Injury, the Great Complicator of Running

How injury can complicate running with pain, fear, and lack of motivation.

By on February 14, 2024 | Comments

Last month, I wrote in praise of the incredible simplicity that running has to offer. It’s true that running can be a terrifically simple sport, but it’s also true that, at times, it’s more complicated than we like.

Injury is a complication to running that most runners experience over the course of their running journeys. Injury adds complexity to our running because it’s painful, it affects our motivation, and it causes fear.

In the rest of this article, I’ll use my long-standing Achilles situation as examples of these factors and share coping mechanisms for each of them.

Trail runner on West Matukituki Track

Meghan Hicks of iRunFar running on the West Matukituki Track. Photo: iRunFar/Bryon Powell

Pain

Pain and disfunction are a sad way to start the day. I start off most days with at least some lower leg disfunction, and, often enough, pain somewhere in my lower kinetic chain. Not surprisingly, that pain often follows me around all day, and, even if the injury’s not worse when I run, it’s certainly more noticeably present.

The same goes for after my runs, particularly if I run faster, climb more (especially steeper climbs), longer, or with a heavy load, such as when out on a multi-day adventure.

Aside from giving up running or nearly doing so, nothing helps relieve my Achilles-related pain and discomfort more than rehab. And, I’m not talking about all day, or even an-hour-a-day, rehab. No, even three sets of 10 eccentric drops on each leg spread throughout the day can noticeably improve the status of my Achilles within a week. When done most days, it really improves my Achilles symptoms in both running and life.

So, why don’t I rehab all the time? The same reasons many (most?) runners don’t do their rehab. First off, it hurts, in and of itself, at least for some days or even weeks after restarting it. Second, whether or not the rehab hurts, it can still temporarily hinder running. Then, there can be the hassle of it.

It might be easy enough during “normal” times, but how often do we let ourselves get too busy in life, place ourselves in different situations, or otherwise get diverted from good self-care practice. I know I’m loving my few months in New Zealand and have enough time to rehab, but hadn’t spent the time to find a suitable rehab location until today.

Finally, it’s easy for motivation to wane. Maybe that big race or adventure is behind us or we’ve simply grown frustrated with our degraded running or our rehab. Often, any combination of two of these is enough to derail us from rehab.

Personally, I generally try to avoid regular use of non-steroidal anti-inflammatory drugs (NSAIDs). I don’t avoid them for any fear of kidney damage, but rather a hesitance to grow reliant on them as well as wanting to avoid disrupting the body’s own healing processes.

Still, occasional use can take the edge off the pain and, in doing so, help me engage in rehab, help me run more functionally/neutrally, and make me more motivated to both of those. For others, icing or other short-term treatments might temporarily lower the pain barrier.

Overall, injury-related pain can be a variable that complexifies running. Short term treatments and, in the moderate and longer terms, rehab can reduce or eliminate the pain, but getting into or sticking with a rehab can be a challenging venture in its own right.

McKellar Saddle at dawn

Looking up towards McKellar Saddle while trail running at dawn. Photo: iRunFar/Bryon Powell

Fear

Injury can lead to many forms of fear. With a particularly acute injury, that could be fear of doing long-term or irreparable harm. Down a step or two on the intensity meter, there’s the fear of the pain and discomfort one could experience on any given run. There’s also the fear that any given run could be a failure due at least in part to the injury and its disfunction.

Personally, it’s these last two that are most often on my mind, while I’m sure we could come up with other injury-related fears to add to this list.

For my own fears of running with injury, I find that self-compassion is the most helpful. Compassion that I can stop and walk if my Achilles flares up on a particular hill. Compassion that I can cut a run short or dial back my effort if I have more discomfort than I’d like. Compassion to accept what I’m willing to do. Undoubtedly, there are times when toughness, grit, or the like are worth engaging, but that’s rarely the case when dealing with a chronic injury and a daily training run.

I suppose I could go a level beyond self-compassion and be curious as to what I might accomplish rather than go into a run with expectations. That would turn fear on its head. But, admittedly, I’m not there yet. So, for now, when my Achilles is an issue, I do try to hamper my expectations and aim to roll through them with self-compassion.

Tooth Peak from lower Capels River

Tooth Peak from lower Capels River. Photo: iRunFar/Bryon Powell

Lack of Motivation

Let’s be honest. Maintaining motivation for an ongoing task that’s painful and therefore not inherently fun can often be a challenge. Sure, some of us are really good at maintaining motivation in some aspects of life that are difficult for others and vice versa. If it’s easy for you to maintain discipline around rehab or the like, good on ya! This is NOT me. And maybe it’s not you either. So what are some ways to increase motivation around rehab?

For me, there’s no better motivator than committing to a big hairy audacious goal. Most often, that comes in the form of a goal race, particularly one that’s 100 miles or longer. These are events for which I know I don’t stand much of a chance in racing… or in the most important training, if I don’t do the rehab.

The same would be true for getting ready for a shorter ultra in a condensed time span, such as when I trained for the The Wild V5000 in two months late last autumn. It’s possible that I could find the same motivation in preparing for something that’s purely an adventure, but it’s pretty difficult to think of what that adventure might be.

In reality, this is a huge reason while I still run any races. Their difficulty looming in an unchanging spot on my calendar gets me to put in the work.

Another way to get over the motivation barrier is to lower it. Make rehabbing or other treatment as easy to do as possible. That could be finding a location in your house or place of work where you can fit in a minute or two of rehab as you pass by. If you’ve got more intense rehab, perhaps you can leave out your rehab or treatment gear so it’s ready to go, and it’s even better if you can do so in a place where it’s visible.

I’d initially written down “create a schedule” in my notes for this article… but, it turns out, there are two aspects of that. Firstly, that means determining a time or times in your day where you can most easily fit in your rehab. Maybe that’s first thing in the morning, before or after your run, or while you’re relaxing in the evening.

All the better if you can combine making it fun with making it easy, such as only watching TV or a certain show that you enjoy while you’re doing your rehab.

The second version of “create a schedule” is more literal. In this case, I mean create an actual training plan, or if the rehab is the same day to day, create a tracking chart.

Personally, I like to create a physical chart with boxes to check off as I do my daily rehab. In combination with some other good habits, I even created a daily point goal that actually did motivate me to tick off the boxes. It might even work better if you can create a reward for accomplishing your schedule.

Finally, accountability can be a great motivator. That could be committing to a running partner, coach, life partner, or other person that you’ll do the rehab and having that person check in to make sure you’re doing it. You might have them add a carrot or a stick depending on your personality, but just having a person holding you accountable is useful.

Heck, I’ve not told any of you that you’re all my accountability buddy, and knowing you’d see this has kept me doing my rehab for a week!

As you can see, there are many ways to overcome a lack of motivation when it comes to treating or rehabbing an injury. They can range from low level and completely internal, such as having a visible, already setup spot for rehab or treatment, to external commitments, whether that’s to a friend or to a race.

Greenstone Hut dawn view

The view from Greenstone Hut at dawn. Photo: iRunFar/Bryon Powell

Final Thoughts

While running is a simple ritual at its basic level, the activity grows more complicated when we add variables, one of which being injury. While we might never be able to prevent all injuries — accidents happen, and so do overuse injuries, to even the most diligent among us — we can alleviate their effects with intentional coping mechanisms.

In the case of my chronic Achilles issue, which complexifies my running by creating pain, causing loss of motivation, and instilling fear, I’ve got a few ways to cope with these issues and keep running as simple as I can.

Matukituki River

Another look from a trail run along the Matukituki River. Photo: iRunFar/Bryon Powell

Bryon Powell

Bryon Powell is the Founding Editor of iRunFar. He’s been writing about trail running, ultrarunning, and running gear for more than 15 years. Aside from iRunFar, he’s authored the books Relentless Forward Progress: A Guide to Running Ultramarathons and Where the Road Ends: A Guide to Trail Running, been a contributing editor at Trail Runner magazine, written for publications including Outside, Sierra, and Running Times, and coached ultrarunners of all abilities. Based in Silverton, Colorado, Bryon is an avid trail runner and ultrarunner who competes in events from the Hardrock 100 Mile just out his front door to races long and short around the world, that is, when he’s not fly fishing or tending to his garden.