Musings on Injuries

injuryThe New York Times recently ran a piece by Gina Kolata that compared the injuries sustained running vs. those sustained cycling.   The article, entitled “Fell off my bike, and vowed never to get back on” contrasts the two sports in terms of the post-traumatic stress that cycling injuries can induce given their relative propensity for higher degrees of acute trauma.   Running injuries, on the other hand tend to be insidious and less dramatic.  Due to overuse and inadequate recovery, they tend to come on more gradually.  A key factor in the psychological impact of cycling vs. running injuries, this article argues, is the presence or absence of a sense of control.  The sense of lack of control in the outcome can result in post-traumatic responses of exaggerated caution, even to the extreme of not getting on a bike again.   On the other hand, when we can rationalize the outcome in terms of something we did wrong it becomes a lot easier to consider hopping on the bike seat again, or lacing up those running shoes.

We are meaning-making creatures and strive to create a sensible narrative out of our injury woes: Anton Krupicka’s recent blog entry being case in point.  After having summited Green Mountain 10 kabillion times over the past year in the context of an insanely prodigious training volume, Anton ‘tweaked’ his calf on a recent ascent, essentially preventing him from competing for the big pie this coming weekend in the North Face 50.  While initially “frustrated and generally pissed off” Anton finds solace and meaning in attributing this injury to too much intensity on poor footing and endeavors to fold this new insight into his future training.

All this is well and good.  I mean, what else can we do really?  We are all an experiment of one and the only way we figure out what works and what doesn’t is by trial and error and common sense.  We have physiological and biomechanical limits that are, in theory, objective and testable.  And hind-sight is always 20-20.

But meaning is not necessarily inherent in the world itself: we imbue it with meaning.  That is to say, just because our explanations provide a psychological salve doesn’t mean they are true.

Having spent a good many years running competitively and cycling avidly I’ve had my fair share of injuries related to both.  In truth, there have only been a few injuries amenable to a clear causal story and these have all involved cycling: “I swerved too tight on that corner and ended up catching my handlebars on those of the guy next to me.  We both went down, I smacked my knee and it hurt for a good long time.”  With running injuries, of which I must have had nearly all of by now, this clear causal story seems much more elusive.  It wasn’t when I quickly and irresponsibly ramped up to 140 mile weeks in marathon training but many months down the road when I nonchalantly did 3 sets of calf raises that my Achilles started hurting and then proceeded to hurt for a year.

Of course, I poured over my training logs for clues, for meaning.  “Next time I’ll do this or avoid that…”  What is also interesting is that my post-injury reaction is just the opposite to that purported in the article: after a year of chronic running related injuries I was so burnt out and miserable that I swore off it entirely and devoted myself to bike racing for several years.  I felt like I had no control.

In sum, I would advise the downtrodden injured athlete to keep doing what you always have been doing: devise a narrative to make sense of your misery.  It might help and probably couldn’t hurt.  But keep in mind that if you looks hard enough for meaning, you will find it.  And finding it doesn’t necessarily mean it was there in the first place.  Rather, with our injury stories there always seems to be a hint of the unpredictable, of the absurd.

Call for Comments
How have you dealt with your running injuries and how have these differed from injuries sustained in other sports?  Is injury simply an inevitable part of the game or can it be otherwise?  How much control do we have over our injuries? More generally, what have been your experiences with injury and how have they influences your understanding and appreciation of the sport?

There are 11 comments

  1. Derrick

    Having run since the early 1980’s (every day since 1989), I’ve had my share of injuries to deal with. This past year has been very frustrating in dealing with injuries though, and I questioned at times whether I would ever be able to return to the volume of running and races that I wanted to be doing. This was a real test for me in terms of my commitment to running. With my running streak, I was still getting out there every day, but just for very short runs, and while still dealing with pain. It wasn’t until I met with an exceptional physio who got to the root of the problem that I finally started to see improvement. Through her guidance I’ve put my year of injuries behind me and very excited again about racing in 2011. The big thing that this has taught me is that it’s not just about the running, but about doing the little things (rehab, stretching, etc) to stay healthy. I’m not naïve enough to believe that I won’t face injuries again, but I think that with a fresh new dose of common sense, combined with a regular preventative rehab routine, that I can hopefully avoid a repeat of this past year and better manage any injuries that do pop up. There are certainly many other outdoor activities that I enjoy, but ultimately none that I connect with quite the same as trail/ultra running.

  2. Craig Redfearn

    I've dealt with injuries throughout my running history. For the past 11 years, I've had my issues as well. Thank god my wife is a "Physical Therapist". 2005/Fractured Sacrum(after running 2:54 @ Chicago Marathon) – set me back 7 weeks(no running). Prior to the time off, I ran through it for 2 months, thinking it was a physical issue and it would work itself out. I came back stronger in 2006. I think from 2003-2005, I thought I was invincible. I could run practically any distance from 5k to 50M without having to take the proper recovery time off. I was at the peak of my running life. Now that I am over 40(41), things have changed for me. The past 2 years, I've dealt with a different issue(animal) in my left knee. I know it is related to my hip flexor, all the way down to the knee. Really hard to diagnose, but it definitely comes down to a strength issue in that leg. I continue to run through it, but know it will only get better with serious time off (or will it). I refuse to take the time off, even though my PT tells me that I need to. I take more rest days now, but still put in quality runs when I need to. I look forward to 2011 as well, not knowing what might be around the corner as far as racing performance is concerned.

  3. mtnrunner2

    Stretching and deep tissue massage.

    In my experience, tight muscles are the root of all evil, and lead to stress on both muscles and tendons, whereas elastic muscles don't stress connective tissue and function better. They just don't get injured as often.

    If you test your deep muscles with your thumb and there are stiff areas and/or pain down in there, you've got trouble brewing. Loosen it up. Get a foam leg roller and supplement it with massage.

    Admittedly, I think I run about 1/3 of what most ultra runners do in a year, but I am pushing 250k vertical this year and run most days now. I haven't had a long-term running injury in years.

    I also think given the volume runners like Anton put in, the fact that they are actually injured so infrequently is amazing.

  4. Bobby Love

    Simply put, you have to respect the injury and learn from it.

    This article is great because it captures so much of the angst we go through trying to find the cause of our aches and pains. The most important things I've learned about running have come from honestly listening to my body's screams…it keeps me at the place in my mind where I know running isn't about cardio or muscle endurance, it's all about technique, and if you take your eye off the ball, even for a minute, you open up someplace, somewhere in your body for injury.

  5. Paul Bateson

    My original sport was bike racing, road, track, cyclo-cross and the difference between cycling and running injuries is down to speed. Come off the bike and it hurts, you lose skin, break bones, fall running and you may get a cut, you may break a bone but generally the injuries are minor in comparison.

    Human beings have been around a long time. The body knows how to run and it is probably the 'invention' of roads/flat surfaces, which the majority of us all live on, plus the culture for over engineering footwear that is the biggest cause of injury. Shoes block the signals to the brain which give the information necessary for a safe and stable run, the more the cushioning the harder the foot hits the ground in a 'search for information' and pronation is a natural way for the foot to 'check out' the ground. By 'correcting' this natural action with assorted shoe marketing innovations you give runners a bigger range of potential injuries to deal with. I would never run bare foot but I do think the minimalist, low cut shoes now growing in popularity will help to reduce the runners injury collection.

    I never got any 'overuse' injuries as a cyclist but having been hit by a car whilst training and suffering spine damage that side of competitive life was finished. I switched to running and despite permanent problems from back and hip I have never had a 'running' injury. I don't do anywhere near the distances that Anton covers and at 60 I never will but I think my bias towards trail running mixed with some cycling and sensible rest periods after races, use of a teeter inversion board, very little stretching and infrequent massages and living in a generally warm climate keep me injury free.

  6. Scott Richardson

    At 59 and a three-year triathlete, I did my longest race to date, a half IM in September. My coach told me to "take it easy," but unfortunately never defined what that meant. He since told me he meant all but stop. But I love the sports so I cut back by about half. It felt like I was doing less. My IT band differed in opinion. I felt the pain on a 10K. I've had to baby it until now. I've learned the importance of stretching, yoga and foam rollers. Just now I am able to start ramping up again without much of an issue. So my explanation is yes, I did this to myself from a lack of knowledge about the importance of stretching and rollers. At my age, I should have been doing far more than I was. I am now. I also spent time in the pool and cut down my time. It was actually a great learning experience. Hopefully it will stick better than my college calculus.

  7. Mariko

    I've had just about every running injury possible (I started running in 1987). When I was younger, injuries really threw me off. I remember losing patches of hair once (alopecia) because I was so stressed out from not being able to run! Now I am older and maybe a smidge wiser, and while it is disheartening to get injured, I try to think of it as a time to reevaluate my running and to just ENJOY the time off. The last time I was injured to the point where I couldn't really run much, I figured it was the perfect time to switch to more natural/minimal footwear and running style. That was a couple years ago, and you know what? I haven't been injured since. I think that is due to the footwear change as well as not overdoing things or going too hard, oh, and doing all my long runs on trails!

  8. Trail Clown

    If you "race" and/or train "hard", you will get injured. That's just a fact. If you go slow and steady, you can go forever without getting injured. Should we all stop racing? No, because the cardiovascular and mental benefits of competing and doing speedwork are awesome. If you read Dave Dunham's blog

    it says he's had 800 injuries over 31 years. Yet he still's competing, at the master's level, and at a very high level.

    1. Craig Redfearn

      I agree! The benefits far outweigh any injury I ever had over the last 20+ years. Sure, down time is required for some injuries, but then I'd gather most are right back at it because "nothing" can really replace what running gives you.

  9. arjune

    I ran 5K daily (that's a lot for me) for 2 years after college and before I went to med school as a way to distract from the pain of taking post-bacc courses and working in a lab. I had absolutely no regard for my knees and barely stretched/warmed up or did any kind of good running hygiene. By the end of those 2 years I started having such pain in both knees I could hardly walk up stairs let alone run on a treadmill or sidewalk. My running career came to a grinding halt.

    Recently I picked up biking as a way to commute to work. A couple days ago I fell off my bike slamming my shoulder, hip and elbow into the concrete. I got up, nearly vomited and then walked into the clinic and started seeing patients like nothing was wrong. Soon I realized I was bleeding through the elbow of my dress shirt and needed to clean up a bit. A part of me enjoyed getting up off the ground and just continuing on. Maybe I've become more of a masochist than I was a few years ago.

    As you can imagine, I'm proud of myself for moving forward after my accident as opposed to the way I quit running altogether a few years ago, but I think there are important differences between the two experiences. As you noted, the trauma of running versus biking injuries is distinctly different. There's a sense of hardcore-ness in digging oneself out of an acute trauma and then trudging forward whereas adapting to the pain of overtraining in running feels smart and mature but far less sexy, per se. For me, dusting myself off and moving forward after the acuteness of a biking injury agrees with me better than appropriately tweaking a running regimen to allow for manageable runs. I've considered mounting a video camera to my handlebars to capture my rides so I can produce a compilation video called "extreme commuting." I'm afraid this says bad things about my judgment with regard to personal safety.

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