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Getting Back In The Game
Dr. Ken Sheridan
Issue 5 (July 2004)
Colorado Runner
Despite our best efforts, injuries can creep into our lives from time
to time. So, what do we do? Go to the doctor, take anti- inflammatories,
and don't run for three to four weeks. But for many of us, this is not
an option (already bought plane tickets for the Chicago Marathon, etc.).
Running injuries are "overuse injuries" rather than "traumatic
injuries". Traumatic injuries are usually the result of a single,
large force causing acute trauma, like a sprained ankle. These usually
cause an immediate halt of activity and a long limp home.
Overuse injuries come on more slowly and are due to repeated "microtrauma".
Running produces approximately 1500 footfalls per mile, at a force of
three to five times your body weight. This repetitive stress on our tissues
can overcome the body's ability to recover and injury occurs. Overuse
injuries typically begin with pain towards the end of, or up to several
hours after your longer runs or more intense exercise bouts, such as speed
sessions. As you continue to exercise, the pain is present more frequently,
lasts longer between training sessions and begins to affect your ability
to train. Examples of such injuries are plantar fascitis, shin splints,
IT band friction syndrome, and runner's knee.
In this author's humble opinion, if you go to a "sports medicine
specialist" for treatment of your sports related injury, they should
provide you with alternative forms of training while reducing direct stress
on your injured tissues. This "active rest" has proven to
decrease the deconditioning which accompanies cessation of exercise, and
has been shown to speed healing of the injured area.
Such training options will provide the
following:
1. Enable you to maintain your aerobic base (keep your wind up) while
your tissues heal
2. Help prevent you from returning to training too soon, risking re-injury
3. Provide the steps necessary to return to activity, with consistent
feedback, thereby reducing the risk of re- injury
4. Cross training exercises stabilize the assisting musculature, creating
better balance throughout your body, which can lead to greater running
efficiency
5. Provide a stress release valve, which will maintain your sanity and
the sanity of the ones you love
Consider all the activities listed in the chart below as a continuum that
can be used to return to running. You can gradually work your way up to
a 30 to 45 minute session. At that point, use that activity as a 10-minute
warm up, then do intervals (2 minutes/2 minutes) of that activity with
the next higher number in the chart. As you progress, decrease the time
spent in the lower # and increase the time in the higher # (activity),
say 3 minutes/1 minute. Continue to progress up the chart until you're
back to running.
Notice I did not say anything about the time between progressions. This
varies with the individual patient, and with my big doctor brain, I have
devised an intricate system called trial and error. We try to push the
envelope in getting someone back to full activity ASAP without injury
recurrence, a medical term known as "tweakage". We also take
into account the patient's individual goals and the time frame for a particular
event.
1. SWIMMING
HR Intensity - 40 to 60% of your maximum
Pros - Works the entire body as well the core musculature without stressing
the joints or other tissues
Cons - Inconvenient; Not specific to running; Requires skill or massive
frustration; The chlorine messes up your hair
Conditions - Safe for everyone, except people with shoulder issues
2. POOL RUNNING
HR Intensity - 60 to 85%
Pros - Less pounding on tissues; Specific to running motion; Uniform resistance
throughout range of motion both forward and back
Cons - Inconvenient; Not specific to running speed which will effect neuromuscular
recruitment patterns
Conditions - Safe for everyone
3. BICYLING
HR Intensity - 60 to 85%
Pros - Works hips, knees and ankles without the pounding; Same sagittal
plane (forward/back) movement of running
Cons - Does not train the core muscles enough for running; Can be rough
on people with lower back and neck pain
Conditions - Plantar fasciitis, Runner's knee (raise the seat), IT band
syndrome, Shin splints
4. ELLIPTICAL MACHINE
HR Intensity - 60 to 85%
Pros - More specific and uses the same muscles as the running motion without
the pounding; Can work arms concurrently
Cons - May not prepare the muscles of the lower leg to withstand the pounding
of running; May bother runner's knee
Conditions - Plantar fasciitis, Shin splints
5. WALKING
HR Intensity - Yes, walking! Pros - Specificity similar to running, without
the pounding; Used intermittently with run intervals to retrain tissues
Cons - Less stress on the aerobic system (less cardiovascular training)
Conditions - Safe for everyone, except people with acute shin splints
and plantar fasciitis
Dr. Ken Sheridan is a local road and trail
runner who enjoys competing in a variety of events, from marathons to
duathlons. He practices at Active Care Chiropractic and Rehab in Golden.
To ask him your injury questions, call 303-279-0320.
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