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Injury Recovery

Yesterday I ran for 2 hours non-stop on the indoor track at DWT in the company of Malcolm Gatenby and Matthew Boice. Malcolm and myself are running in New York marathon in November and the run put me right back on track for the event.

It’s 10 weeks since I sustained an injury to the peroneal tendon in my right lower leg. I initially rested for 2 weeks and then tried to run again, but could only manage 200m. So I had a physio session at Dubai Physiotherapy clinic. I rarely go to a physiotherapist, but had gone just before the Boston marathon to get my calf muscles loosened up so I chose the same guy Chris Page. Chris correctly diagnosed the problem and gave me some treatment. Far more important than the treatment was the advice he gave. He told me not to attempt to run for another 2 weeks. Although he showed me some preventative exercises to do, he told me not to do them until I had fully rested the injury. He gave me alternative aerobic exercises to do in the gym which would not aggravate the injury, cycling, cross training and rowing.

I also was very grateful for advice from Lucy Merigold and Martin Dewhurst who have gone through similar injuries and from Norrie Williamson who took the trouble to call me up from South Africa to discuss the injury. There was a lot of overlap in the advice, which gave me a lot of confidence, but each added something new. I also checked out a lot of information on the internet.
After a full 6 weeks of rest I returned to running and now I have no soreness at all from the injury. I have been running for 4 weeks, have completed 12 sessions and yesterday’s 2 hour run was a triumph.

For all of us, when we get injured it seems like the end of the world. We wonder if this is the end of our running career. Are we going to be prone to this for the rest of our lives? Yet, book after book on running says the same thing. There is no such thing as an injury caused by running! That’s pretty hard to swallow, particularly when you injured and devastated. Yet I read it time and time again. Gordon Pirie in his book says that injuries are caused by body imbalance and bad running style along with a big contribution from running shoes. In Born To Run the author overcame his injury problems by learning to glide along as he ran. In the book Tread Lightly again running style is emphasised. Chi running is all about learning to run again as a child runs. The first 20 minutes also talks about correction of style to avoid injury.

Hard as it is to accept it, the key to recovery from any injury is to believe that you will recover and hence motivate yourself to do the right things to recover and to take the correct preventative measures to avoid recurrence of the injury.  Help from experts and friends is vital.

The exercises I have been given to follow are eccentric exercises. Eccentric muscle action takes place when you use your muscle to lower your weight. In my case the exercise  involves standing on the edge of a step, raising myself to my toes and then lowering myself slowly using the injured (now recovered) foot until my heel is below the step. The exercise tones up the calf muscles which then reduces the strain on the tendons whilst running.

Eccentric muscle exercises are all too often neglected by runners yet they form the basis of many core body exercises. When we do hill training we often think of it as an uphill exercise. To build up the muscles for attacking a hill in a race and also to give us a good work out. After all, running downhill is easy isn’t it? Well as I found in the Boston marathon neglect of training for running down hill has severe consequences. Running downhill is an eccentric muscle action, you are lowering your weight. I didn’t train for it and paid the price.

I’ll finish with the following e-mail and picture from Monique Strange describing what happened when she decided to venture into downhill running without having trained for it.

Hi Graham
Following on from you post about older runners, we entered (&completed!!!) a 2-day trail marathon. I thought it would be a nice fun ‘cool down’ after the ironman we did 3 weeks ago.  I am not sure if that adequately describes the pain and mutilation it actually involved. It involved starting at 1000m running 14km downhill on trails, 14km of flats on the road and the 14km uphill. We did this on Saturday,& just for fun repeated it on Sunday.

The overall winner, and can I say, surprisingly that there are very few nutters in Australia as there were only about 14 idiots who managed both days, was an elderly fellow easily 55+ who quite simply kicked everyone’s butts.

Trail runners seem to have a completely different mindset to road runners. They don’t do road marathons. They are hard, & carry everything they need with them. They don’t whine, or make excuses, they just get on with it. They are very friendly. When I was bleating about my ITB that almost had me retire after 20km of the first day, they all were encouraging and said, just strap it tight, she’ll be right! take the downhills a bit easy and take some panadol tonight, you’ll be fine tomorrow! The organizers pander to them by supplying a couple of Esky-tanks of water and sometimes (shock, horror) electrolytes, at the 3 aid stations (revisited twice) to refill their bottles. And the token handful of sweeties.

It makes marathons and ironmen races seem like a 7 star buffet.

Trails are just the worst things ever I have decided and should I venture away from my beloved 3.4km strip of soft Safa running track, somebody can shoot me.  Today I had trail-shoe envy for sure. Malcolm managed to complete both races in just under 5 hours, and I limped home in 7 & 6.45 hrs respectively. My right knee is double the size of the other and I have new respect for downhill fell runners.

So I guess that winds up our summer of sports!

Hope all well
Regards
Monique

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One final comment from me. I never take pain killers or anti-inflammatory medication. I can understand that people do take medication to get themselves through an event. However, it does not cure an injury, it prolongs the healing process, it increases the risk of further damage to the injury and it can override the body’s normal systems of control risking heat stroke or cardiac arrest. Use of medication should be never become habitual. Not that I’m suggesting that Monique is a drug addict or being critical. I just do not believe that medication should b part of the recovery process.