Take a Break
Overcoming injury is more than physical
The pain is indelible: my shoes slap hard against the pavement. The soreness in my left shin amplifies. Each step is like shards of glass sticking into my bone. It's mid July and I'm finishing, what was for me, a grueling eight mile cross-country workout.
I had tolerated this pain since the end of my spring track season in May. Everyday my workouts filled with doubt as the pain increased. I wondered how many miles my leg would remain pain-free. At what mile would I feel that knife-like pain? I was experiencing the unthinkable for any athlete a debilitating injury. My mind was telling me to continue pushing through the pain, but my body couldn't endure it any longer. I tried convincing myself it wasn't anything serious. In seven years of competitive year round running I had never been injured. There was no way this would impede my final collegiate cross country season at Umass Amherst. I had so much I wanted to achieve before ending my career. This was not going to go away on its own. Something was wrong. No more ignoring the problem. Time to get examined by a doctor.
My doctor explained that diagnosing a stress fracture is a complicated process. Although it's possible to see swelling around the bone, in a fresh fracture the break is rarely visible on x-rays. After a couple of weeks of continuous pain, tiny cracks can be seen on the outside of the bone. To my relief, my x-ray results revealed no obvious signs of a break. Skeptical, my doctor ordered a bone scan. Bone scans are expensive but almost always detect the exact location of the fracture in it its early stages.
A stress fracture is a common overuse injury resulting in a partial break of the bone. High milege runners are at risk because they put repeated stress on their bones. "Stress fractures can be caused by over training, a shortage of calcium, or a flaw in your running style or your body structure," says Sports Nutritionist Caren Weiner at the University of Massachusetts. According to Weiner, female athletes have a much higher incidence of stress fractures and it is very important to make sure calcium and estrogen levels are adequate. Weiner describes how stress fractures are similar to a hardboiled egg. After the shell is cracked, the bone breaks. This is one injury you can't not ignore.
As I waited for the results, all I could do was hope. After the longest seven days of wondering, my doctor confirmed my diagnosis: a tibial stress fracture. The tibia is the lower leg bone located near the ankle. The only treatment is to stop running completely. No running for me for a month and no racing for two months. The news was devastating.
Don't Despair
"Don't run and you'll heal," are the dreaded words every passionate runner wishes to avoid. A non-runner might find this downtime welcoming, but competitive runners develop a psychological dependency on running. When you love your sport, injury downtime is brutal. Distance running is an obsession. It's almost like a positive addiction that controls part of your life. When running becomes a habitual part of your daily routine you make every effort to enjoy its positive effects and sense of well-being. I was immediately starting to suffer from the common running withdrawal symptoms.
I missed the euphoria of my heart pumping, sweat on my face. It was summer and most of all I missed being able to train outdoors. On my way to the gym I would drive by people running and I would be itching to race again.
My season started in September and my teammates were prepared for their first meet. I always loved the excitement of first races, but this time was different. As a senior, it was my last first race ever and I couldn't run. I was sidelined watching and fighting my overwhelming desire to run with my team. Not being able to do my favorite thing and only watch is like giving a child a bowl of ice cream to just look at. I missed the anticipation of race day and the adrenaline from the competition. I envied the opportunity my teammates had in front of them. I desperately wanted to experience that nervous feeling on the starting line again.
When you're injured it's natural to feel depressed over the unfairness of your condition. I found myself asking, "Why me? Why now?" Dwelling in your sorrows does you no good at all. Your goal is to recover and your mission is to find a way to remain positive from the day you're told to stop running and the day you are healed and ready to start again.
Cross Training
The doctor says you need to rest your injury, but this doesn't mean you have to stop training. So now what do you do? The simple answer is to cross train. Cross training includes low impact and non-weight bearing workouts that are safe for injuries.
If you want your body to remain primed for peak performance, cross training shouldn't be approached haphazardly. There are a variety of ways to stay in shape. "Deep-water pool running is the best possible cross-training activity you can do while injured with a stress fracture," says Umass women's cross-country coach Julie LaFreniere. It mimics real running. Any workout you would normally do on the road is done in the pool using a foam aqua belt. The belt is fastened around your waist to keep you in proper form above water. You can vary long jogs with interval speed work. "Many runners who train in the pool return stronger. Some of my athletes were able to pull off personal best races when they returned," says LaFreniere.
In my cross-training experience I benefited from aqua jogging the most. Some days I would combine aqua jogging with either biking or the elliptical if I was feeling strong. Conveniently, I had access to a pool available at my gym that supplied aqua belts. You can purchase a belt at most sporting goods stores for about twenty dollars.
Back in Action
Ready to hit the road again? It's important to stay strong mentally, but don't be too ambitious. Ease back into running with realistic goals in mind. Many runners are insistent on adhering to their training schedule refusing to deviate by a single mile, fearing it will ruin their chances of running a good race. You need to accept that you have to scale back the miles at first.
When I returned to running after six weeks off I couldn't wait to participate in running workouts again. My excitement subsided when my coach started modifying my workouts. It was difficult for me to resist that sudden and irrational temptation to cram more runs in. I thought it was the only solution to make up for lost mileage. I tried secretly running double workouts to catch up. It only left me feeling exhausted for my workout the next day.
It's inevitable that frustration will overwhelm you. You don't know if you should push harder or back off during workouts. Every time you feel the slightest ache you jump to the doomsday conclusion that the injury has returned. You lack the confidence to challenge yourself again.
Negative thoughts are constantly looming. The psychological pain of my withdrawal became worse than the injury itself. My attitude about running changed. At one point, I was convinced the injury was setting me back and it turned into a frequent excuse for not pushing enough. Now that I'm completely healed I still catch myself saying, "I can't run up this hill today or my injury will come back." In races my mind is in and out of competition mode. I know where I should be and I want to go faster, but I'm trapped in the paranoia that's holding me back.
One step at a time
What happens when you do everything right but you're not meeting your expectations? Remember, it's impossible to pick up where you left off. Dealing with the emotional stress after an injury is difficult. If you aren't feeling you're at your best, remember that running is a sport full of ups and downs. A sport full of "what ifs." Sometimes when you're down you feel like you'll never run fast again. While that is, of course, not true. It's hard to see the top when you're stuck at the bottom, but you will surprise yourself. Wait for one improved time, one good practice, and the possibilities will open to you once again to be the runner you want to be (and can be). You will get reach the confident zone again. You know that place. Every stride is efficient, every breath perfectly timed. Muscles and joints working as they were made to work. Lungs filling. Heart pumping. Blood flowing. Mind drifting with the air you move through. No sense of struggle, no sense of pushing it. No sense of time.
Do's and Don'ts of the Healing Process
(from Caren Weiner, Umass Health Services)
DO: Wear the correct footwear with proper support and cushioning
DO: Rest, ice, and elevate the injured leg
DO: Reduce your mileage to a pain free amount or none at all depending on injury.
DO: Cross-train to maintain your overall fitness level with exercise such as biking, aqua running or elliptical.
DO: Get at least 3 servings of calcium a day to keeps bones strong
DO: Progress at a gradual comfortable rate.
DO: Warm up before your runs
DO: Cool down slowly at the end of your run
DO: Stretch before and after every run
DO: Get on a weight training program to strengthen muscles
DO: Avoid hills and training surfaces that will irritate the injury
DON'T Run though the pain. Your body is trying to tell you somethinglisten to it.
DON'T Think you have to give up running forever.
DON'T Ignore the problem. If you do, it is more likely to come back. Or get worse.
DON'T Drink alcohol or consume too much protein and phosphorous. They can have a negative association with calcium balance.
DON'T Drink soda or caffeine because they dehydrate you and prevent calcium absorption
Coach LaFreniere's Cross-training Workout Plan
Monday Bike for 1 hour
Lift weights (arms)
Tuesday Aqua running (endurance): 5x 6:00 min, hard with 2 min rest between sets
Wednesday 45 minutes on elliptical
Lift weights (legs: use non-injured leg only)
Thursday Aqua running (speed): 6x 3:00 min hard with 30 sec rest between sets
Friday Bike or elliptical: 1 hour
Saturday Aqua running (distance): 50 min, moderate effort
Sunday Rest/recovery