August 14, 2016

Marathon Training: 4 Tips to Rebound from a Serious Injury

marathon training for injury-prone runners

The MRI machine whirs, clicks, and shakes ominously; I try to keep still.

A few days later, I find myself confined to a walking boot and crutches, diagnosed with a metatarsal stress reaction. I'm only a few weeks out from the full marathon I'd dreamed of racing, I'd already completed the 20-mile training run, and this was my second attempt to train for a marathon after surrendering to a knee injury the season before. 

This was my spring 2015. Even worse, three out of my four most recent training seasons had ended in overuse injuries. I was frustrated and dejected--it seemed as if I had already done all I could. After my first unsuccessful marathon attempt, I dedicated half my workouts to crosstraining. I was averaging under 30 miles in running most weeks, yet I still managed to hurt myself. I began to wonder whether my body could even physically handle chasing my long-time marathon dream.

After meeting with the training center doctor, I limped back to my dorm. You'll need to take at least two and a half months off from running, he had said. I wanted to cry, but I was too numb. 

My full marathon would have to wait, and it would have to wait for a long time. Quick calculations told me I'd be far from ready for another attempt in the fall. Delayed gratification, delayed gratification, delayed gratification...I repeated the words in my head like a mantra.

Then, I hobbled back to the gym for a workout. 

My doctor recommended no lower extremity exertion for at least two weeks. The arm bike in the training room, however, was safe. My scrawny limbs pedaled furiously in attempt to quelch the inky sadness of yet another unattained goal. 

"Lily, this tells me a lot about you."

I looked up--it was my doctor. 

"The fact that you're back here training after what I just told you tells me a lot. I have no doubt that you'll run your marathon before you graduate."

I smiled, thanking him. 

And just one year later, I ran that marathon.

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So if an injury has postponed your race ambitions, I know exactly how that feels--I've been there several times. In a few months, however, I'll have been injury-free for a year (minus the little aches that don't upset training). Here's what I did to finally conquer my long-time goal, and stay as healthy as possible.

1. Get a gait analysis.

Since I'd significantly reduced my mileage but was still getting hurt, I figured something must be inherently wrong with my biomechanics. So, I made an appointment with my local sports medicine team to have my running form analyzed. My two-part analysis totaled about $250; while it was definitely an investment, my MRI was even more of an expense--I knew that if the analysis were effective, I could save hundreds of dollars on medical bills from injuries. 

In the first part, my physical therapist performed a strength evaluation. After completing several resistance exercises, I learned that my left hip was weaker than my right, potentially resulting in compromised form.

In the actual gait analysis, I ran on a treadmill as my PT videotaped me. I learned that my knees turned in, straining my lower legs more than necessary. I also learned that my cadence was a little low and that my arms swung across my body. My PT taught me how to run more efficiently, and showed me strengthening exercises for important muscle groups. A year later, I still complete these exercises several times a week.

After correcting my form, running felt different. It felt lighter and freer. Consequently, I ran faster--in fall 2015, I broke my half-marathon PR by 5+ minutes, averaging 7:57 a mile.

I never realized how crucial form was to healthy running--heck, even breathing patterns can make a huge difference! Other sports preach technique, but I rarely heard my coaches offer informed biomechanics advice--with so many runners, the focus was always on running harder and faster, not on running more efficiently. 

I can't attribute the past year's running milestones to only one source, but implementing what I learned from the gait analysis definitely tops the list. Proper form really is the foundation of successful running, and with a strong base, I was finally able to build to my dream distance.

2. Cross-train to maintain fitness.

Exercise is my antidepressant. As a student at a selective college, the workload and self-imposed pressure to perform well can be suffocating. Without workouts, I'd have long since fallen apart--training is like a separate world, one where deadlines are inconsequential--it's just sweaty me and my desire to become stronger. And this summer, when I was trudging through bogs of emotional unrest, training brought me peace and purpose. 

I know it's easy to fall into a funk after learning unfortunate news. It's easy to feel discouraged and to wonder whether your goals are even attainable. 

So what better time to dive into a new discipline than post-injury diagnosis? (Obviously, only if it's safe). Of course, take a couple weeks off completely if your body needs to repair from a season of exertion, but really do consider crosstraining if you'll be out from running for a long while. 

At a time when you're questioning your body's ability, there's nothing more empowering than tackling something new. I'm a firm believer that unfortunate circumstances are so capable of becoming something positive, but only if we use our disappointment as an impetus to improve. 

After my stress injury diagnosis, I decided to train for a triathlon. Then, I was a horrible swimmer--I could only doggy paddle, and going just one length of the lap pool felt excruciating. Today, I'm still pretty horrible, but I've made massive strides--I'll tell you more when we get to tip #4.

3. Create a more gradual, balanced training plan.

I trained for a marathon running only 2 days a week.

Yes, you read that right--only two. My workouts, however, covered a full six days a week, plus one rest day.

After my first triathlon, I decided to maintain my multi-discipline schedule, even while I prepared for running-only events. For instance, here's what I did from 3/6/16-3/12/16:

Sunday: 24 lap swim (3 warmup + 1 kickboard + 8 + 8 + 1 kickboard + 3 cooldown)
Monday: 45 minute run (about 5 mi) + strengthening exercises + core
Tuesday: 27 minute outdoor bike + 10 minute tabata + strengthening exercises
Wenesday: rest
Thursday: 35 minute spinning workout + strengthening exercises + lifting + core
Friday: yoga
Saturday: 3 hour 30 minute run (21.59 mi) + strengthening exercises

Running fewer days a week allowed my body more rest between high-impact training--my other disciplines (swiming and biking) required less pounding on the legs. While I'm sure experts wouldn't recommend fewer than 3 days a week for marathon training, 2 days worked just fine for me--it was just enough for the critical long run a week plus one regular run. I had gotten my stress injury running only 3 days a week, so I wanted to be as cautious as possible the third time around. 

This time, I also increased my mileage more slowly--coming off of a peroneal tendon injury from the fall, my first marathon training run on 12/5/15 was only 10 minutes long. I increased time in increments of about 5 minutes until I reached 60 minute runs. After that, my increments became 10 minutes. Once I hit 2 hours, I began increasing by 20-30 minutes. 

Spacing these longer efforts was also crucial--once I hit runs longer than 2.5 hours, I realized that my body could no longer handle weekly long runs, especially if I were to keep building. So, I scheduled some lighter weeks with no long run at all, allowing me 2-3 weeks of relative rest between these big endeavors. 

Beginning training almost 6 months in advance also allowed me more cushion for unexpected changes, such as illness, aches, or burnout. I adjusted my training plan countless times based on my physical and mental condition, which ultimately made a huge difference. Leaving ample time to train well really alleviates the pressure to complete a workout when your body may not be ready. Because of fewer time constraints, I was free to focus on building my body, rather than forcing arbitrary milestones upon myself.

olympic distance triathlon

4. Embrace the detour and keep pushing on.

As I mentioned in #2, my stress injury took me on a triathlon detour, and I wouldn't have it any other way. In spring 2015, swimming was a monumental task--just a few laps depleted me. 

Last week, however, I competed in my first olympic-distance triathlon, swimming 1500m (.93 mi) in the open water. I never would've imagined being able to swim over 40 minutes straight in a pool, let alone in a murky Midwest reservoir. Yes, I am still a far-from-stellar swimmer. Yes, it's still not my favorite discipline. But I've learned to appreciate the sport, and I find it empowering to have tackled what I used to fear, and to have improved. 

My injury led me to run more efficiently, freely, and gratefully. It led me to plunge into new disciplines, and to become stronger physically and mentally. 

Unfortunate circumstances don't need to be tragic endings--a lot of times, they can push us to grow in ways we never expected.

Train happy. Dream strong.

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