How To Architect A Comeback

Let’s talk about techniques to deal with an injury and build back up to full strength. It’s something that requires a plan. The most important thing I can stress is patience. You’ll need a lot of it too.

Injury

You just suffered an injury and you’re going to be out a few weeks/months. The longer you’re out, the tougher it’ll be mentally to keep it together during this time. You need to focus on channeling your frustration into useful activities. Since you can’t run, there’s a few things you can do to make this time worthwhile.

1. Crosstraining

Do it. Do as much of it as possible. Make a point in figuring out what exercises are doable and which cause inflammation. If it causes inflammation, stop. Any amount of benefit will be lost by lengthening your recovery. The more cardio you can do the better. I recommend swimming, elliptical (use your arms, you’ll notice a huge difference in heart rate), and biking. The more cardio you can do, the less you’ll lose during your time off.

2. Weights

Hit the gym. Lawyer up. Delete Facebook. Just kidding, this isn’t a divorce (although it probably feels like one). But seriously, hit the gym and maintain strength. If you have any muscle imbalances or weaknesses, this is the time to work on them. Do your core workouts and strengthen your overall body. It may feel like it’s worthless, but you’re preventing relapses and other injuries by doing this.

3. Work on flexibility

Stretch. Take up yoga or pilates (if your injury allows). This is another activity we all procrastinate doing because we’re too busy running. Now is the time!

4. Donate blood

Want that warm tingly feeling inside? Donate blood. Since you’re not running workouts and not racing, now is the time to do things like donating blood. They want your blood.. it’s highly oxygenated. It’s runner’s blood, only a short step down from tiger’s blood.

5. Volunteer at a race

Let’s be honest, you’re too busy racing to volunteer usually. Now you have the time. Give back to your community, get to know the running community, make some new friends. It’ll be hard to watch, but when you realize those runners need you and the water cups you’re handing them, you’ll feel like you’re part of the race.

6. Be patient. Don’t come back too early.

Talk to your doctor. Pay attention to your body. I know you’re chomping at the bit to come back but if you come back too soon, you’ll re-injure yourself and prolong the problem.

Rebuilding

You’ve taken a large chunk of time off. Your body feels ready to start training again. Want to stay healthy? Be cautious and come back slowly. Build up base mileage over a few months. I know you’ve had a few months off and want to get right back to your previous mileage, but your body isn’t ready for that yet. You took weeks/months off, so it’s going to take at least that long to build up again.

1. Build base mileage

In the first weeks, just do easy running. Depending on your injury, you’ll probably only want to do 3-4 days a week at first. Cut your mileage down. If you’re used to a 7 mile run, do 4 miles. Just at first. Every week (if you’re feeling injury free) you can add to some or all of your weekday runs. You’ll need to find some of that patience now. It’ll pay off.

2. Throw in some tempo paced fartleks

You want to keep the workouts unstructured until you’re back to regular mileage. Increasing intensity and mileage at the same time is asking for trouble. So a month into your build up, throw in some tempo paced segments here and there. You want to remind your body what hard running feels like without an extended effort.

3. The long run

If you’re anything like me, the first thing you lose is aerobic fitness. Make a point to build up your long run 1 or 2 miles a week until you’re back to your normal weekend long run. It’ll feel like hell, but don’t sweat it. In a few months, you’ll be back to thinking nothing of a 20 miler.

4. Patience Patience Patience!

Don’t build up too fast. You don’t have to adhere to the 10% rule unless you’ve been out for 6 months or more, but don’t make large leaps in consecutive weeks. Your muscles and aerobic system might feel great, but there’s a lot of connective tissue that went on vacation and it’s going to need time to acclimate again. Look out for common overuse injuries such as IT band, tendonitis, plantar fasciitis. If you encounter one of these, take a few days off, drop intensity and focus on base building. Cross train if you can.

Conclusion

Going through injuries is hell. If you’re out a long time you start to feel like you’ll never run again. Your previous PR fitness and all your hard work went out the window right? Not exactly. Your body comes back more quickly than if you’d never been in shape before. You can make huge leaps in fitness in a short time. I’ve seen 10k times drop a minute or more over 4 weeks and we’re talking times in the mid to high 30s. You just have to learn to be patient, deal with all of the mental anguish in a constructive way, and focus on building back in a way that doesn’t cause re-injury. Listen to your body.

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Update

I haven’t been writing, mostly because I haven’t been running. It’s been a long summer and it’s very demotivational to read/write about running when you’re pretty much forbidden from exercise.

When I last left you, I had a diagnosis of insertional tendonitis. After a few weeks of therapy, it wasn’t getting any better. So I got sent off for an MRI (that’s another story) and found out I have a stress reaction in my acetabulum. Even worse, I have a bone marrow edema in my acetabulum, which basically means the bone is swelling. The stress reaction is a 4-6 week fix, whereas the bone swelling doesn’t have a time table. Yeah, I’m not happy either. From the literature I read online, it’s typically a 3-12 month healing process with an average time of 6 months. A friend of mine has the same thing but on her pubic bone and she’s been off running for over a year. This doesn’t sound good.

I’ve been completely off running for about 6 weeks now, minus a little bit of jogging to escape a storm in Zion National Park. I’ve been off my normal training for 3 months now. It was killing me for the first month or two but now it is starting to seem normal. Although I still get sad when I visit places I usually run, because I’d love to be skirting down the sidewalk with the wind blowing against me and businesses fluttering by. The worst part is knowing that I have no idea how much longer I’ll be out. I’m guessing another month minimum. On the bright side, I can tell it’s improving, but not enough to resume running. Let me run you down what happened.

My injury occurred during the Rock n Roll Marathon I ran in June. I’d done lots of long runs, even one that was 23 miles, but I hadn’t done any marathon specific speedwork. To be honest, I didn’t plan on even running that race until a few weeks beforehand. I was only doing it to get a Boston qualifier. I felt fine during the race. Afterwards I tightened up and at one point walked to a port-a-potty in the finishing area. I decided to jog back to where my friends were sitting and suddenly my IT band grabbed. That was the start. We had to walk about a mile and a half to our cars and my IT band was getting more and more inflamed with every step. I didn’t realize how serious it was, because I couldn’t even run for a week. I couldn’t walk without pain or a limp for 3 days. Once that subsided I started running and within a week I started having issues with my left hip flexor. It flamed up so badly on one morning run I wasn’t sure I could make it home. I took a few days off and the problem was there, but was being managed. After a week and some change I felt good enough to resume workouts. I ran a tempo run with no issues. Then that Thursday I ran a 6x1mi on the track and just about died because I felt so out of shape. Nothing felt structurally wrong or sore. The next morning I woke up and my adductor was so inflamed I didn’t even make it to the end of my street. That was the end of June. Since then I’ve been able to run, but it still felt tweaked. After getting my diagnosis, I know now that it was all related to the bone swelling. Everything that connects to my acetabulum has been inflamed (IT band, hip flexor, adductor). I’m told the best thing I can do is keep it loose so that when it heals, I’m not aggravating it.

In the mean time I’ve been doing very little cardio. Everything aggravates it. Swimming, elliptical, the bike, everything is a problem. I started doing weight lifting at the gym, at least in a modified way, so that I’m at least doing something. I’ve made it my mission to fix all of my muscle imbalances and that’s coming along nicely. Hopefully when I get back to running the pounds I’ve put on will melt away to show a six pack. I can dream, can’t I? I’ve also been doing one legged exercise bike. I use my bad leg for gravity, but I’m mostly pushing down and pulling up with my right leg. I’m finally getting to a place where I can use my left leg without aggravation, but I’m being cautious. My cardio is going to be shot when I resume running.

There’s no timetable on the bone swelling. The stress reaction should heal in short order, but there’s going to be this long period where I’m afraid to push myself because I don’t want to dig this hole again. I decided I’m going to stick with 5k/10k stuff for a while until enough time has passed that I’ve built up the mileage and the confidence. I’m not looking forward to racing, to be honest. I’m probably going to spend a lot of time training before I even enter another race. I don’t want to go out there and run a 5k at a pace slower than my last half marathon.

My biggest regret about this injury is that I had planned on some serious trail running this summer. I was in good shape and had trips planned. I meant to do Mt. Baldy. I had a running vacation to Zion National Park and Bryce Canyon which turned into a hiking vacation (hiking aggravates it too, but I couldn’t stop myself). I still haven’t conquered El Cajon Mtn. I just have to tell myself 2013.. by this time next summer I’ll be good as new and ready for adventures.

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Blah.

Insertional tendonitis. The injury that ruined my summer. Not just for running, but for pretty much everything else too. It’s been a weird summer. My normal summer running crew ranges from 5 to 15 on any given Tuesday/Saturday. This summer it’s been a shell of what it used to be. It took me a while but then I discovered why nobody was showing up anymore. Everyone who hasn’t moved away is in a relationship all of a sudden. Many of my running friends have gotten married or started to have children over the last year, but there used to be a fairly large single contingent and they showed up regularly. Not this summer. They’re not single anymore, so socializing has taken a back seat. It’s frustrating for me, because the group of friends I’ve hung out with regularly for the last 2-3 years is suddenly only hanging out when there’s an occasional party/BBQ at someone’s house. The same thing happened 3 years ago when all of my roommates moved in with their significant others and stopped making time to hang out.

So what’s the solution? Meet new people, make some new friends, find a new relationship. What are the most social hobbies I have? Running and hiking. Because of my injury, I can do neither. I’m having one of those Charlie Brown moments. I’ve been injured for 7 weeks, it’s been a long boring summer.

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The Waiting Game


It’s now been nearly 4 weeks since I was able to run regularly. I took the last two weeks completely off after an attempt to return that was accompanied by pain. The adductor is truly a terrible injury to get over. It’s slow to heal and you use it for roughly everything. So it’s really difficult to rest. I’ve been going to the gym and working out what I felt comfortable working out (and I can definitely feel the added strength) and I took a long weekend to visit family where I did a lot of nothing. I’m hoping it’s healed up enough that I’ll be able to take it out for a short 4 mile stroll this evening. I really hope so. I’m dying to run. Like.. I walk out of work and see the Double Peak trail and I want nothing more than to be running drenched in sweat in the heat of the day running on that trail. When I’m not running I can’t eat like I’m used to and I feel lazy.

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The Importance of Strength Work

I’ve read a lot of articles that say the best exercise you can do for running is running. It’s the concept of specificity. It seems obvious, but I believe it’s more complicated than that. Running more will make you a better runner, but running to the detriment of everything else is going to lead to muscle imbalances and eventually injury. This is why cross-training is vital.

Running is a high intensity workout that works a number of muscle groups in the body. But it’s motion in one dimension. You’re constantly running forward. There’s a number of muscle groups that will atrophy if you stay in this single plane. Coach Jay Johnson has a good warmup video that explains the concept and demonstrates a lunge matrix to workout and warmup these alternative plane muscle groups.

When I started running I came from a background of basketball and very strong muscles in my hips/glutes area. After getting serious about running, I stopped playing basketball and as my mileage increased my trips to the gym became less and less frequent. That was a mistake. I ended up with some serious muscle imbalances with my hips that I’ve worked diligently to correct. With my recent injury, I took up the gym again and discovered I had lost a ton of strength in my glutes/legs. I also made a connection between this lack of strength and the staleness I’ve been feeling lately.

The first few years I was running I had the ability to crush my interval workouts. The challenge felt good. I wanted to push myself. Over time that good feeling slowly waned and I figured it was due to motivation. Now at the gym, that explosiveness I used to have has been replaced by that same stale feeling. The explosiveness isn’t there because I’m not as strong as I used to be. It’s time for a correction. I’ve now decided that the gym is going to stay a part of my running routine. I run a lot more hills now and I’m running as fast as ever, but it’s obvious that running alone isn’t building enough strength. Specificity is good, but it’s limiting my potential. Once I’m recovered from injury and back to high mileage I’m going to make sure I hit the big leg muscles at the gym at least twice a week. I think it’s going to pay off big time.

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Injuries and Catching the Crazies

I find myself in a period of downtime. It’s been one little injury after another since the marathon. After trying to do speedwork last week and injuring my adductor, I decided it’s time to back off the running and let my hip flexor completely heal. The bad news is that after 4 days I went for a test run and saw zero improvement. So I’m taking a different tack, I joined a gym.

It’s been a little over a year since I belonged to a gym and even then I was rarely ever using it. When I’m running a lot, there’s just no time. I’m not a professional athlete. Running 60-70 miles a week eats up my free time so there’s not much left for the weight room. Back in my heyday as a basketball player, I used to hit the gym after playing ball and as a result, grew some very strong legs. Everyone has that moment where they realize they’re not as young as as fit as they used to be. Yesterday I had that moment. 6 or so years ago I could sit down at the leg press with 5 plates on each side and bang out three sets of 10. Yesterday I put 2 plates on each side, got into the contraption and released the weights. I literally crumpled and couldn’t get the weight back up. Holy crap! The guy working out next to me quickly helped me get the machine back to the locked position. Thankfully. Now granted, it’s not the same leg press machine I’m accustomed to using, as that one was busy the whole time. I chose the stand up machine and I don’t know if it’s weighted heavily without added weights or if I’ve really lost that much strength, but that was a little defeating. I removed a plate from each side and destroyed my quads with the workout. So much for putting up 500+ lbs on the leg press. Oh glory days..

Meanwhile I’m unable to run until this thing clears up. Running really reduces a lot of stress and you don’t realize how much until you’re not running. I’m a creature of movement. I can hardly sit still to string together 8 hours of work. Since I can’t run, I’ve been trying to do the elliptical. So far so good. No pain. But I don’t get the same workout and I can’t push the way I do with running. It’s a sugarfree cookie to my buttercreme frosted cake. Meanwhile the stress builds…

Let’s hope I don’t burst.

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Post-Marathon Remorse


When I went up to Orange County to run the OC 5k I was pretty close to PR shape, if not PR shape. Two weeks later I ran Rock n Roll Portland. The original plan was to then prepare for a 5k in June and a series of track races. What happened instead was that I was talked into the marathon, so I took a week down to recover after RNR Portland, then tapered slightly for RNR San Diego and ran the full. Since the marathon I’ve had IT band issues, hip flexor issues, and the latest adductor issues.

I ran my first fast workout since the marathon yesterday (really since mid-May). It was nothing crazy, just mile repeats, my bread and butter. I was a little leery of my hip flexor but after taking Wednesday off it seemed pretty okay. The workout was hell. I was slower than my goal pace for the 10k next week and it was killing me. Last time I did mile repeats I was in the 5:20s and not maxing out while last night I was struggling to keep it under 5:40. It was a confidence destroyer. I’m out of shape. Bad. Fucking marathon ruins at least a month of training and that’s why I dislike it. When I signed up I was hoping to run conservatively and not destroy my body so I could continue as planned. Instead, my worst case scenario has come to pass and not only am I out of shape, but I’m injured too. So I’m going to take some time off to heal and hopefully come back and start putting in the mileage. The problem is that I’m about 13 weeks out from Chicago and that’s going to abbreviate my training schedule. 2:40 is pretty much out the window. Let’s be honest, I don’t want to run Chicago at this point. I’d much rather take the time to build a base, hit some high mileage, then add workouts, then be in good shape for a bunch of halfs at the end of the year.

One extra marathon has ruined my whole season. I’m not happy about it. I understand how Lauren Fleshman felt after NYC.

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