What it Takes to Rehab a Running Injury
Running injuries are pretty common and come in all shapes and sizes. While treatment and recovery time will vary widely depending on the injury (severity and type) one thing is always true: injuries heal faster with treatment. “Just Rest” is not a good recovery plan.
Related Reading:
Your Injury Needs Treatment
Running Injuries, Rest & Treatment
I figured I’d write about my most recent injury because it’s a good example of the time and money investment that can be required to rehab a minor injury as quickly as possible. Here’s what happened:
Pain Onset
At the end of March I sustained an injury to my iliopsoas - a stabbing pain in my abdomen that I first noticed in the middle of the night while turning over. The next day I couldn’t take a step without pain. I have a history of issues with my right leg & hip and I knew this injury was somehow related. My most recent workout (before the injury) had been hill intervals and my hamstring was feeling a bit off that day. I didn’t run the hills as aggressively as I normally would, and got through the workout without any pain, but I had a tight hamstring and something felt a little bit off.
It was a couple days later that the abdominal stabby pain came up, and I was not really sure what to do for it. I wasn’t about to use the theragun on my abdomen! Trying to stretch it was really painful. Running was out of the question so I rested it and occasionally put an ice pack on it.
Treatment (4 days later)
Because I suspected the injury was connected to some asymmetry or alignment issue with my right hip I decided to see a chiropractor* (see note below) for advice. Just 4 days after the initial pain, I went in for treatment. I got a very thorough evaluation, ART (active release technique, for soft tissues) on my right leg, an adjustment and some homework: breathing exercises and some stretches to do daily. I left the appointment feeling very hopeful that I would be back to running in no time.
One of the exercises I was assigned to do, called the “Wall Runner”
Continued Treatment
My recovery however, was not quick. I did my breath work and stretches diligently, and they helped. But it was still another week before the pain while running was low enough to manage a 2 mile jog. Up to that point, it had been 12 days without running at all.
I returned to the chiro a week after my first appointment, then 2 weeks later, again another 2 weeks later, and my (hopefully!) last appointment will be this week (3 weeks after my last appt). Each time I went I got new homework of exercises to do.
Time Frame
My injury lasted 6 weeks from the day I first noticed the pain to the first pain-free run. As mentioned, the first 12 days I didn’t run, so I ran with manageable pain for over a month.
I got treatment 4 times and did rehab exercises throughout. I was able to increase my running load (only easy miles — no workouts) gradually and by avoiding running on consecutive days. In addition to running I did strength training, jump rope, and once a week pilates, and an erg workout.
The Happiness Cycle of Pain-Free Running
It is often possible to keep training through an injury, but the key is to constantly evaluate the injury and make sure you’re not preventing your injury from complete recovery. The flow chart shown is a good way to evaluate your situation and navigate training through discomfort. During the month+ of rehabbing my injury, I was able to run — but would be in pain afterward, pain greater than 1/10 just while walking around. When this happened, I continued my treatment and did not run for as long as needed to get to zero pain while walking around. Then I would do another run.
We do not want to be managing pain or discomfort in then long term. The goal is to get back to ZERO pain. Sometimes training through an injury will delay getting back to zero pain. That’s a trade-off: to be able to maintain some fitness we take a bit longer to get back to 100%. This is ok as long as we’re not preventing a complete recovery.
Remember: the trend should be towards zero pain and complete recovery.
Related Reading:
Why You Got Injured
Running Injury Comeback
Return to Running: Injury Comeback
Investment
I paid a total of $465 to rehab this injury.
$185 initial evaluation & treatment, plus 4 subsequent visits at $70 each.
I did not see my primary care doctor and did not have a referral. That process takes way too much time and I wanted to get treatment ASAP. There’s no way I could have been seen within 4 days if I’d tried to go that route. Fortunately, I was able to use our insurance health savings account to cover the expense, but this isn’t always the case.
For me, the investment of getting treatment is worth it even out-of-pocket because of how much I enjoy running and working out. It’s a high priority for me to be healthy and get back to running ASAP. It’s likely that I could have eliminated a couple treatment appointments if I’d been willing to slow down my return to running and run less during the process.
**A note on chiropractic care: Generally I don’t recommend chiropractic for running injuries. In my opinion, the most helpful medical providers offer us a way to help ourselves and improve our situation between appointments. They give homework: exercises and stretches that we can do daily. This is something that most chiropractors do not do. I decided to try the chiropractor near me based on reading his bio. I was fairly confident that he would be able to help me, and I was right.
Nicole Sifuentes is a full-time Running Coach for adults of all ages and abilities. She is a former professional runner and 2-time Olympian, and Certified Strength and Conditioning Specialist. Read more about her services, and schedule your free coaching consultation.
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