Returning to running after injury – autumn 2021 edition

Some observations and reflections following my recent injury

So there I was, nearing the end of a 16-week training block for a 50-mile race, when I felt a searing pain in my left butt cheek during what was the final long run. Stretching, massaging and a few days off didn’t help and left me facing the unfortunate truth: I was injured again.

My injury rate seems to be increasing as I get older, which is annoying, but it does allow the opportunity to try new things in the pursuit of a quick recovery.

What follows are some things I tried this time around to overcome my gluteus medius issue.

Chiropractors are 💩

If any physiotherapists are reading this: can you please put a live booking system on your website? It’s 2021 and most of us have better things to do than make several calls, checking on availability.

I spent an entire morning ringing physios and waiting for callbacks, and then, in a moment of desperation, I followed the advice of a running buddy and did the unthinkable: I booked an appointment with a chiropractor.

I am fairly open when it comes to most alternative treatments and medicines, but I have always been sceptical about chiropractors.

Their central premise is based on the unscientific belief that nearly all ailments of the body are due to misalignment of the spine. Some may have adopted more science-based practices, such as massage and physical therapy, but the underpinnings of their practice are still based on hokum.

Somewhat unsurprisingly, the one I saw did absolutely nothing to change my mind. After yanking my legs and cracking my back, I politely left the clinic vowing never to visit one ever again.

Coincidentally, while writing this I was listening to the latest episode of the Koopcast podcast and exercise physiology researcher Nick Tiller came out with a great rant about chiropractors being “full of bullshit.”

You can listen to it below (skip to 63 minutes). Alternatively, his piece on The Conversation about pseudoscience in sport is a good read.

Conclusion: Don’t bother seeing a chiropractor if you have a running-related injury. Go and see a proper physio instead.

I went and saw a proper physio

Annoyed after wasting my time and money on a charlatan, I did what I should have done originally and booked myself an appointment with an actual physio.

To say she was thorough is an understatement. I was put through a series of tests to gauge my leg strength and stability, and if you haven’t seen a physio recently, then prepare to have your ego dented.

There I was, thinking I would waltz through the assessment with glowing praise – I’m an ultra runner, so of course I am strong – only to be told certain muscles resembled that of an OAP. Great.

I was then given some rather savage hip strengthening exercises to do for homework (resisted hip abduction and clam shells, bridges etc.), then returned a couple of weeks later for an evaluation.

Sure enough, within a fortnight my glutes were now able to break walnuts, but most importantly, the pain had also subsided, allowing me to make a gradual return to running.

Conclusion: If you have an injury or niggle, go and see a physio. Try and see one that specialises in sports injuries and rehabilitation.

Hello running, my old friend

Returning to running after an injury is obviously risky. There’s the constant fear and risk that you might aggravate the injury, even go back to the beginning. That’s why you shouldn’t just return to running from where you left off.

The best thing I found to prepare myself for running again was to go walking and hiking. Both are biomechanically similar to running and on a musculoskeletal level, prepare your body to withstand the impact again. I started off simply by walking as much as possible everyday, before progressing to a four-hour hike in the Chilterns, with no ill effects.

Now it was time to start running again. Albeit, a mix of running and walking.

I often see people on Strava hopping back into full-on runs at the earliest opportunity, which baffles me. The initial goal shouldn’t be about trying to work the aerobic system, it should be about training the musculoskeletal system so that it can absorb and adapt to training later. If you start working the aerobic system too much too soon, then you risk being injured again.

Hop on an exercise bike or elliptical machine if you want to try and stay on the cardio train, but don’t worry if you can’t, because you won’t lose much fitness over a few weeks.

I would recommend listening to the following episode of The Real Science of Sport podcast, which explains better than I ever could. It explores how fast fitness is lost, how quickly it returns again, and what you can do to minimise those losses.

I also randomly found a decent run-walk programme here, which I adapted for my own circumstances.

They suggest doing each step twice before moving on to the next. My approach was to do them once and then monitor within the 24 hours that followed for any aches or pains. If I experienced any, I would take a rest day and then repeat the step again the day after.

I was able to sail through the programme in about three weeks, doing three to five runs a week, and by the end of it was running for an hour, separated by three one-minute breaks.

It’s a decent, gradual programme and one that I would recommend to anyone wanting to get back to running, especially long distance runners.

Conclusion: Don’t be in a rush to start running again. Mixing running with walking is a good start.