When Pain is an Injury
Snap, Crackle, Ouch!
Occasional aches and pains are part and parcel of
marathon training, but when is the pain symptomatic
of injury?
The fact that I'm a chiropractor doesn't exempt
me from the consequences of over-exuberant training.
In fact, one could argue that my running foibles
inspired me to become what I am today.
I remember my first twenty-mile training run,
back in my days as a student at the University of
Montana. I was training for the Governor's Cup: an
annual marathon in Helena.
The training run itself went fine. But when I lay
down on the couch afterwards to rest, I discovered I
couldn't get up. That day I learned the difference
between the joy of accomplishment and the pain of
stupidity.
Balancing work and rest
Training is a balance of challenging the muscles
to new limits, and giving them time to rest. It's a
give and take affair: overstress the muscles to make
them stronger, and then give the microscopic damage
that occurs within the muscle fibers a chance to
repair.
Not giving the muscles enough time to recover
leads to burnout and increases the risk for overuse
injuries. These injuries range from simple muscle
strains that heal with rest, to meniscus tears and
stress fractures that can require surgical
treatment.
Unlike other sports, running involves a lot of
repetitive movement. The feet and legs go through
the same basic motion through hundreds of
foot-falls. Compounding this problem is the fact
that running is a high-impact activity, which many
of us do on relatively hard surfaces.
Reading the Symptoms
The people at greatest risk for injury are first
time marathoners, partly because their bodies aren't
use to the mileage, and also because they are less
able to distinguish between a normal ache or pain
and the beginning of a serious injury.
Here's a few basic guidelines:
Learn the difference between mild, moderate and
severe pain. The severity of pain isn't strictly a
factor of how much it hurts, although that's
certainly part of the equation. It also has to do
with when the pain comes on, how long it lasts, and
whether it continues after the athlete stops
running.
An injury may start as an ache during a run, or
as prolonged muscle soreness afterwards. The
difference between this and normal delayed onset
muscle soreness is that injury soreness is confined
to a specific area, such as the ankle, foot or knee.
A mild injury is one which the runner may feel
during warm-up and several hours after the run is
over. The best treatment is ice and in some cases,
light stretching. Cutting back slightly on mileage,
and especially hard work-outs or long runs until the
pain subsides will prevent the mild injury from
progressing to the next level.
A moderate injury causes pain during warm-up and
later in the run as well. The runner will also feel
localized pain several hours after the workout: that
muscle soreness can last up to forty eight hours
after the run. At this point, it's important to cut
back on training significantly.
Cutting weekly mileage in half may be a hard pill
to swallow, but it's better than having to miss the
race due to a serious injury that takes weeks, or
months to heal.
When pain continues throughout the run, and in
some cases forces the runner to modify his form, it
has progressed to a serious injury. At this point,
it's important to stop running and seek professional
help. The painful area is often tender to the touch.
The road back
Most runners would rather chew glass than take
time off. The body gets used to running, and doesn't
want lose the feeling of well-being that comes from
it. High-mileage runners worry about weight gain
during breaks from running, and runners training for
marathons worry even more about loss of fitness.
The unfortunate fact is that no cross-training
activity completely replicates running, although
deep water running comes close. But the longer the
runner tries to train through a serious injury, the
worse that injury will become.
The best course of action is to see a specialist
who is familiar with running injuries. This may be a
physician, physical therapist, or specialized
chiropractor like myself. Find out as much as
possible about the injury: the best ways to promote
healing, and what cross training activities will
maintain some aerobic fitness without making the
injury worse.
I like to think that all runners are closet couch
potatoes: we run hard in the morning so we can lie
on the couch and watch football in the afternoon.
But nobody wants to be sidelined on a permanent
basis. For more information on diagnosing and
treating running injuries, log onto
http://www.robertsonfamilychiro.com.
Back to Chiropractic Resources
 Dr. Carson Robertson is in private practice at
Alpha Chiropractic. His clinic services the
chiropractic, massage therapy, and physiotherapy
needs of the Chandler, Ahwatukee, and Gilbert area.
He has a special interest in athletics, running, and
soft tissue injuries. Carson Robertson DC can be
reached at (480) 812-1800. |
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