What being injured has taught me

I was making excellent progress within my training program, having just completed a really good block of my periodised training program. I was on my way to achieving my all time goal to break 2 minutes for the 800m. I was placing myself under the right stress to help me become the better athlete.

Or at least I thought.

In early March this year I was diagnosed as having a stress fracture at the base of the third metatarsal. In short, I was in a moon boot for 2 months before undergoing a 12-week return to running program. Those two months were almost a living hell for me, as I am sure that anyone who has been told they cannot partake in an activity that they love would feel. Even though I was “blessed” because all sporting competitions had been stopped throughout lockdown, all my training partners were still able to get into their program. Running was one of the few sports that training didn’t get impacted severely, and whilst this is one of its benefits, it was a bit of a curse for me.

In this blog, I’m going to explain the process/steps I had to take to get back on track, how discipline & my attitude towards training has changed and how I will use what I have learnt as part of my programs in the future.

The process of getting back up & running

So for those who have never had to experience a musculoskeletal injury, such as a stress fracture, the rehab process can be summarised into 3 key phases: immobilisation, weight bearing and running again. I’ll briefly recount how these played out for me:

Phase 1 (Immobilisation + cross training) - Like I said earlier this lasted 8 weeks for me, where I was placed in a moon boot completely for the first 6 weeks and the final 2 where I slowly started wearing sport/casual shoes. I would often joke with athletes that I coached about how I was wearing it so I could get a chance to fly up to the moon (very cringy yes, but I had to find some light in the injury). I was restricted with my walking abilities; my right foot could not land in front of my left leg, only next to or behind. I was very lucky to have my friend from UNSW, Harrison (who has also been grinding through rehab/treatment for Osteochondritis Dissecans over the last two or so years), who had crutches that I borrowed (and yet to return) whilst in the boot.

In terms of exercises, I was very constricted to what I was allowed to do. Before everything shut, I was able to do some swimming at the San Souci Leisure Centre with the squads there. However, I was only allowed to do pull swimming (no use of my legs) and no dive starts/tumble turns. Being a swimmer in my high school years, it felt a bit weird, but I had to adapt to my situation. Bradley was also very kind in providing me with an aerobic circuit consisting of arm-cranking (a lot of it) with some non-weight bearing core exercises.

As we all went into lockdown in March and April, I was confined to completing a resistance training circuit (all exercises for time) in my own bedroom. Again, non-weight bearing core exercises were prescribed, as well as A LOT of knee push ups. By the end of the program I managed to get 60 knee push ups done in 50 seconds, I felt so accomplished with myself.

Phase 2 (Weight bearing and gradual return to running) - Once I had been given the all clear from my podiatrist to start weight bearing, I started undertaking a 12-week return to running program. This was broken up into 3x4 week blocks.

The first block of the program aimed to get me walking more and getting some body weight resistance programs completed. I remember how good it felt for me to start moving around again, I could finally record something else onto Strava apart from the same body weight, non-weight bearing, circuits. I was prescribed resistance body weight exercises 3x per week and fast/easy walking 3x per week. I was also allowed to do some “Kenyan shuffle” at my local park on a Saturday, a slow progression to get me running again. Although this part of the program was the most tedious, I had to remember that I didn’t want to end up in the boot again, and so I didn’t do any more/less than what was prescribed.

The next 4 week block introduced more aerobic work in the form of an elliptical (cross trainer) and bike. This was a turning point where I could have more options for training, which meant I could finally start doing some exercise outside my local area. I could also finally include some jogging/walking sessions into the program. This was the first time I was able to get some form of running in. Again I had 3 resistance training sessions per week, but all the exercises were changed upon the last program.

The final 4 week block was similar to the last block. However, I was doing more jogging and my elliptical/bike sessions were longer to assist developing a half decent aerobic base without increasing re-injury risk. The resistance training programs I had to undertake included weights, which I was very happy to start completing. By the end of this program I was able to jog for 20 minutes non-stop, which was a big step for me compared to when I first got injured. Although these jogs were definitely slower compared to what I used to do pre-injury, it had seemed like I had never missed the beauty of running around.

Phase 3 (running again) - I have just recently moved on into this phase, only being cleared a few days ago. This phase aims to gradually increase my running mileage, and towards the end of the program, increase the intensity of my running. The elliptical/bike are going to be utilised further to help increase my fitness, just to a lesser extent. Strength training will still be implemented and further improve my running performance. Obviously, this will be pain dependent, as well as ensuring that recovery is optimised through this phase to ensure that I will not injure the area, as well as other parts of my body.

The change in my discipline and attitudes towards training

Before my injury, I just focused on what my program said. Nothing more, nothing less. I never took the time to properly warm up for those easy runs, as well as cooling down properly. I also probably didn’t get enough sleep during this time for the amount of time I was spending training, working and studying.

Although this injury has been rough on me, it has also been a wake up call for how I go about the whole training process. The biggest lesson I have learned is that it is ok to go slow during your non-quality sessions. I always had the feeling that I needed to go a bit faster on my longer runs, trying to keep up with the guys who are a few seconds quicker than me.

I mean, if you train their paces, you should be running at their speeds in competition in no time right? That was my belief, and to my stupidity it has left me unable to run the last 5 months.

Doing three quality running sessions (sometimes four) per week was also a contributing factor to the injury. Although this was part of my program at the beginning of the year, I should have been more proactive and discussed my beliefs about this with my coach. One of the things I learnt from some light reading is that you should aim for only ~20% of your total running mileage/time to be at high/vigorous intensity.

Finally, I also wore the same pair of shoes for almost every session. Aside from my track sessions, I only wore the one pair for easy/long runs and warm up/cool down. Although it turns out that my specific pair of shoes was a faulty pair, I still feel guilty for not buying an extra pair of different shoes. Although I was trying to be cost-effective (as any typical uni student would be), it could have prevented the extent of my injury, and instead a “stress reaction” (this usually requires no moon boot and less recovery time).

As a result, I am aiming to introduce three new components to my training program. I aim to be accountable for this as I am making these goals public:

1 - buy 2 pairs of running shoes every 6-8 months

2 - incorporate more cross-training modalities into my program

3 - leave at least 15’ to warm up and cool down for every easy/long run

Why I won’t forget the rehab process

Although the obvious reason for this might be because people think that it has helped me get back to running, I’d also think of this as a prehab/prevention routine that I can start applying to training in the future. Depending on how I’m tracking in the future, I aim to start incorporating some of these non-weight bearing training modalities into the program as a method of increasing my training load. I have been doing some reading lately about running, and I have learned that even the top athletes use cross training as part of their program in order to maintain a really high training load.

Although this will be in direct consultation with my coach, I think this will be a great way of supplementing my training and help me achieve my running goals, not just over the next 3-6 months but my overall goals as well. As I recently bought a new bike a little bit after lockdown, I hope I can use this a bit more. The last thing I want is to have the same injury in the same area, and I believe that some of these exercises prescribed can aid the prevention process.

Although this was a really long blog, I feel like I had to discuss this and share my story with all of you. Hopefully, through my mistakes and complacency, you will have a harder look at your programs and how your body is coping with all the stresses in your life.

Keep up the running,

Paul

Intermediate Running Coach