Dealing with injury. To run, or not to run?

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Running For Beginners: The North Face 100

Four weeks ago I ran a 100km trail race called The North Face 100 held in the Blue Mountains near Sydney Australia, it was a fantastic thing to be a part of, the only downside was I rolled my ankle about 10km into the run. It wasn’t a serious twist of the ankle, at the time I only just felt it. I was easily able to keep running, however the more miles I ran, the more hills and steps I went up and down, the worse the pain became. By the 40 mile mark, it was hurting quite badly, and I took some pain killers I was carrying which successfully masked the pain for another three hours or so, before I had to take more pain killers to keep going. I made it to the finish in just under 18 hours, which was right around the time I wanted to achieve.

I stayed at a hotel near the finish line the next day to recover from the run before getting on a plane and flying home, and I ordered a bucket of ice to try and treat the swelling, and lessen some of the pain.

Three days later on Wednesday I was home, and while my ankle was somewhat swollen, and experiencing a level of discomfort, I still decided that going for a recovery run of some 5 miles would be a good idea. On Saturday I repeated the dose, going for an easy 6 miles, and then again on Monday for another 5. All this time the ankle was swollen and uncomfortable, and when I woke the morning after the Monday run I decided that since it wasn’t improving, getting some professional help might be a wise thing to do.

I made an appointment with my podiatrist later that day, and as she inspected the ankle, asked what I was training for. I told her I had a marathon coming up in three weeks, and she gently told me that “might be ok”. One thing I have learnt over the years is the best medical professionals to go and see about running injuries are other runners. My physiotherapist, massage therapist and sports physician are all regular runners, and the podiatrist I see is one also, having run ultra marathons herself. I find if you see non runners they often have little empathy for your problems, with an attitude of “rest and get over it”, not usually what you want to hear.

The podiatrist sent me for a ultrasound scan of the ankle which found there were luckily no tendon tears, however the tendons were badly inflamed, or “extensive tenosynovitis” in medical terminology.

The treatment regime was two weeks off running altogether, with minimal walking, taping of the ankle, icing and anti inflamatories. I had my first run back two weeks later for an easy 3 miles, and the next day experience some return of swelling and discomfort. I rested two days, and then ran another 3 miles where the ankle was somewhat better the day after. It was about that time I was due to run that marathon, but on advice from the podiatrist and my coach, I didn’t take part. The main reason I was running the marathon was because I had a lot of friends running that day, and it would have been great to have enjoyed the experience with them. That given, I have more important events coming up that I don’t want to jeopardize, and running the marathon could have set me back with another month off running if the ankle had gotten worse again. For once I was sensible.

Which brings me to the reason for this post, when should you be sensible with injuries, and stop running? There is a case that could be argued that I should of stopped when I rolled the ankle in the first place, 10km into the 100km race.  If I had been that sensible, I don’t think there would have been any injury to worry about at all in the subsequent weeks. Or should I have been sensible when I was in pain at the 40 mile mark and decided to take pain killers? I could have pulled out at the aid station at that point, and probably not have injured the ankle as badly as I did. And surely I should have been sensible the days after and gone and seen the podiatrist earlier, rather than continue to run on it?

The problem I think is that as runners we just get so used to running with some level of discomfort and pain. If I stopped running every time I feel an ache, I wouldn’t run very much…just about every run has some level of discomfort.

Couch to 5k The North Face 100And what if the marathon had been an “A” race in my calendar, should I have taken the chance and run it, and treated pain during the race with more pain killers? Probably not a sensible course of action, but one I could understand someone taking if it was an event of real importance. While I run many more miles a week than most beginner runners, the questions I have raised here apply to those just starting out with their running also. For example, if you are doing the Couch to 5k program and you get muscle soreness; do you rest, or keep going with the program? And if you decide that with muscle soreness you would keep going, what if it was shin pain instead…and shin pain can turns to shin splints and stress fractures, what then? On the other hand a little soreness very quickly becomes a convenient excuse not to run.

Unfortunately I don’t have the answers for this one, I think I probably made a few bad decisions regarding this ankle injury, so I am probably not the guy you should be looking to for advice on this. Injuries though are something you should consider carefully, and if in doubt, go and see a medical professional.



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