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Facilitating Optimal Injury Recovery

At the root of all injuries, there is a need to find the foundational cause of the injury and focus on facilitating optimal recovery.

There’s something oddly comforting about hearing the injury woes of other runners. It’s not that we ever wish an injury upon someone else or that we ever hope our fellow running tribe suffers the dreaded DNS due to injury, but sometimes it’s just helpful to know we aren’t in it alone.

We all want to bounce back from injury as fast as possible when it comes to running. But often, our impatience or fear of falling behind in training means we don’t do the right things to optimize recovery, or to come back without risk of re-injury. The reason behind that of course, isn’t necessarily that we don’t know we should focus on optimizing recovery, rather that sometimes we don’t realize the proper method of injury rehabilitation.

Dr. Cherie Miner of Andrews Sports Medicine and Orthopedic Center says that the injury type is very indicative of what the proper treatment needs to be. Acute injuries typically only require rehabilitation, while overuse injuries, such as stress fractures and tendonitis are often more related to biomechanics. In these instances, a “running evaluation to analyze mechanics and rehabilitation are important for overcoming and preventing” these types of injuries.

This methodology was backed by a recent study focusing on male runners, who presented with Achilles tendinopathy. While addressing Achilles tendonitis may often include a lot of KT tape and a lot of unwanted time off, the study showed it may need to address something else: hip biomechanics and ankle structure. One study revealed altered hip biomechanics, and another study revealed looser ankle structure. As these studies suggest, in certain cases of Achilles tendinopathy, as with other injuries, simply rehabbing the Achilles will not suffice: the recovery needs to also address biomechanical factors.

What exactly does it mean then, to address biomechanical factors versus simply rehabilitating an injury? A biomechanical driven injury can be related to the biomechanics of any part from impact to push off, and stresses that are placed on the lower extremities are the ones that typically lead to injury and can be most readily addressed by altering running mechanics.

The start of these injuries can be related to stride, cadence, muscle weakness, decreased flexibility, joint rigidity and overall body misalignment, often stemming from things such as poor posture or increased time spent sitting. In the case of Achilles tendinopathy for example, the injury stems from the hip joint angle, where, for example, the study results showed increased peak hip external rotation.

When it comes to injury, it is important to denote that it is typically due to increased load, and it is how well the body is able to handle and disperse that load that will allow a reduction in injury occurrence, severity and recurrence of the same injury. That means that priming the body for optimal load bearing is key. This comes with setting the body up so that it physically and physiologically is able to handle the load. Addressing biomechanical factors as listed above is key, but also nutrition, shoe selection and the quality of recovery time.

As a runner, maximizing recovery and coming back from injury requires several considerations:

  • Assess whether the injury could be driven by biomechanical factors. This can be done based on understanding the type of injury (i.e. overuse versus acute), and the onset of the injury. An injury that has come on slowly may have biomechanics at the root, gradually getting worse, while an acute injury, which often comes on suddenly, likely won’t.
  • Be aware of injuries that are reoccurring. The same injury coming back is often an indication of the need to look deeper for a cause.
  • Speak to a professional, or a selection of professionals, including a chiropractor, sports medicine doctor, physical therapist or nutritionist to begin to address the injury at the root cause and work together to look at stride, shoe selection and nutrition.
  • Focus on deliberate rest and recovery, including getting enough sleep, myofascial release techniques, and post run refueling.

Finally, it is important to make the distinction in overuse injuries between male and female runners. For the latter, in injuries such as stress fractures, it is often assumed that the necessity is to go back to evaluating for evidence of the female athlete triad due to the risk of low bone density. This is not always the case however, and females have many other potential root causes to injury occurrence. Furthermore, as addressed in a recent article, males also have their degree of risk and tendency towards insufficient caloric intake, which can affect injury rates.

At the root of both genders and all injuries, is the need to find the foundational cause of the injury and focus on facilitating optimal recovery, whether biomechanical, rehabilitative or otherwise. And as Miner also notes, “athletes tend to have fewer injuries when they cross-train,” and all athletes should spend time focusing on their core and hip strength.