Tips for Injured Runners

Research shows that 30 to 55 percent of regularly training runners will be injured in the course of a year. When you're hurt, taking a break seems like the most obvious course of action, but certainly not an easy one, especially for stubborn runners. "Other types of exercise just don't give you the same sense of satisfaction as running," said Bryan Whitesides, runner and physical therapist in Colorado who founded the Web site, InjuredRunner.com.

Whitesides tries to keep his clients running as much as possible at a reduced distance and lower intensity while they nurse their injuries. But, he cautioned, if you're limping or have a pain more serious than an ache, you should take a break from running altogether. That's sometimes a difficult piece of advice to digest, but the key to making your rehab pay off in the end is to change your mindset about your time away.

"I try to get people to view this time as an opportunity to focus on core strength and hip adduction," he said. "These are probably the most neglected areas by runners but they have the most significant impact on injury prevention." Whitesides also encourages runners to understand that rest will allow you to come back stronger -- a strategy, called periodization, which weight lifters have been using for years, but one that hasn't been incorporated into the running community. "Your body has a limited ability to adapt to stress," said Whitesides. "A period of decreased training can help you rebuild so that you can move up to a higher level afterward."

For injured runners who can't run at all, Whitesides suggests the stationary bike, deep water running, rollerblading and cross country skiing. "The two most important things to consider when choosing your cross-training activity are what's available to you and what can you do without pain," he said. "One of the reasons running is so appealing is that you just have to lace up your shoes and go outdoors."

So, you need to choose an activity that's very accessible and that you'll actually stay motivated to do. There's no point in committing to swimming if it's difficult to get to a pool. You're setting yourself up for failure. Whitesides likes the elliptical trainer because the action is similar to running, but, he emphasized, "It needs to be a pain-free mode of training." The amount of impact should be determined by how significant the injury is -- swimming being the lowest impact.

Whitesides understands that a running break is more than a physical setback -- it can be a mental one, as well. "It is hard," he acknowledged. He advises his patients to utilize visualization techniques while they're sidelined -- another move that will help improve running performance when they resume training. "I highly recommend the book, 'The Mental Athlete,'" he said. "I also like remind people that running injuries are usually a temporary speed bump not a derailment."

Another to-do during your rehab? "Hopefully you'll use the time to analyze the factors that contributed to your injury," Whitesides said. "Unfortunately there are a great number of factors that can cause injury from nutrition to biomechanics and core strength." But consider some basic questions: Are your shoes too old? Did you increase the duration of your runs too quickly? Is the running surface too hard? Understanding what went wrong will help you avoid injury again.

When you're ready to start back, Whitesides suggests starting with half the time of your previous runs. If you ran for 60 minutes before your injury, start back with 30 minutes and spend the other 30 cross-training. Then gradually increase the ratio of running to cross training. How will you know when you're ready to get back to it? "I give the single leg hop test," Whitesides said. "Stand on one leg and hop 30 times. When you can do that without pain, you're ready to start running."

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