I start every talk I give to runners by asking “who is currently injured”? There are usually only one or two outcasts that don’t raise their hand. This is because pushing through pain has become an acceptable part of running culture. There is a lot of click bait type of information on the internet and health care providers giving misinformation, so I want to set a few things straight, because the more you know the better.
Quality vs Quantity
Distance runners are inherently obsessed with volume (Quantity), yet the extent of most runners formal training in running technique (Quality) ended when they learned how to tie up their shoe laces. The act of running doesn’t make you a better runner, getting better at the skill of running makes you a better runner. Did you catch that?
Running is a SKILL !
I will go into this in more detail later in this series, but this is the fundamental paradigm shift needed to make exponential improvements in your running. Most people think I am selling them snake oil when I say I can make them run faster and farther with minimal volume, all while significantly decreasing time lost to injury. Performing at a high level is a result of skill compounded by conditioning. Without skill, the conditioning can only take you so far.
Pain = Not Good
Point blank, pain negates progress. Continuing to train through pain will actually make you slower, cause further tissue damage and unwanted adaptations. Seems like common sense, so why are most runner’s injured?
Motivation > Reason
Some may call it denial. I call it Willful Blindness. When someone intentionally turns their attention away from a problem. Pain is a signal that there is a problem, and it will get louder if not addressed. This is why runner’s present to my office at a stage of their injury where activity is limited and recovery is delayed.
The vast majority of injuries are non-traumatic. This happens when tissue breakdown is greater than tissue regeneration. This is best explained through the supercompensaiton cycle.
Training —> Fatigue —> Recovery —> Supercompensation —> Decline
Above is the flowchart version of the Supercompensation Cycle. Basically, it tells us that training provides a stimulus, followed by a period of adaptation to allow for a greater training stimulus. With the right balance of training and recovery over time, you build your training capacity. The key is training in the Supercompensation part of the cycle, before decline happens. Here is another way of looking at it,
Stimulus —> Breakdown —> Adapt —> Ready for Increased Stimulus —> Too Late
Injuries happen when the next training stimulus is implemented regularly in the fatigue and recovery portion (breakdown portion) of the cycle. Amplify this over months of training without adequate recovery, and you’ve got yourself an injury. 99.9% of the time its not a programming problem, it’s a running problem! Most running programs take into account the supercompensation cycle by gradually increasing running distance. However, they don’t take into account mechanical insufficiencies.
Case Study #1: Overstriding - This runner sits at a desk all day for over 10 years resulting in tight hip flexors and a stiff upper back. Due to his poor posture he has a more forward running position, causing him to land well in front of his centre of mass. His tight hip flexors give him poor back-side mechanics causing most of his leg movement to happen in front of him. This causes him to over stride, leading to a quad dominant and a breaking action when he lands, resulting in increased stress on the knees. The tissue around the knee is stuck in the breakdown and results in Patellofemoral Pain Syndrome aka “Runner’s Knee”.
Case Study #2: “Glutes don’t fire” - This runner has poor pelvic stability which leads to her hip dropping when she lands, resulting in a rapid shift inward of the knee. This aberrantly stresses and breaks down the fascia on the outside of their knees, which never recovers over subsequent training sessions and causes iliotibial band friction syndrome aka “IT Band syndrome”.
Case Study 1 is an example of a hardware issue where the runner is physically limited by joint and tissue extensibility. Case Study 2 is an example of a software issue that has to do more with programming of muscle activation and motor control. In the first example, even if the hardware issue is removed the software program used to adapt to his previous limitations will still be operating.
Even though symptoms only started to appear 4 weeks ago, the breakdown could have been occurring for months, even years prior. This is why resting a non-traumatic injury doesn’t work and tends to come back once training is resumed. It’s like trying to rest a flat tire. Not to mention the mechanical dysfunctions that caused the excessive breakdown is still present. Standard rehab and strengthening measures are ineffective because they don’t carry over to running. It should be noted that rehab and strengthening are important, but it has to be incorporated into proper running technique to be effective. You will just continue to build running fitness on top of a dysfunction. One of the reasons why injuries tend to come back.
The 2 keys to preventing injury are:
1) Master your running technique
2) Smart programming
This may seem vague to you now, but I will go into more detail in subsequent posts in this series. There are no quick fixes, but its worth it, because the side effect of bulletproofing yourself against injury is that you will run faster and farther in 6 weeks than you would in 52 weeks of standard volume progressions.