At the first sign of injury, most runners have the same reaction: Ignore it and keep training. “There’s a bit of OCD with runners,” says John Ball, a chiropractor in Chandler, Ariz., who works with elite athletes like Lauren Fleshman and Andrew Wheating, as well as recreational runners. But most running injuries only get harder to treat the longer you let them linger. Dan Bannink, a physical therapist in Lake Orion, Mich., emphasizes this rule of thumb: “If it’s hurting, it’s not healing.”
Ultimately, taking the time to find and fix an injury before it becomes a chronic issue will give you the foundation to train injury-free throughout the rest of the year. See it as a healing period that will give you the ability to train well later when you need to. Here’s what Ball, Bannink and other experts say about three common injuries.
Achilles Tendinitis
Stop or go? Achilles pain is an injury that you shouldn’t try to run through, Ball says. Continued stress on the area can lead to Achilles tendinosis, a more serious and longer-lasting injury. To know when it’s safe to return to running, Pete Kitto, a physical therapist in Ann Arbor, Mich., who has worked with Ron Warhurst’s elite training groups, recommends a simple test: “If your first step in the morning hurts, you’re still injured,” he says. When that first step is pain-free, you can begin a conservative return to running.
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Treat it: Jay Dicharry, a physical therapist in Bend, Ore., and the author of Anatomy for Runners, says eccentric training is a well-established method of working the Achilles tendon. Ball concurs, saying that this type of training, strengthening-while-lengthening, “is the best that we have right now. For the vast majority of people, that’s the right starting point.”
At home, Dicharry recommends calf drops. Start in a standing position with both feet on the floor. Raise yourself to a tiptoe position using both legs. At the top of this position, lift one foot so that your body is supported only by the injured leg. Slowly lower your heel until you’re back at a standing position. Then use both legs to lift yourself again. Repeat for three sets of 10 drops.
This training won’t fix all cases of Achilles tendinitis, because other underlying factors may be causing the pain. If pain persists, a trip to the doctor is your next step.
IT Band Friction Syndrome (ITBFS)
Stop or go? During the initial stages of recovery, you need to back off from running and cross-train. “Pain that affects gait mechanics should be fixed,” Bannick says. “It’s an inflammation of tissue. Too much of that over time and tissue gets changed—and not for the better.” When cross-training with ITBFS, it’s important to pick exercises that don’t irritate the area. Stay away from the elliptical machine, Ball says, because it can place the hips in a position that puts more stress on the IT band. As you recover, start doing shorter, faster work such as strides first, because they tend to irritate the IT band less than long, easy miles, says Brian Fullem, sports medicine podiatrist in Tampa, Fla., and former captain of the Bucknell University track team.
Treat it: Although runners usually reach for the foam roller when dealing with ITBFS, neither Bannink nor Dan Selstad, a certified athletic trainer in Solana Beach, Calif., who specializes in runners and triathletes, recommends it. The foam roller doesn’t address the underlying issues—usually hip and glute weakness, Bannink says, adding that it is important to remember that even though the pain is felt at the IT band, “It’s never the IT band’s fault. The pain is the canary in the coal mine that points to a larger mechanical problem.” Selstad agrees. “The problem is the soft tissue that’s pulling on the IT band,” he says, not the IT band itself.
To get to the root of the problem, strengthening exercises are vital for overcoming ITBFS. Kitto recommends holding the fire hydrant position (on all fours, lift a knee out to the side so it’s parallel to the ground) for three reps of one minute on each side. Add three sets of 25 clamshells. (Lying on your side with your knees bent to 90 degrees, lift your top knee away from your bottom knee, engaging your glutes to perform the motion.) Bannink suggests sets of 10 to 20 shallow, single-leg squats done in front of a mirror. The emphasis is on keeping your hips level and your knee coming straight out over your toes, rather than focusing on the depth of the squat.
Plantar Fasciitis
Stop or go? Good news: Having plantar fasciitis doesn’t automatically mean you have to take time off. Treating plantar, Ball says, “is about bringing the training load down until it’s manageable.” Reduce your running to the point that the injury doesn’t cause you to alter your stride while running or cause you pain that impacts your day-today activities, he advises. Supplement your running with cross-training that doesn’t put additional stress on your feet—activity that doesn’t irritate the plantar fascia can help promote healing. “Jump rope isn’t going to get it done, but swimming would be great,” Ball says.
Treat it: Kitto recommends traditional wall stretches for the calf. Lean against the wall, alternating with your back leg straight and bent, for three sets of 30 seconds in each position. He also swears by pulling on your big toe while seated and stretching it up and back, three times for 30 seconds, three times a day. “The literature shows it works,” he says. After the plantar fascia is stretched out, Kitto recommends using a massage ball to roll the area for five minutes, twice a day, for maintenance.
