Dr. Tim Nokakes, the author of the bible on running, "Lore of Running," gives running injuries 4 grades based on the severity of the injury. A grade 4 is an injury so severe it prevents you from running. Grade 3 is an injury causing pain to the point that it limits your training and impacts race performance. A grade 2 injury causes discomfort, but not pain, while running. A grade 1 injury causes pain only after running and is often only felt some hours after running. The trick is to catch an injury at a stage 1 or 2 and treat it before it becomes a stage 3 or 4 injury.
I've got a stage 1 injury. I feel fine while running, but end up with soreness and stiffness behind the knee several hours after running. I believe I know the cause of the injury: over-striding coming down those 8 bridge crossings at the Miami 70.3. A running friend, Jen, from "Yeah, I Run Like A Girl..." blog, was able to give me the diagnosis the hard way: she's coming back from the same injury. Jen ignored the grade 1 signs of the injury until it became a stage 4, forcing her to take several months off from training. Jen's diagnosis: an injured hamstring tendon.
The trick is treat an injury properly in order to get back to normal training. First step, rest and and relaxation. Easier said than done. As regular endurance athletes, it's very hard for us to give up our regular training routine and sit on the sidelines/couch while our regular training buddies participate in events or text you to join in the next workout. Not only are up a bundle of pepped up energy with no outlet, but you have to keep reminding your buddies that you are coming back from an injury and can't join them. This makes you sound like your looking for sympathy, which you are not. You want nothing more than to get back out on the road with your buddies to bike and run. Thus, it takes discipline to do the right thing and rest.
After taking what you think and hope is enough pure down time, you start slowly returning to the road. You go for short distances and don't push the pace. Well, I gave it 10 days of pure rest. Hopefully, with my stage 1 injury, this is enough pure rest. I've started back with an easy 10 mile ride. I did an easy 3 mile run, a 20 mile ride, and today a 6 mile run. On my return run, I stopped by St. Bart's cafe, a sidewalk cafe on A1a near the Swimming Hall of Fame popular with a lot of our training group. Buddy Tony is sitting having a coffee. Having seen me on the outbound run, he ordered me up a class of ice-water. As I stop to chat, Tony asks if I feel better. I tell him: "I'll know this evening if it stiffens up."
Anyway, so far so good. I hope I stay on the road to Wellville and don't end up in the ditch by doing too much too soon or going too hard. I hope everyone is enjoying the long holiday weekend and training just enough to balance out all the good eating going on.
I think you did the right thing by listening to your body and letting it rest for 10 days. That is the hardest part...taking the time to rest! I really hope your knee is better soon!
ReplyDeleteBill, thanks for visiting my blog. My chiro/ART guy figures i've got a slight tear in the medial meniscus of my right knee. There might be a patellofemoral issue as well. He is mildly surprised to find that running doesn't get slowed down by my knee, but by other stuff. The biking though, ouch. I'm currently doing a bunch of leg exercises that I work into the core stuff I'm doing. Lots of overlap there, but a few specific ones for the knee. Chiro and Active Release Therapy, as I mentioned. The other thing is prolotherapy, where they inject a solution into parts of the knee to provoke a healing response. The jury is out on that one. Part of the trick is to stay active and keep the knee mobile, but to not overwork it in terms of power or rpm on the bike.
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