Nov 14, 2022
No fast kilometre this past week, as I was on the annual Tour de Bois, albeit a shorter version this year. Having cycled a couple of hundred kilometres over three days, with no cycling training whatsoever, has resulted in a bit of soreness and fatigue in the muscles and tendons, but nothing I won’t recover from in a few days. By the end of this week my running should be back to normal – normal for recent times, that is.
Below is another in the series of running articles I wrote. Hopefully it helps some readers.
Coming back from a running injury
An overuse injury is one of the most frustrating afflictions a runner can endure. But the moment that injury has healed is one of the most joyous of times for a runner. Or so it should be. But it’s also a time fraught with danger. It’s not as simple as hopping back on the road when the pain is gone.
Firstly, it’s never as clear-cut as a runner having an injury one day and not the next. Injuries heal gradually and the healing process is rarely fully complete when a runner ventures back on to the road. So how should an injured runner approach this delicate time, when coming back even slightly too early can set the individual back by weeks?
Only the individual can judge when the time is right. The instant there is no pain at all emanating from the previously injured region is obviously an acceptable time, but waiting for that moment can leave a runner sitting around for months longer than may be necessary. Running with some residual pain is usually OK, but how can you tell what pain is acceptable and what will simply lead to an exacerbation of the injury? An appreciation of the healing process can help facilitate an understanding of the pains that can ensue during the comeback stage.
All physical activity leads to some degree of muscular micro tears. An injury is an excessive case of this natural process. It happens when these tears either accumulate over time without adequate daily healing, or occur rapidly (or instantaneously) during a particularly intense training session (for example, a hamstring tear from rapid acceleration).
The aftermath of a muscle tear or strain (a strain is simply a lesser version of a tear) will result in the runner’s body laying down new fibres to strengthen the region. However, this process occurs somewhat haphazardly, with new fibres growing at random angles, overlapping each other, and forming a patchwork of new tissue. This is more commonly known as scar tissue.
As one starts to reuse the injured muscle again, the weak and poorly aligned new fibres will break apart and be reabsorbed by the body, while the properly aligned fibres will be strengthened. This is the phase whereby the scar tissue gradually shrinks away. It’s the breaking of these superfluous muscle fibres that can cause fleeting pain in the inured region. These pains are often interpreted by the runner as a sign the injury has not yet fully healed. In a sense, this is true. Yet a sensible transit through this stage, with a gradual increase in running volume, can result in a more rapid recovery from the injury than would otherwise have been the case.
Every injury exhibits its own peculiarities. It’s simply not possible to prescribe a one-size-fits-all remedy for all injuries a runner may encounter. The injured individual must firstly allow adequate rest time for the injury to initially heal. Once the original pain associated with the injury subsides, a runner can start thinking about getting back on the road.
Sharp but very brief pains – akin to a pinch or pin prick – are a classic sign of a superfluous fibre of scar tissue breaking apart. While the runner should still exercise caution, these pains can usually be run through. However, if the pain is similar to that of the original injury and doesn’t subside quickly during the run, cease running and give yourself more time to recover.
And, even if the pain is due to poorly aligned scar tissue breaking apart, it will still result in some further inflammation. Ice the area when you finish, and keep the distances relatively low until you can run without any pain at all. And don’t forget, if unsure, err on the side of caution.