"Something that I learned by sitting on barstools is that if the stool is narrow enough you can straddle the stool and while drinking your favorite brew you can massage out those tight adductor muscles. If you drink enough while straddling the stool, when the adductors let go you’ll see, rather feel, how those muscles deter you from sitting or standing up to your full height. It may take a few bars and a few brews to find the right barstool. It is well worth the effort."
-Ozzie Gontang
Running is good for me. Running helps me manage my weight and my blood pressure, builds my strength and endurance, and works to prevent cancer, osteoporosis, and other diseases. My dad had his first heart attack when he was about my age, but my running should help fend off heart problems. A good run relieves stress and can help manage depression. Humans evolved to be good long-distance runners because ancient man hunted for food by chasing animals until they dropped from exhaustion.
Running is bad for me. Studies show that in any one year, 60-80% of all runners have to take time off because of an injury. Running damages my joints and strains and tears my muscles. Running is stressful. The running writer Jim Fixx is just the most famous person to die of a heart attack while running. Running generates free radicals, which have been linked to cancer. Another famous running writer, George Sheehan, died of cancer. Ancient hunter-gather humans lived short lives compared to today’s humans.
I really don’t care. For me, the enjoyment I get from running outweighs any possible negative impact on my health. Running is an addiction, but it’s usually a benign one. Maybe I’m just an endorphin junkie, but I always feel good after a run.
When my running is going well, I train harder and race more and enjoy every minute of it. Unfortunately, I inevitably push too hard, overdo it, and end up injured. When I can’t run, I don’t get my endorphin fix. The fact that I can’t run because of an injury shatters the illusion that I have control over my running. I’m told that I get cranky and irritable when I’m hurt. I don’t notice it myself. I’m too busy wondering when I’ll run again.
I try to avoid pain and injury as much as I can so I can feed my addiction. That means taking care of myself before, during, and after each run.
Good health for runners starts with the sorts of things that everyone should be doing, whether or not they’re a runner. That means eating right, drinking plenty of water, and getting plenty of sleep.
I try to eat right, to consume more whole foods and fewer sugary, salty, or fatty processed items. Unfortunately, no one has made a vegetable that tastes as good as bacon or ice cream. Part of the reason to run is so I can eat what I want and not get fat. And I want cookies!
Runners need to stay hydrated. Beer and coffee have water in them, right?
I 've been known to have a beer or two in the middle of a run and three of four afterwards. I don’t drink anymore, but I haven’t noticed my running getting better because I quit drinking. The Tarahumara Indians of northern Mexico are supposedly the best distance runners in the world, and much of their culture revolves around massive consumption of corn beer.
My morning coffee is one of the highlights of my day. The active ingredient in coffee, caffeine, is addictive, so that first cup is just quenching my withdrawal cravings. Still, some studies indicate that coffee actually improves performance. A cup before I run can help me use fat for fuel, release calcium stored in my muscles to help me run farther or faster, and give me the energy to get going and keep me alert and focused while I’m running.
Of course, nothing is perfect. Coffee can act as a diuretic, though the effect is minimal for regular coffee users. The acids in coffee help cause acid indigestion and force my body to use extra minerals to keep my system in balance. Coffee can also leave me jittery and interfere with my sleep, especially if I have any late in the day. And if I miss my daily dose, I get cranky, tired, and headachy.
When I’m not drinking coffee, I usually drink water. I have a soda (never diet!) once in a while, but soda is maybe the one place where I have successfully cut down on my sugar intake.
I try to balance healthy eating and comfort foods. It’s more important for me to enjoy life than it is to maximize my potential as a runner. No diet is going to make me an Olympic-class athlete or even a regular winner at local races. Most of the time, the food I eat supports my running. When it doesn’t, I eat the lobster with butter and fried onion rings guilt-free, and I just go for another run to make up for it.
Sleep is different. I’d love to sleep more, but it’s not really something I can make myself do. I get up at more or less the same time most mornings, I try to avoid napping during the day, and I let the rest take care of itself. Quitting drinking has helped here. I’m much more likely to make it home at a reasonable time so I can get up and run the next day.
Most runners do more than just eat and sleep properly to help support their running habit. It’s easily possible to spend more time preparing to run and recovering from running than you actually spend running.
Everyone – runners, doctors, therapists, little old men smoking at the lottery counter – says you need to stretch in order to run well and stay injury-free. But no one agrees on the best way to stretch. Do I spend 10 seconds, one minute, 15 minutes at a time on each muscle? Stretch before or after running? Hold a stretch, or repeatedly swing the joint to the limits of my range of motion? Stretch sore and injured muscles, or leave them alone? Everyone has a different opinion.
I think stretching for runners may be a plot created by people who are flexible enough to actually enjoy stretching. I’m not. I do some stretching anyhow, partly because it does seem to help me retain the little flexibility that remains in my legs, but mostly so when my doctor or therapist asks me if I stretch, I’m not lying when I say yes.
I’ve tried yoga classes, and I’ve enjoyed them up to a point. Since I lack flexibility, I get quite a workout as I struggle to get into my best approximation of the correct pose. An hour of yoga, with all the meditation and controlled breathing, is relaxing in spite of the strain. But it comes down to a choice between spending my time on running or yoga, and running always wins.
Massage is another form of therapy that many people use. Unlike stretching, getting a massage feels good, and I definitely feel better after I’ve received a massage. My legs might be a little sore right after a deep-tissue massage, but after a day or two they usually feel fresher and ready for more hard training. The main difficulty with massage is the expense. A good hour-long massage costs as much as a decent pair of running shoes. It’s worth it, but the price does add up.
I have a foam roller, a "Stick," and some other self-massage tools, but they never seem to work as well. Partly, I expect, because I don’t spend as much time with them. Fifteen minutes with the foam roller is tedious. An hour with a good massage therapist is heaven.
I suppose stretching and massage do some good, because so many people do them. However, when scientists study the effects of stretching or massage, they never find conclusive evidence to show that they actually do anything to help people run better or prevent injury. I love seeing those studies – they help justify my lackluster approach.
Many runners work to develop strength with exercises and weightlifting. Stronger muscles are supposed to help runners maintain good running posture longer and be more resistant to injuries.
I have about 20-30 minutes of exercises I do a couple times a week, mostly sit-ups and other exercises designed to maintain strength in my core muscles. A strong core helps me protect my back and keep good form while I’m running.
I’ve tried some weightlifting, particularly when I was doing a lot of trail running. The main effect was that I gained weight. It was muscle, but the muscle didn’t seem to help much with running and it certainly didn’t protect me from injuries, so it was just more weight to carry around. On the other hand, eccentric weightlifting -- extending muscles under load rather than contracting them -- has seemed to help me recover from nagging injuries.
I do other sports for fun that happen to be good cross-training for running. Biking and cross-country skiing help build strength and endurance while giving me a break from the pounding I get when I’m running. Kayaking is great for developing my core muscles, though my tight runner’s hamstrings sometimes make it difficult to sit in the boat for long periods.
Some people go so far as to compete in these other events, or mix them together in multi-sport "athalons" of one form or another. They’re forced to spend time cross-training when they could be running if they want to be competitive in multi-sport events. That’s not for me. Also, it’s hard enough to train and use whatever natural physical ability I have when I’m competing with others. If I need to buy better gear to help me to improve in a sport, staying competitive on that level can get expensive. So I’ll stick to buying running shoes instead. Anyhow, I prefer running. Biking for transportation and swimming to cool off are enough for me, thank you.
I do some things before I go for a run to help avoid discomfort while I’m out, especially when I’m going on a longer run.
I use a stick lubricant on sensitive areas, like my inner thighs, to reduce chafing. People used to use Vaseline. Races would often have someone at aid stations holding a sheet of cardboard coated with Vaseline so runners could scoop some off on the way by and use it to coat any sort spots. Today, there are products available that do the same thing, but last longer and are not as messy.
I might stick a band-aid or an anti-blister pad on spots that tend to get blisters. My feet have gotten tougher, and blisters are less of a problem than they used to be, but when I’m going on a long trail run, I still need something to protect my feet.
A long time ago, the goodie bag for a race I was in came with a sample of a product called "Compeed" that was great for preventing blisters or protecting blisters while they healed. A Compeed pad stuck to my foot through the stresses of running better than anything else, especially if I helped it with a little tincture of benzoin. Then the brand was bought by Johnson & Johnson. They relabeled the product with the Band-Aid brand, and then they watered them down over time until they adhered no better than anything else.
When my little stock of real Compeed was running out, I turned to the Internet in desperation. I found that they still sold the original version in England so I ordered a quantity of the good stuff by mail. Six years later, I still have some left because I hoard them, using them only in marathons and other long races.
In the summer, the heat and the sun add to my problems. I put a little round band-aid on each nipple to keep them from chafing against the lightweight mesh shirts I wear when it’s hot. I have some electrolyte capsules I bring with me on long runs on sweaty days when a sports drink isn’t enough to keep me from cramping. Sometimes I even remember to put on sunscreen.
Some of the things I use to prevent pains before a run, like stretching and massage, also help me to recover from any discomfort that persists after a run. If I apply ice to sore muscles, that brings down the swelling and dampens the pain, and I hardly ever get frostbitten skin. Soaking in a cold tub right after a long run is a good way to reduce inflammation and speed my recovery. I only do that in the summer. I’m not going to hop in a cold tub after spending a couple hours outside on a New England winter day, no matter how much it might help in the long run.
Running helps runners retain our youthful appearance, but in another way, it makes us more like old people. Just like the elderly, when runners get together, a main topic of conversation is our health and our aches and pains. There’s always plenty to talk about.
No matter how much I prepare, running still hurts. The hurt that comes from extending my limits and pushing through simple tiredness to go faster or farther is a good hurt. Unfortunately, there are always other pains unless it’s a very short run. A toe joint complains, my lower back protests, a hamstring rebels – every body part has chimed in at one time or another.
Running through those pains has taught me to pay no attention to little things. Many non-running injuries can be ignored. I know runners who have run after shoulder surgery with their arm still in a sling and runners who’ve run with their broken arm in a cast. After I had my own shoulder surgery, my doctor said I could do whatever I wanted as long as I could tolerate the pain. That was good enough for me. I took off the sling and went for a run. He had no idea how much pain I’ll put up with in order to run, but I wasn’t going to straighten him out.
Another time, I signed up for a 5K while I was on a business trip. The night before the race, I had a muscle spasm in my neck. I couldn’t straighten my head, and the pain kept me from sleeping. The next morning, I ran in the race anyhow, though I couldn’t move my head and it was locked at an angle that made it hard for me to run smoothly or see around some of the turns. My only regret was that someone I couldn’t see passed me at end and beat me out for 2nd place in our age group.
I try to ignore illnesses too. I might cut back some when I’m sick, but I usually keep running, unless I have a fever. Sometimes running seems to help me burn out the germs and get better faster. But that’s balanced by the times I get worse after running, and I have to dial it back further or even stop for a while. I may feel bad about taking the time off, but the forced extra rest sometimes ends up helping me out. In 2004, I was in bed sick for two days just before I ran the Green Mountain Marathon. That turned out be enough tapering off to help me finish in 3:26 despite little training and a sore hip.
The pains that develop while I’m running can usually be managed. A new pain means it’s time to check my running form. I’ll usually find I’ve let something slip, and when I correct whatever it is I’m doing wrong, the pain goes away, or at least becomes tolerable.
Sometimes nothing I do makes a pain go away. It keeps nagging at me as the miles pass. But if I keep going, sometimes a new pain arrives. The new ache can sometimes almost serve as a welcome relief, by distracting me from the old one.
My hips and back often start to stiffen up and hurt somewhere around 10 miles into a run. That makes it hard to keep going even when I’m not tired. For a long time, I regularly took ibuprofen to help get me through my long runs. Vitamin I helped keep the pain and inflammation away. If I was going to run much more than 10 miles, I took ibuprofen before I started to delay the onset of the pain. If I was running far enough, I’d often end up taking some more during the run.
Too much ibuprofen can be dangerous. It’s implicated in a long list of potential problems, including stomach ulcers, kidney problems, and hypertension. Tylenol is safer, but it doesn’t have the same beneficial effect, presumably because it doesn’t have the same anti-inflammatory qualities. I was willing to ignore the risks of too much ibuprofen, but after a while my stomach started to get upset from the pills. When I mentioned that to my doctor, he gave me a prescription for Celebrex. Celebrex didn’t have the same effect on my stomach so I began to take that before a run, though Celebrex was supposed to increase my chance of having a heart attack or stroke. Again, I chose to ignore that risk so I could run with less pain.
I finally worked my way up to a case of acid reflux disease. The painkillers probably contributed to that problem, so these days I’m trying to stay away from the pills as much as I can.
Another reason to back off on the painkillers is that they can make it harder to tell the difference between pain and injury. The trick is to decide whether a new pain is just another ache and I can safely run through it, or it’s a serious injury that needs treatment or, even worse, rest. That can be a very hard choice to make, especially mid-run, when I’m used to pushing through pain to get to the finish. If the pain is muted by ibuprofen, it’s harder to make the correct decision.
From time to time, someone trips over a rock and breaks a leg, or tears an Achilles while sprinting, and no matter how tough they are they have to stop and get the problem taken care of. But most running injuries are not caused by a traumatic event. They’re due to wearing down from repeated stress, not a single blow.
I usually find out I have an injury when the pain doesn’t go away after a run is over. If a pain is still there when it’s time for the next run, the prudent choice is to postpone the run until the pain goes away. It’s that simple for a lot of people - if something hurts, don’t run. Of course, I never do that. The problem is, if I don’t run when something hurts, I’ll never run, and that’s not acceptable.
Sometimes ignoring the pain works, sort of. The pain persists for days, weeks, months, or in some cases years, but it never gets so bad that I can’t run. The balance between the physical discomfort of the pain versus the mental discomfort of taking time off to heal never tilts far enough in the direction of rest to get me to stop running.
My right Achilles is a typical example. For years, it’s been creaky, especially in the morning. The tendon catches against the sheath when I get out of bed and walk. The problem fades away when I’m not running much, but it always comes back when I build up the miles again. It loosens up when I move around, and it usually doesn’t bother me much when I run, but it’s something that I worry about. Not enough to do anything about it, but…
Sometimes ignoring problems is stupid. I have hemorrhoids, which bleed a little from time to time. I was taking a medication whose side effects caused the bleeding to increase in frequency and amount, but I ignored the problem and kept running. Running got harder, and I almost quit before I went for tests and found that I had lost enough blood to become anemic.
When denial doesn’t work, sometimes rest helps. That’s how a runner defines a serious injury – it’s a problem that keeps him (or her) from running.
When I do have to stop running, the tricky part is making sure I rest long enough. For example, I had an illiotibial band problem with my knee that kept me from running. I’d rest for a couple of days and it would feel fine. Then, when I tried to run, the pain came back after a mile or so, and I’d be forced to walk home. I finally had to take a couple of weeks off to let it heal for good, but I spent a couple months messing around before I could make myself leave it alone for that long.
It’s hard to stop eating like a distance runner when I’m forced to take time off. It still takes the same size portions to satisfy me, even though I don’t need as much fuel. Weight starts piling on when I’m not burning 3,000 to 5,000 calories a week by running. Non-runners start telling me how healthy I look, because I’ve lost my usual gaunt, desiccated appearance. I don’t gain extra weight quickly, but it’s still a problem. Luckily, the stress and anxiety of worrying about gaining weight helps me burn some of those extra calories.
Taking time off because of an injury does make me realize just how much time goes into running. All of a sudden there are extra hours in the day that I need to fill with some kind of activity. Normally I’m not much of a TV watcher, but during one month-long stretch of downtime while recovering from a nagging hamstring injury, I discovered Turner Classic Movies. I watched a lot of old movies that I had never made time for before, like "Casablanca," "Roman Holiday," and "The Philadelphia Story". Audrey Hepburn and Cary Grant helped fill the days, but once I could run again, the TV went back off. Even Audrey can’t compete with running.
The extra time I have when I’m not running gives me more time for cross-training while I recover, if the injury permits it. When the weather’s cooperating, I’ve got time for more spur-of-the-moment skiing or kayaking. Yoga classes also help pass the time, as long as the injury doesn’t keep me from struggling into the poses.
I try to use cross-training to keep my fitness up for when I return to running, but it’s just not the same. I can only do 10-15 minutes on an elliptical trainer or a stair-stepper without a lobotomy.
When I was training for my first marathon, I tried running in a pool to keep my weight off an injured leg, using a flotation belt to hold me upright. It was funny-looking to watch. All you could see was my head poking up from the water as I slowly traveled back and forth. Pool running was better than nothing and I did stay cool and comfortable in the pool while I was working out, but when I’ve had other injuries, without the desperate need to make it to my first marathon driving me, I’ve never gone back.
I usually bike just for transportation, but when I’m injured, I will do more biking just for the exercise. Biking is probably the best alternative form of training, but mostly, spending a lot of time on my bike reinforces my preference for running.
My body usually heals with time and a little self-therapy. But if rest and treatment don’t work, or when it’s a traumatic injury and there’s no other option, then it’s time for me to visit the doctor.
Doctors are people too, with all that means. They can be just as kind, mean, diligent, lazy, happy, sad, smart, hungry, tired, or distracted as anyone else. Sometimes they’re right and sometimes (hopefully not often) they’re wrong.
I work with my doctor, but I keep my mind working too. He (or she) is the medical expert, but I’m the expert on how I feel and how I’m reacting to treatment. That’s important too. I also have more time than my doctor, an Internet connection, and more reason to search for information specific to runners.
The first time I had plantar fasciitis, I found information on the use of night splints to keep my foot stretched and help relieve the pain. I took the information to my doctor. Today, you can order a night splint ready-made, but at the time, they weren’t very common. My doctor hadn’t worked with a night-splint before, but he thought it sounded like a good idea. He put a cast on my leg with my foot flexed, carefully cut it off, and fashioned a custom-fitted night splint that I wore in bed to help me recover.
I’m not always an easy patient. When I go to the doctor, I want the doctor to fix what’s wrong, right now. I’ve already tried resting, stretching, anti-inflammatories, and everything else available to me. I want him to Do Something to get me back on the road right away, if not sooner. That’s almost never possible.
Sometimes the cure for a problem is actually pretty simple. I’ve had a couple cases of persistent jock itch that I couldn’t treat with over-the-counter medications. My doctor prescribed a simple cream that soothed the rash away within days. Another, more serious incident occurred when I was stung by wasps a couple times while I was running trail with the hash, and I collapsed from anaphylactic shock. Luckily, my friends were able to flag down someone with a phone and call an ambulance, and the EMTs and the emergency room staff were able to get me back on my feet in time to make it to the on-in party after the hash.
Other times, professional treatment helps, but it still takes time to get better. I’ve been dealing with a case "runners butt" for most of the last year. I first noticed a problem when I didn’t recover well after a 20-mile race, though in retrospect, the problems I had during the race were probably a sign of the injury. I kept running anyhow, limping slowly along for short distances, until I reached the point where I couldn’t lift my left leg or sit for long without pain.
A couple of months of rest did not help, so I went to my primary care physician, who referred me to a series of other doctors. None of them were able to help, and nothing showed up in any of the various tests and scans I went through, though we did eliminate bursitis, arthritis, osteoporosis, and a host of other possibilities. For the most part they suggested treatments I’d already tried, like rest, ice, and anti-inflammatories like ibuprofen, and none of them worked.
When I was leaving one doctor’s office after he failed to help and had given up, he told me that I should be grateful that "it wasn’t a serious injury". He was allowed to live, but it was a close thing.
We finally settled on a diagnosis of hamstring tendinosis, which happens when tendons are damaged repeatedly and not allowed to heal properly. The tendon develops snarls and chokes itself rather than working the way it should.
I went to a pain management clinic. My therapist there used deep tissue massage and ultrasound to break up the crud and allow healing. I also visited a doctor for a few sessions of trigger point injections. The doctor felt along my hamstring for knots left behind by previous injuries. When he found one, he stuck it with a needle, wiggling the needle and injecting a saline solution to try to get the knots to release. The treatments helped restore flexibility to my hamstring. I could stretch farther and with more comfort after each session. I also added eccentric hamstring extensions based on research I found on the Internet. I’d lift the weight with both legs so I wouldn’t strain the sore leg, and then I’d let the weight down with just the injured leg.
All this finally helped enough so I could get back on the roads. My therapist also introduced me to some exercises inspired by the Feldenkrais Method, a system designed to help people move more efficiently to reduce pain or limitations in movement and promote general well-being. I’ve incorporated some things I’ve learned into my running form, and I’m hoping that’ll help reduce my chance of injury in the future.
There’s still some pain, almost a year after the problem began, but I’ve been able to slowly build up my mileage.
One nice thing about running while recovering from injuries is that if I’m supposed to limit myself to 3 or 4 miles of easy running, I get the virtuous post-run "I did what I was supposed to do today" feeling without having to run far or fast enough to be tired. That’s sort of like appreciating unemployment because I get to run whenever I want, but it’s still true.
I’m trying to put more effort into managing my aches and pains and reducing the frequency of my injuries. The work I’ve done to build stronger muscles and improve my running form has helped some, though there are times when I get discouraged and think that I may finally have reached the time where I just can’t run as far any more. If I run less and rest more often, maybe fewer of my aches and pains will turn into chronic problems. I’m not sure if that’s a sign of wisdom on my part, or whether I’m just wearing down after years of struggling with injuries.
Maybe I’m learning from all this. Whatever. As long as I can keep running….