Excellence vs. Injury

By Dr. Aaron Case BSc, DC (March 2009)

First, let me define excellence. By excellence I mean personal excellence – not winning the Sun Run or the Boston marathon, or even finishing a race (although those are all great achievements). Excellence involves achieving personal running goals, feeling satisfied with your performance and running consistently with limited time off due to injury, overtraining, or lack of motivation. To achieve excellence, I recommend the following rules:

  1. Be consistently inconsistent
  2. Stop running, if necessary

These rules are based on research, my patients’ running experiences, my own running experience, and the habits of others who have achieved running excellence.

1) Be Consistently Inconsistent

a) Use a variety of stretching styles to prevent injury but NOT to TREAT injuries

  • If you are already experiencing pain, do not stretch the pain source.  Better alternatives are ice or any movement or activity that does not cause pain.
  • Stretch dynamically before, during or after your run. For example, exaggerate your stride length (strides and/or bounding), hop or skip. You can also try crossovers, ‘grapevine’/sideways running or ABC (high knees, butt kicks, horse stomp) drills.
  • Stretch statically after or between runs, typically not before. For example, stationary stretches held for 15 seconds to 2 minutes.

b) Modify your workouts

Modify your workouts so that your pain or ache does not accumulate. For example:

  • Switch to a cross training activity that causes no pain such as the elliptical trainer, swimming, cycling and pool running.
  • Stretch more/less/different areas.
  • Run at different speeds.
  • Run at different times of the day.
  • Run on different inclines and terrains.
  • Run with different/new shoes.
  • Try to self-treat by trying ice (bath), time off or self massage.
  • If necessary, pursue early health care diagnosis and treatments such as Active Release Techniques®, Massage, Acupuncture, Intramuscular Stimulation (IMS), etc.

c) Periodize (cycle) running distance and intensity.

A typical 12-16 week running program may look like the example below:

  • Week 1-3: 5-10%  increase in running volume (total time or distance) per week
  • Week 4: 50% volume of the previous week (intensity also reduced)
  • Week 5-7: 5-10% increase in running volume per week
  • Week 8: 50% volume of the previous week per week (intensity also reduced)
  • Week 9-11: 5-10% increase in running volume per week
  • Week 12: 50% volume of the previous week per week (intensity also reduced)
  • Optional:
    • Week 13-15: 5-10% increase in running volume per week
    • Week 16: 50% volume of the previous week (intensity also reduced)
    • Race followed by 1-3 weeks of very little running (0-50%) replaced by cross training

In general, vary your speed:

  • Run slowly/comfortably (aerobically) MOST of the time
  • Run faster LESS of the time (once or twice per week):
    • Intervals – typically range from 30 seconds to 5 minutes with half of the time (or more) for recovery
    • Tempo – Between an extended warm up and cool down consisting of slow running, run comfortably hard for 15-20 minutes

d)  Adjust Resting Periods

Staying active during the off-season and recovery periods (post-race or post long run) contributes to running excellence.

  • Try to avoid fully resting (zero activity) for more that a few days.  Instead, replace inactivity with short, easy running or low-impact activities such as the elliptical trainer, swimming, cycling, yoga/pilates and pool running.

Remember, 2-3 weeks of complete inactivity could require 4-6 weeks to get back to your original conditioning.

2)  Stop Running, If Necessary

If you experience the following conditions, you should visit a Chiropractor/Physiotherapist or Medical Doctor (MD) who specializes in running (and/or sports) for an accurate diagnosis and specific treatment.

  • Pain on or near the bone **
  • Pain that persists 12 – 48 hours after activity despite rest, ice and gentle stretching
  • Sharp pain – especially around joints may indicate cartilage damage
  • Pain localized to joint
  • Pain that limits motion
  • Pain that alters running or normal activity
  • Pain in addition to numbness, tingling, weakness, or swelling

**The first sign of a “stress fracture” is pain along the bone, which occurs with activity. As the fracture worsens, the pain continues after exercise. This may lead to a limp and even pain at night.  If you have a stress fracture and don’t get treatment, you may develop a lifelong problem if the bone heals in 2 separate pieces (non-union fracture). It is impossible to tell if there is a fracture without an X-ray (and/or a bone scan).