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Fitness

10 Tips for Training With an Injury

About 2km into my regular run - BANG - a searing pain in my foot. Surely life was over, my fitness would evaporate, and I would be morbidly obese by the end of the week.

Written by Graeme Turner Last updated on Nov 22, 2021

Four weeks ago it was a nice morning so I decided to go for a run. It wasn’t a tempo run or an interval run, just a nice run to enjoy the sunshine and the beach. About 2km into the run – BANG – a searing pain in my right foot. By the end of the day I couldn’t even put weight on the foot.

#1: Go to a Professional Right Away

Find out what the problem is quickly and from a professional. Don’t go see a general practitioner, don’t see a physio, and don’t spend hours checking out Doctor Google.

Four weeks ago it was a nice morning so I decided to go for a run. It wasn’t a tempo run or an interval run, just a nice run to enjoy the sunshine and the beach. About 2km into the run – BANG – a searing pain in my right foot. By the end of the day I couldn’t even put weight on the foot.

#1: Go to a Professional Right Away

Find out what the problem is quickly and from a professional. Don’t go see a general practitioner, don’t see a physio, and don’t spend hours checking out Doctor Google.

Surely life was over, my fitness would evaporate, and I would become morbidly obese by the end of the week (this seems to be the thinking whenever an athlete gets an injury). So the next day I went to get it checked out at a podiatrist I know whose partner is a runner. An ultrasound scan revealed a 17mm tear and inflammation in a tendon in my foot.

#2: Find a Professional You Can Work With

Find out what you can do rather than just what is off limits.

According to the podiatrist, I shouldn’t run for six weeks. Weight bearing was out, and even swimming was to be avoided (due to plantar flexing). Rather than focusing on what I couldn’t do, I asked him what I could do. There is an important difference between pain and damage. For example riding a bicycle in a carbon-soled shoe was painful, but according to the podiatrist, it wasn’t going to cause further damage. Riding up hills (additional stress on foot) was out, but flat riding was fine.

#3: Heal the Injury, Don’t Just Mask the Pain

Would you just take painkillers for a broken arm or have it reset in place?

For most of the day I wear an air boot. One of the keys to healing is to make sure you don’t create a situation that will cause you to re-injure, meaning you don’t want to heal in a shortened state. This is an important one for things like Achilles injuries. Simply having a cortisone injection would mask the problem (pain), but would not allow for proper healing. The boot keeps the foot flexed, which means the tendon doesn’t heal in a shortened state. I also roll the foot on a hockey ball to facilitate blood flow. (Note: I also avoid anti-inflammatories due to the direct link to gut issues and COX-2 inhibitors.)

#4: Don’t Panic, Instead Make a Plan

Check the fine print on events. Most major events will allow you to defer your entry if you have a medical reason.

I have a number of events coming up that I entered and paid for. Rather than panicking about missing them, I checked whether it was possible to defer my entry, what the deadline was for, and what the cancellation fee was. That way I knew how long I had to fix the problem and at what point I needed to decide it was a go or no go.

#5: Get Strict With Your Nutrition

Don’t work against your body. Don’t “distract” the healing by creating other problems for your body to deal with. Be stricter on an anti-inflammatory diet.

Most injuries cause inflammation. Inflammation can be a good thing as it martials the body to the fix the damaged area. However, if we are introducing additional inflammation into our body, then we slow the healing processes. My diet is pretty good, but after the injury I decided not to work against my body and instead focused on cutting out inflammatory foods even more. I focused on completely cutting out wheat (even hidden wheat in gravies, hamburgers, or crumbs) and refined sugars. I essentially followed a ketogenic diet.

foot injury, running injury, dealing with injuries, running injuries, injuries

#6: Take the Right Supplements

Look at supplements that can help you body recover from injury. Look specifically at the type of injury you are dealing with, e.g. tissue, bone, etc.

There are several supplements that can aid with healing. Colostrum and lactoferrin are two I use to help the body heal faster, as well as curcumin for pain relief and for dealing with inflammation.

#7: Use High Intensity Intervals

Do what you can to get that heart pumping. Krank cycles, single-leg riding, whatever maintains or increases your fitness without loading the injured area.

Fitness can be simply broken down into two factors:

  1. The blood’s ability to carry oxygen
  2. Strength

The blood’s ability to carry oxygen is measured by the red blood cell count (hematocrit). Studies, such as this one have shown that high intensity, anaerobic intervals cause an increase in red blood cell count even more efficiently than long boring miles.1 But surely you need to run or ride to do intervals, right? Enter the Krankcycle. The Krankcycle allows me to do high intensity intervals with zero impact on my foot. My protocol was thirty seconds hard, followed by three minutes of recovery, done ten times.

5 ways to implement the Johnny G KRANKcycle® by Matrix

I also kept on top of my iron intake so as to not waste the intervals. The net result is my red blood cell count has gone from forty up to 44 in four weeks. To give context, professional cyclists aim for a count of fifty, often using artificial means to get there. So, in essence, I have actually become fitter while injured.

#8: Work the Uninjured Body Parts

If like me, you have an injured leg, then work the uninjured leg. You will still get an increase in strength in the other leg and also reduce atrophy.

Obviously it is hard to do strength work for the legs without using the legs. Or is it? In a number of studies it was found that when working a single leg that growth was also shown in the other, unused leg.2 It wasn’t as much growth, but your body does like to try and balance itself. Single leg squats, leg extensions, and lunges can all be used to build and maintain strength, and at the same time develop hip and core stability.

#9: Consider Using Alternate Tools

Tools such as electrical nerve stimulation, isometrics, and aqua jogging can create muscle contractions without loading the injured area.

The TENS (transcutaneous electrical nerve stimulation) tool I use is made by Compex. These devices have come a long way since the old days of simply placing the electrodes on your chest and hitting a button. Modern units have variable levels and even specific programs. For example, the unit I use has an endurance program that uses shorter duration shocks. I use this to build strength, but also to fatigue my legs before a flat ride to solicit greater fiber recruitment. (It’s also good justification to keep shaving my legs. Pulling the electrodes off hairy legs is not a highlight of my day.)

As you can see, dealing with an injury is holistic. You should look at diet, look at alternate tools, and work with a professional. Trying to do this on your own is difficult and time consuming, especially with the amount of misinformation out there so this leads me to the final and most important point.

#10: Tell Your Coach

Your coach won’t (or shouldn’t) think you are soft but he or she should work with you.

References:

1. Satish, Sharma et al, “Effect of Intensive Interval Training on Red Blood Corpuscles and Cardiovascular Endurance,” International Journal of Sports Science and Engineering 06 (2012): 111-117.

2. P. Kanus, et al, “Effect of one-legged exercise on the strength, power and endurance of the contralateral leg,” European Journal of Applied Physiology and Occupational Physiology 64 (1992): 117-126.

Photos courtesy of Shutterstock.

About Graeme Turner

Graeme Turner gave up a lucrative IT career to pursue his passion in helping people achieve their fitness and lifestyle goals. Apart from being a nationally accredited triathlon coach, he is also a qualified sports nutritionist, strength and conditioning coach, and masseuse. He is a Retul Certified Bike Fitter, and he is even WKA certified to coach kickboxers and MMA fighters.

Graeme’s training and coaching philosophy is based on aminimalist program with an emphasis on power and strength over long junk miles. His typical Ironman coaching programs are fewer than twelve hours a week and he has worked with numerous Kona and other World Championship qualifiers. He also “coaches the coaches,” conducting development coaching courses for Triathlon Australia. Graeme is also very active in print and online media and presents regular seminars on running and sports nutrition.

Graeme doesn’t just talk the talk, but also walks the walk and has competed in triathlons and running events for over ten years, including the 2009 Hawaii Ironman and 2011 Ironman 70.3 World Championships, as well as qualifying for the Boston Marathon and New York Marathons.

On top of his triathlon and running success, Graeme is also a fourth-degree black belt in karate and even performed for a while in a circus.

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