plan you find, and everyone says you should have them. But should we schedule recover weeks? Maybe it's better to let them happen by de facto when you have a niggle or some other commitment stops you from training as you normally would.

Last week I was feeling great. But it was a recovery week, so I held off from running on a couple of days and kept my long run short.

I had this feeling that I might be wasting an opportunity to get in a good week. Who knew what would happen next week?

Lo and behold, next week has come along, and I'm struggling to hold it together.

First, an adductor strain because I was too keen with my cross-training, and today a strain in my lower left calf that might mean taking a day or two off.

So maybe last week I should have done a normal long run and even hill sprints.

You never know what's coming!

I'm not sure what to do with this information. But I think it goes back to listening more to your body.

But then you can feel really good, do more, get injured, and then look at your over zealous ramp and see that as the problem.

But perhaps there's a way to both things.

Follow a plan loosely, make sure you don't make any big jumps, but always understand that even the next workout isn't guaranteed. You might have to cancel it because of a niggle.

And don't stop if you don't need to. Maybe just wait until you get a niggle to take a couple of days off.

Picking up niggles while cross training: Fail!

That'll learn me! Too much breaststroke on sore muscles = adductor niggle.

I was eager to train some more on Tuesday afternoon. I couldn't do my ME workout because my legs were still sore from a leg workout I did on Sunday (starting again, hence the sore muscles).

So I swam some laps.

I ended up doing lots of breaststroke, probably too much. I just wanted to stay in the pool longer! Later on I noticed a niggle in my always weaker or at least overstressed left adductor. Fail!

It was nothing serious and is now gone (on Thursday). But it did mean I couldn't do the ME workout I wanted to do yesterday.

Lesson: Take cross training easy when it's for recovery, especially on sore legs when doing a movement you don't usually do!

Yes, I am getting mountain stronger!

What I suspected in my last post has been confirmed this week.

I did my longest muscular endurance workout yesterday evening with and increase in weight, and I felt fine during it and even pretty fresh on my run this morning.

Niggles mean something! Who'd've thought?

I'm also seeing how wise it was to take days off here and there a few weeks ago when I was getting seemingly random niggles.

They were frustrating, but they certainly weren't random. It looks like my body was asking for a bit of rest so it could adapt to the new stimuli.

In hindsight, it's obvious. But at the time it wasn't because I didn't feel tired, fatigued or even sore. I just got tweaks and niggles out of the blue. (Of course it wasn't out of the blue because I was doing new things.)

Now I see that these niggles meant something. I was right to heed them. 

In my usual short-sighted way, I thought I'd never get through them at the time. I thought I'd have to scrap the training plan. But now I see how small a setback those niggles and few days off were.

Let's hope I can remember this for next time.

The main goal in running is to not get injured

That's it: don't get injured!

At now, for me, a 48 year old. But even before.

Perhaps not when I was running in high school, doing cross country and training for other sports. 

Perhaps not when I was in my twenties and running just to stay fit and get outside. Although I did have injuries and niggles even in then.

But in my late 20s and beyond, when I was trying to get better at running and doing races, the goal always should have been just to not get injured. Everything else would have taken care of itself.

I wasted many a year piling training on injuries and niggles until I buried all chance of making it to the start line.

Other sports aren't like this. Even the contact sports I've done. You can get injured. But serious injuries --- ones that stop you from training --- are near freak events. And most of the minor injuries can be trained around. You can still do your chosen sport.

But the threat of running injuries always looms. And the injuries normally stop you doing your sport.

Not even cycling's like this. You can overtrain. But it's difficult to get overuse injuries unless you've got serious imbalances. You can fall off your bike. But these are one-offs that are easier to take. Even if it means time away from training. It wasn't the action of cycling, per se, that caused the injury. So it doesn't seem as bad.

Despite this, when I'm healthy and running well, I don't think about avoiding injury. I can't imagine having an injury or niggle. Even though I've had hundreds from running. My mind is on upping my training as much as possible to do as well as I can in the next event I've signed up for.

Eventually something snaps, and I get a small injury. A niggle perhaps. But I don't treat it properly and end up see-sawing between resting and running. I get less fit and robust and even more vulnerable to injury. Other niggles emerge. From there it's a downhill spiral.

Not in recent years, I should say. I have had injuries and niggles, but I've mainly handled them well.

But I need to keep the goal in mind: First, don't get injured!

Number one running goal for 2021: no big injuries

My main running goal for 2021 is to not have any serious injury or niggle, with a serious injury or niggle being when I have to take more than three days off in a row from running.

So I can rest up to three days without it counting as an injury. This should encourage me to take days off to avoid injury.

In 2020, I only took more than three days off in a row twice. Once four days for a sore foot (the top of it). The other time, nine days for a knee injury. Not bad! Better than I would have thought.

Anyway, the goal this year is to get that number down to zero.

Other goals

1. Do the two ultras I'm signed up for: the Ultra Montseny in April (76k, 4347m+) and the Ultra Pirineu in October (94k, 6200m+)
2. Get comfortable doing 3000m+ a week running or hiking
3. Run or hike 2600km, 75,000m+ and 270 hours in 2021

I don't care so much about goals 2 and 3. The main thing is to not get injured and get to the starting line and finish the two ultras.

It's nice to see you've done a certain amount of work each week, month or year, but I don't think it should be the main focus if you're managing to train enough each day to keep you sane and happy. 

Focusing on mileage type goals is like following a training plan blindly. It can make the means an end that jeopardises the real end or goal.

Say "tissue senstivity" not "injury" or "tissue damage"

Lots of wisdom here that jives with my experience with pain and (phantom) injuries.

So often, based on pain (or should I say "tissue sensitivity"?), I've self-diagnosed what appears to be an injury that the Internet tells me will be around for a while.

But after a few days of rest followed by easy running or cross-training and maybe rehab exercises, the issue fades.

The pain seems more a warning than anything else. It might be nociceptive or even inflammatory pain as described in the post linked to above (in the later case, there might be a slither of damage). There may be no actual or at least significant damage; just pain.

And hear what the author (a physio) has to say about overuse injuries:

If there is no pathoanatomical basis for the athletes pain it should not be labelled as an injury. Wording such as ‘overuse injury’ can be associated with tissue damage when none has occurred. 

Relapses especially, I've often felt, may be nothing more than cautious, brain-made pain. While the initial injury may have taken time to get over, I find relapse "injuries" or pain can pass in a matter of hours.

The above site also has as comprehensive and insightful as you'll find page on calf rehab. Not the usually recycled, out-of-date, non-runner-useful fluff Google normal serves up.

The tricky part of injury recovery: keeping up with rehab exercises

Up or down?

It's easy to rest the first few days after an injury or niggle. Well, it's not that easy. But you can learn, and it's easy to tell when you've rested enough for mild injuries and tweaks (usually one to three days).

It's easy to start running again. You find a distance or time you can manage and build from there. This is usually a steep curve: you're tentative at first, but within a couple of weeks, you're likely to be back to where you were before the injury.

The tricky part

The not-so-easy-part is to keep your guard up after the first two or three weeks. It's easy to slip into doing hard sessions too quickly. There's no pain, so you totally forget you're still recovering from an injury.

But the hardest thing to do is to keep going with the rehab and strength exercises that probably sped up the recovery or at least reduced the pain during the early stages.

I always fall at this last hurdle.

I strengthen the injured area just enough to get by and then drop the rehab work because everything is going good.

What I should be doing

• keep the daily rehab exercises going and build on them until I've equaled if not surpassed my previous level of strength in the injured area
  

Key foam rolling exercise for runners: the hips, quads and IT band

Fixes your lower leg, too!

This page prescribes rolling the front and side of your upper legs and hips for alleviating not only IT band tightness and knee pain but also Achilles tendon pain and plantar fasciitis.

I wouldn't have thought these exercises would directly affect the last two issues. I normally roll the bottom of my foot and lower calf for these problems. Although I always start with my quads and hips as they are always tight.

Another key area for me to roll and stretch are my shin muscles. This can alleviate ankle and top-of-the-foot pain.

Roll the shortened muscles; not the overstretched ones

The page in the above link contains a further gem of wisdom: 

...in general the basic goal with foam rolling is to lengthen short muscles so that the lengthened muscles can also relax.

This vital point is illustrated with a typical complaint for runners: a sore hamstring. Stretching and rolling may do nothing because it is the opposing muscles, the quads, that are tight. The hamstring hurts because it is overstretched; not shortened.

In this case, you need to stretch the quads to relieve the pain. And sure enough, as soon as you touch the quads, you realise how tight they are. Ouch!

Nearly everyday

I've found preventative rolling and stretching can do so much to help dodge injury. Niggles sneak up on me when I get slack with it. I need to do it just about everyday, at least on my quads and hips. It's also a matter of staying alert and noticing the first inkling of tightness.

 

 

Weekly day off back in fashion

I'm going to start taking Mondays off from running, mainly because I've started a training plan that has rest days then, but also because I'm coming around to seeing a day off a week as insurance against injuries, as argued in this article. 

Having a day off when you don't need one is far better than not having one when you do need one.

Could I listen to my body and play it by ear?

Ideally, yes. But I find it difficult. If I usually run on Mondays, it's hard to take one off, even if I suspect I probably should.

In fact, the last two (slight) injuries I've had reared their heads after I ran easy on a Monday after a few days of hard training.

I had no pain. I went for an easy run. I had pain afterwards.

The main cause of the injury wasn't the Monday run, but it was the trigger or the last straw. If I hadn't have gone for a run on those Mondays, I might have dodged the injury.

Tendon rehab protocol

 As mentioned in this podcast with Pete Dickinson.

1. Rest up front (just a few days maybe, depending on the extent)
2. Isometrics a few times a day
3. Bipedal exercises
4. Single-leg exercises
5. Heavier

 I can imagine, depending on the injury, you might be running when you can do 3 or even 2.