As you probably know, lately I have been dealing with some nagging pain and tightness that has interfered with my running. Did you notice how I didn’t use the word “injury” there? I didn’t even want to use the “I” word in the title of this post but I also didn’t want it to be 15 words long.
When does something cross the line from a tightness/pain to an injury anyway? I have no idea what the answer to that is, and that’s not what will be discussed in this post anyway. However, it seems more helpful to think of this as anything but an injury so let’s just go with that! All I am planning to do today is share what I think I have learned about what is causing some of my trouble and what I’m doing about it.
First off, I’m no sort of medical professional (my degree is in mental health- we could probably argue that it is related to this topic but today will be strictly about physical stuff, although I often wonder if 95% of my aches and pains are in my head!) Please understand that I am summarizing what I think I have learned from doing a lot of my own research and working with my own sports medicine providers over the years.
I’ve been running “seriously” for about 7 years give or take, and I have been dealing with injuries for 7 of those years. Actually, my injury history begins before I even started running seriously. I had plantar fasciitis in 2005 when I was doing some light running combined with aerobic classes like step and kickboxing. So for almost 10 years, I have had some sort of “injury” (ugh I hate that word!) almost every year. Here is a brief summary of my injury history:
2005-2006: Plantar fasciitis (left foot)
2007-2008: Achilles tendonitis (left side)
2010: Hip labrum tear + surgery (left hip)
2012-2013: Piriformis syndrome (right side)
Early 2014: Pain and tightness in upper left quad (left side)
Late 2014-2015: Return of piriformis syndrome (right side) and more pain and tightness in upper left quad (left side)
Yikes. How did I ever run 30+ races with all of that going on? There were so many mistakes I’ve made over the years. Like running through pain, taking ibuprofen for pain and still running, following doctors advice without really understanding what was going on…I remember back when I had PF and achilles problems my podiatrist made me orthotics and said “you can keep running, the orthotics will eventually help the pain, but until then take ibuprofen every day” and wrote me a prescription. He was a medical professional so I listened and never questioned it.
I would like to think that over the years I have gotten smarter about things. I still make plenty of bad decisions when it comes to running, but the difference is my awareness of what’s going in. If something hurts, I question it, I try to address it, and I try to figure out why it’s happening. Are my shoes too old? Did I run extra miles this week or do something different? Have I been neglecting my foam roller?
What I am trying to say is, we need to take responsibility for our own health. Seek advice from those who are more knowledgable, but trust your own instincts, do your own research, and try to understand what’s happening. Be your own injury detective.
Last year I wrote about how my last chiropractor told me I have weak glutes. Well that’s all well and good but I’ve always been one to do core work including glute exercises so what was really going on? He wanted me to do tons of band exercises focusing on the glutes and honestly don’t think it translated into better running or getting stronger. Maybe those specific exercises work for some people but they didn’t seem to work for me, or I wasn’t doing them correctly.
So now that I am in a place where I am willing to back off the running and figure out what is going on, I’ve been doing a lot of thinking and reading about running injuries, form, etc. Here are some thoughts and realizations I’ve come to:
-My initial injuries on my left foot and ankle may have caused some gait changes on my left side. I know that my left achilles is still much tighter than my right.
-My hip surgery likely left me with tighter and weaker hip muscles on that side. Even though I did a lot of PT after, that stopped 6 months after surgery. It was arthroscopic so I only have tiny scars but there still may be scar tissue there causing restrictions.
-I seem to feel the tightness in my left quad the most when I am running all easy miles (which is a vicious cycle because when it starts to hurt I take it easy and stop doing speed work). When you run slower, you use your quads more than your other hip flexors. Your psoas works more when you are running faster and your hip is flexed up higher. Also, if my psoas is weak and not working properly than the quad is going to need to work extra hard as a hip flexor. This article explains this really well.
-The imbalances on my left side are probably causing my SI joint to shift around, which can contribute to piriformis pain.
-Based on the crossed extensor reflex, the glutes of one side get activated with the hip flexion that happens on the opposite side. So that could mean poor hip flexion on my left side= poor glute activation on my right side (which could also cause the piriformis to jump in and try to compensate).
sort of a confusing picture, but you can read the article here which is the source of the picture
-the weak glutes are also probably due to tight hip flexors and sitting too much during the day.
So what am I going to do about all this? Here are the areas I am addressing:
- Release the tight muscles (quads/hip flexors, piriformis, everything really!)
- Mobilize (using dynamic stretching type exercises)
- Strengthen the weak muscles (hip flexors, hip abductors, glute max)
- Stabilize the core
- Then put it all together by improving running form
I won’t go into more detail today because this post is already so long, but leave a comment if you want to know more about what I’m doing. I know a lot of people were curious about the dry needling, which is a way to release trigger points in a tight muscle. I had it done in my piriformis and rectus femoris. For some more info about it you can click here or here.
Have you had consistent running injuries over the years? Do you notice any patterns?
Do you try figure out why you are getting injured or focus on relieving the symptoms?
You may also like:
One More Piece of the Injury Puzzle
Being A “Tough Runner” VS A “Smart Runner”
Core Workouts
Gah, PF pain is the WORST. It sticks around for.eh.VER. My recurring issue (I’m avoiding the word “injury” too!) is my SI joint and how it gets jammed up a bit. It’s from having babies (hormone relaxin loosens joints) so sometimes my SI joint on the right side gets junky and my physio guy puts it all back into order and I’m good to go. But yes, when my hip is “out” it affects everything else like dominoes.
I think that some of my issues are related to my SI joint too (probably tight or weak muscles moving it out of place) and its not a good sign that I already have these issues before having kids, because I hear that after kids it just gets worse! i need to really work on my stability to hopefully prevent future issues!
I know what you mean by not wanting to use that word, especially when you’re going through it! Add that to my list of thinks I like to be in denial about. My injuries seem to be pretty straightforward in that if I’m running 50 mile weeks with speedwork and old shoes I can guarantee myself an injury. It’s always been some sort of tendonitis. I do notice however that my hamstring injury from age 11 (crazy) factors into weakness all over my left side and that’s where things tend to hurt.
Isn’t it crazy how stuff that happened so long ago can play a role in how our bodies work now? Im not sure how all my years of dancing affected things- I used to be so flexible but not necessarily strong in the way runners need to be. I was told that dancing likely contributed to my labral tear. Its good that you are aware of your limitations and what usually causes issues! Its still something I am trying to figure out.
It’s amazing what we can figure out for ourselves isn’t it? I don’t think doctors always have the answer even though we need to turn to them sometimes. Relying on medication is so often the answer but it’s not the answer! I am afraid to use the injury word (knock on wood) because I haven’t had to deal with any aside from a random bad shoulder (I still can’t explain how I injured my shoulder almost two years ago) but thankfully that lasted two weeks and never bothered me again. I pay really really close attention to every feeling in my body and try to nip things in the bud. I try to recognize my limitations (like I can’t race during my cycle) and just go from there. I hope you are feeling 100% soon.
Thanks! I think I have a pretty good sense of medical providers at this point after working with so many. Everything my current chiro tells me lines up with the current stuff I read about running injuries and prevention, plus he is an endurance athlete himself. We have actually joked about how ridiculous some of the medical advice is these days!
Reading about your different aches and pains on your left side, I thought all along, maybe you were compensating, and that’s why you developed pain on your right side. Here you are, trying to do something good for your body, and you are plagued with these bothersome annoyances. You know your body better than anyone, and only you can make the decision about how much to proceed. Good luck and I hope you feel better. Notice I didn’t use the “I” word! Happy Weekend!
I have definitely noticed that too! For awhile after surgery I think my left leg was actually stronger than my right because so much of my PT was focused on that side!
Wow, isn’t it crazy how so many of us endure injuries for so long, yet we keep on trucking.
I know, its really amazing. Are we all just crazy or just that dedicated? The truth is I don’t think that my ailments would disappear if I stopped running. Maybe running has contributed to them, but they are now imbalances in my body that I need to address.
Love this! I too have been through a cycle of injuries and I can tell you right now that they are all very much relates. I don’t think people truly understand how very connected our bodies are—the kinetic chain truly is a real thing! Sounds like you have more of a problem with glute activation than just straight up weakness. There are some good exercises for that.
Its amazing how much everything is connected- and I think the most complex but important area is the hip/pelvis/spine area. Everything going on there affects everything else and you don’t even know what the initial cause was!
Hopefully you can teach me some awesome glute activation exercises. I’ll be E-mailing you today!
This is a really good post – I think what is important when it comes to running aches and pains that we become our own advocate. That doesn’t necessarily mean ignoring medical professional’s advice but going in with an understanding of what you think is going on. Often, it’s hard to know if something is training-ending or rehab able, and my experience is that doctors will err on the side of “run less” if they aren’t sure!
I definitely agree! And while its better to play it safe I also want to know that I am doing something to help myself get better. Majority of the time rest will not address the issue!
I think every runner at some point has had aches and pains throughout their running career. I too do not like the term injury. I have been having knee pain lately but I refuse to go to dr just so they can tell me to rest and ice. My sister on the other hand has been to several drs and chiropractors and they haven’t even helped.
I think it can be so frustrating to pay to go to Drs and not get better. I think the key is finding someone who is helpful which can take some looking around!
Really good post with so much helpful advice. I am hesitant to use the injury word too. It’s great to see you are being so proactive with trying new things (like the dry needling and the stretching work). You totally need to be your own healthcare advocate.
Thanks Lauren! I feel like I can’t just sit around and do nothing…that will get me nowhere! And I can’t rely on medical providers forever…I like to use them for guidance but in the end I need to be responsible for my own body.
I think you are being so smart about all this. I think after a series of injuries it is important to stop and take stock like this in hopes of knocking it all out for good. And oh my gosh–the doctor who told you to take ibuprofen daily! I had one give me orthotics years ago and tell me never to take a step again without them. I even wore shoes w/ orthotics on the beach! It makes me cringe now. The medical profession is sadly very behind in the latest info re: running.
Good luck with the rehab/prehab!
I have become so picky about medical providers after seeing some not-so-great ones. My current chiro is totally up to date with the current running injury research and is an endurance athlete himself, so I trust him. But at the same time I can’t be 100% depending on others and I think that in order to truly get better and move forward I need to understand and know my own body so I can treat it properly.
Wow, awesome post! You gave some great advice that any athlete can benefit from. I hope you start feeling better soon!
I normally try to just relieve the pain so I can keep running, but normally while I run I think of why I’m hurting. Normally I can tie down any ITB pain to running down too many hills or bad form. I still haven’t figured out my calf problems yet…
It’s great that you are thinking about what caused your pain! I wonder if your calf pain is somehow linked to your ITB pain (like overcompensating in some way)? Those are the types of questions I like to ask myself and research to start putting together the pieces of the puzzle:)
Ugh, I feel you. As smart as I’ve thought I was getting about my running and injuries and strengthening and all that good stuff … I wasn’t. And I agree on the exercises. I’ve done those, included them into my weight lifting sessions all with this fantasy of fixing everything. Stronger glutes, stronger hips, stronger cavles … still suffer from piriformis pain, added achilles tendinitis to my list but did fix my plantar fasciitis but now I have a stress fracture too. It feels overwhelming sometimes doesn’t it?
It can definitely be so overwhelming! I feel like I do all the things that are recommend for runners and still have issues. Not sure why some of us always deal with injuries no matter what while others can do minimal prevention stuff and be fine!
I tore my right hip labrum 3 years ago and had the surgery, I understand your pain and I hate that “I” word too. I think going through the recovery process makes you so much smarter with exercise because you start from the ground up to get strong again!!
We do get better at being a detective when we learn from our past mistakes!! 🙂
I learned so much in PT as I was recovering from the surgery! In frustrates me that as far as I have come I am still dealing with issues. Do you notice any imbalances as a result of the surgery?
The biggest pattern I see from my own history as well as coaching other runners is too much too soon. Sustainable running progression is painfully slow and not many have the patience to build that very big base to support the training they think they can handle.
Very good point! Especially when returning from an injury, and thats likely while chronic/recurring injuries are so common.
Would love to see a post about what you’re doing to accomplish your five goals!
Sure! I’ll try to talk more about what I’m doing over the next few weeks!
Goooood post! Loved you “I” comment.
Gosh I didn’t know you’ve had so many injuries! It makes running sound like a dangerous sport!
I like your approach with it all though, that’s how I try to deal with things. Good luck missy!!
It really does make it sounds dangerous, doesn’t it? The crazy thing is that there are so many runners who have a similar laundry list of injuries with the same amount or more as me.
Ugh…you poor thing! You are a trooper! I haven’t been able to run for over 9 years now and I miss it dearly…but I have no choice! I shattered both legs and now my left leg can’t take any type of striking impact and lacks the range of motion to do so. I do have to tell you though, that when I was a runner (I ran marathons and long distances constantly), my knees caused me so much pain all the time. I continue do what runners do and push through it no matter why. My knees no longer bother me (in that way-I get knee and hip pain due to my altered gait and movement patterns from my accident). Runners are some of the toughest people and I know the feeling of not wanting to admit your ‘injured’. Although- you only get one body. Take it from me and don’t take it for granted…LISTEN TO IT! If your constantly getting injuries, it is trying to tell you something! Hang in there girl…great, informative post! Have a great weekend!
First off I am so sorry that you can’t run anymore. You are right that we only have one body and shouldn’t take it for granted. I definitely agree that my body is trying to tell me something- I just can’t figure out what!
I have a list that looks somewhat similar to yours…I’d love to follow your progress.
Sorry to hear you are dealing with some of this stuff too! Anything in particular you would like to know more about?
Is it weird that I feel like injuries almost, sort of, kind of, go with running these days?! It’s so sad, but we’ve all been there. This post is AWESOME though and definitely a good reminder to keep cross training, strengthening, and stretching.
Thank you! It does seem like everyone who runs gets injured- but it shouldn’t be that way! When thinking about the big picture I feel like modern society of sitting all the time plays a big role in affecting how our bodies work.
Pretty good analysis there! I love reading about other peoples injuries and figuring out what’s going on-it’s my job as a PT =). But don’t like that you are injured. Hope the plan works out.
Great post, although all those injuries sound rough! It’s inspiring that you keep running and racing despite those injuries! It’s fascinating how much hip tightness and glute strength can affect running. I fortunately have never been injured from just running (although a non-running injury which I then ran on left me in PT for a few months!), and I think part of it is I do lots of bridges/planks/squats and Pilates/yoga. I’m interested in reading more about mobility work, I definitely could improve on tightness in my hips!
You are very lucky that you haven’t had any running injuries, but it sounds like you are doing all the right things! However, I feel like I do all that stuff do and it doesn’t necessarily help. I think maybe when I do them I’m not working the right muscles for whatever reason, plus tight muscles have led to alignment problems that lead to other issues. I hate that is has to be so complicated:)
This is such a great post, Lisa! I agree. It’s important to seek the help of medical professionals, but to also that we know how you feel more than they do. I’ve had the same thing with prescriptions of anti-inflammatories, then the more research I read, the more I understood that they were just slowing the healing process. One of the patterns I seem to notice is that my left calf is the only one that usually gets tight, but that’s also the side I broke my foot on a few years ago. I was in a cast for the majority of the time, so my left leg had extreme atrophy and it’s had problems off and on ever since. And then my hips are just crazy. Our athletic trainer in college would check to see if I was aligned on a daily basis and I was out of line every single time, but obviously I can’t go and get adjusted every single day, especially now that it’s not free haha.
I had a labrum tear and had hip surgery over the summer too! Now I’m dealing with Achilles pain. It seems like it’s always something!!
So sorry to hear that! I remember after I recovered from my hip surgery I was so excited to be running well again, and then less than a year later I got piriformis syndrome on the other side. It was SO frustrating! I hope that your achilles gets better quickly!
I think it’s definitely good to try to figure things out on your own. And you’ve been running long enough that you are aware of the things that work and don’t work for you! I’m still new at this, but I have definitely been researching the hell out of my foot issue. I’m actually hesitant to call it an “injury” too because it only hurts very intermittently – most of the time I feel completely normal. But I did go get an actual diagnosis so… I guess it’s an injury! Haha. I went to PT today for the first time and finally got it through my head that I really need to work on my hips (as do many of us runners!) because they affect the rest of our body too! Needless to say, I’ll be incorporating clamshell exercises into my routine now 😉
As much as its frustrating to come to the realization that you have an “injury”, often times thats what it takes for us to really focus on getting better. Good luck!
It sounds like you have a good handle on the situation now. Even though it stinks being injured so much, it seems like you really learned a lot about listening to your body and making sure you’re comfortable with what the doctors perscribe.
I guess that is the silver lining! I wish it was easier and that i didn’t feel like I needed to know so much in order to be a healthy runner!
Wow you’ve given this a lot of thought–excellent. I share some of your injury history–hello peroneal tendonitis, piriforimis syndrome (still nags me) plus ITB and a partial hamstring rupture.
I always look at the pros and wonder how they can sustain the mileage and intensity they do. I think it comes down to body work. Yes I foam roll and stretch but I rarely take the time for massage, myofascial release, etc. unless I’m injured then I do and it all heals up. Plus I’m ancient so there’s that. Ha!
I wonder the same thing about runners who can sustain intense workouts and high mileage. With the pros I assume they have the best trainers and PTs there to make sure they stay healthy. Unfortunately most of us average runners can’t afford to have all the personalized services that would likely keep us injury free!
I’m always plagued with injuries…and I’m actually having some back pain right now that is really preventing me from starting to training for a 10 miler I signed up for in April. It’s so hard to tell if a pain will turn into in an injury until, well, it is an actual injury. I think strength training and cross training are key (which is something I need to work on!). I hope you feel better and have a great weekend!
Sorry to hear about your back…but hopefully with catching it early it won’t turn into an injury!
Yup, I dislike the dreaded 6 letter word. Since early November, I’ve been dealing with a tender heel spot and achilles tenderness on my right leg. I gone between PT and Chiro- for ultrasound therapy and strength training exercises for hips, glutes and lower leg/foot muscles. This whole process has led to a deeper understanding of all the muscles and tendons in my body and the role each has in running. I feel like everything I’m doing now, has me on the road to recovery. These post resonate because we all just want to run:)
Its great that you are figuring out whats going on and how its all connected! Hopefully you are on the road to recovery:)
I am so glad I saw this post! I was beginning to think I was the only person who lost confidence in medical professionals. I was mis-diagnosed 3 times recently with an ankle stress fracture. It’s disappointing what we can figure out and they cannot. And you’re right, we have to be our own health advocate!
You can read more about my experience with injuries here http://skinnyfitalicious.com/care-health-care/
Agreed..and after reading about what happened to you i seems like the issue is people jumping to conclusions or not taking the time to figure out what is really going on!
I wish you a speedy recovery. Injuries suck.
I am injured myself and recently decided to take a break from running. I’ll be sharing a post within a week about my injury (ankle tightness on mostly my left foot). I was supposed to run my 2nd marathon, the Pittsburgh Marathon this year but that probably won’t happen. At least I got into the race for free so I won’t lose any money from not participating.