Since 1982 I've written a newsletter, Running Commentary. A new issue appears here each week, and material is archived.

Sat, 02 Feb 2008 05:47:22 -0500

Take Care of Yourself


(rerun from February 2004 RW)

I'm not a doctor, but I often play one in my working life. Questions about running medicine come my way almost every day. I decline to guess at specific diagnoses or to suggest medical treatments, despite having soaked up some knowledge from editing the books of four different doctors.

But I do talk in general terms about getting hurt and getting well. In that area I am an expert, having done both so often myself.

This I can tell you about injuries: Everyone gets hurt eventually. You might argue that you're never injured. You've read all the right stories and taken the proper precautions.

There are other ways to hurt yourself. While you may be smart enough not to make running mistakes, you probably aren't lucky enough to avoid all the accidents that can interrupt your running. Just wait; your chance to be injured will come, if it hasn't already.

I've repeatedly made all the dumb mistakes in the Big Four -- running too far, too fast, too soon, too often. These injuries are self-inflicted and therefore largely preventable.

But accidents happen to the smartest runners: trip over dog and crack a rib (yours, not his)... stumble to a sidewalk and smash a knee.... step off a curb and sprain an ankle. Life outside of running is also risky, and its risks include the intentional "injury" of surgery.

Don't let the dire tone of the preceding paragraphs scare you. This too I can tell you about injuries:

-- Most are minor. Seldom do these injuries interfere with normal life, or require a doctor's help, or extensive and expensive care.

-- Most are temporary. Usually they respond quickly to simple adjustments in training type, length and pace.

-- Most allow activity. If it isn't reduced running, then it can be an agreeable alternative.

Let's say an injury has knocked you off your feet. A doctor can only diagnose why you're hurting and suggest what to do about it. YOU are responsible for your rehab.

Your best friend now isn't a medical professional. It's your own pain, which tells you what you can and can't do while recovering.

Whatever the specifics of what ails you, there is a path back to health that lets you heal and still stay active, fit and sane. Choose your level of activity according to the severity of symptoms, then climb these steps of rehab:

1. If walking is painful and running is impossible, bike or swim for the usual running time periods. These activities take nearly all pressure off most injuries, while still allowing steady effort.

2. If walking is relatively pain-free but running still hurts, start to walk as soon as you can move ahead without limping or increasing the pain. Observe these two warning signs at all stages of recovery.

3. If walking is easy and some running is possible, add intervals of slow running -- as little as one minute in five at first, then gradually building up the amount of running until you reach the next stage.

4. If running pain eases but minor discomfort persists, the balance tips in favor of running mixed with walking. Insert brief walks at this stage when you can't yet tolerate steady pressure. Many injuries respond better to intermittent running than to the steady type.

5. If all pain and tenderness are blessedly gone, run steadily again. But approach it cautiously for a while as you regain lost fitness. Run a little slower than normal, with no long or fast efforts until you can handle the short-slow runs comfortably.

Stretching and strengthening exercises? Again, let pain be your friend and guide. Exercise too violently, and you can set back the healing.

Run on soft surfaces? They aren't as soothing to sore legs as they may seem. Uneven ground causes twisting that can cancel the benefits of softness, so choose a smooth, flat running surface during recovery.

Also it's wise to repeat yourself at this stage. Run laps instead of a single big loop to give yourself a place to stop a run early without being miles from home.

A patient patient knows when to stop. Cutting short a run during rehab isn't a sign of weakness but of wisdom.

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