Are you injured or are you hurt

It’s been said there are two kinds of runners: those who are hurt, and those between injuries.

So are you hurt? Or are you injured? What’s the difference? How can you tell?

Rule # 1 when you’re injured or hurt: Don’t panic.

Injuries are emotional. I’m writing this having just gone out for an easy hour run when out of nowhere a dagger shanks into my left calf. I stop, mobilize the affected area, try to run another 10 steps and no. It’s not happening. I am scheduled to run a marathon in 26 days. My entrance check cashed yesterday.

I’m just lucky I guess.

Everything was going so well. This isn’t fair. I’ve been stretching and foam rolling. I do yoga five times a week. Why me? Why??????????

Don’t panic. Breath.  I sometimes read the teachings of great yogis and they start to get deep, and they talk about the soul, and the flow, and enlightenment and I think they’re about to reveal the meaning of life… and then POW! BANG! BOOOM!  They steer me towards 2 things (one of which is relevant here):

breathe and use your block.

There it is. The meaning of your life. Breath and use your block. No blocks in running.

So Breathe.

It’s natural to get emotional when injured or hurt, even when I know that If I take time off and get the right help I’ll be back at it in no time flat. So Take a moment, throw a fit, scream out loud and then cut the pity party and get back to work.

Rule #2 when injured or hurt: Assess risk vs reward of continuing.

Reward of me pushing through this injury: I may qualify for the Boston Marathon. Validation of my summer training.

Risk of me pushing through this injury: Prolonged discomfort. Risk of further (permanent?) injury. Risk of Surgery. Lots of rehab. Co$t of lots of rehab. Further injury impedes my enjoyment of other activities such as yoga and biking.

The decision is pretty easy. There will be other races. There will be other competitions. The smarter you are now the sooner you will be back at full speed.

Life will go on.

Barring a super human recovery I’m skipping this marathon. So be like me, take time off. Time heals most wounds. I may have to accept that this marathon is not meant to be or risk arriving to the starting line, running a slow, miserable marathon and then being injured for months while I pay for expensive rehab and neglect my yoga and cycling.

Back to the big question? Am I injured, or am I hurt? Let’s define injured:

-There is pain.

-The pain is sharp.

-There may be swelling.

-It will likely be on one side of your body (important sign).

-There was probably a traumatic incident i.e. you were tackled or you slipped and sprained your ankle.

-You can’t keep playing right away (Thank you James Caan and the writers of the Program for the above clip).

(also thank you for this scene)

Back to reality.  Even if you can keep playing, don’t keep playing. Why? Because you’re injured. When injured there is a risk of permanent damage. Your body is asking you to take a break. Bill Rodgers used to take 2-3 days off whenever some phantom pain or injury reared its ugly head. I’d say this is sound advice coming from a guy who presently has 4 more Boston Marathon victories than you or I.

Rule #3- LISTEN TO YOUR BODY

Runners suffer from something I like to call ‘Runner’s guilt’. You know that feeling you get when you didn’t get your run in. You feel anxious. You feel lazy. You feel you’re one more missed workout away from being fat.  You feel like you should ignore the pain and get that run in. It drives us to do stupid things like push through a pain because it’s only mile 4 and my running plan has me doing 14 today. Ignore your runner’s guilt. It’s just your body asking (begging) for your daily endorphin rush. I’ve never taken drugs but I bet the crave for that endorphin hit must be like a high.

You’ll be fine without it for a while. I know it’s hard but do yourself a favor.  Listen to your body and take a break. Missing one run, or even a week’s worth of runs will not set you back that far. Your body will remember your fitness. Cross training can be a beautiful thing.

Now if you’re hurt… there is pain, swelling can happen but…

-The pain is on both sides of the body.

-The pain is dull.

-You can keep playing, but you’re not playing as well bc of the pain.

-There was no one incident you can think of that caused the injury.

-More likely you began feeling run down, run down became sore, sore became painful and painful drove you to read this.

Quick aside about something mentioned above:

Rule #4 when injured or hurt: two sides bad, one side worse. One side means you’re injured. There was a specific trauma. A slip, a twist, you heard it pop. Two sides means over use. You’re hurt, but if you’re smart you can get back in fighting shape quickly. Two sides can go away quickly. Rest, a change in shoes, some time on the foam roller and you’re almost back to normal.

Now that we’ve defined Injured vs hurt, let’s define why this matters. It matters because it dictates how you should proceed.

Hurt? Proceed with Caution. Scale back your training.

Injured? Stop and reevaluate.  See a professional.

So let’s run down a few chronic running injuries and assess whether you’re injured or hurt.

We’ll start with my own injury since I can think of little else presently.

Achilles pain/achilles tendonitis: Injured. All injuries have degrees of pain. You can have mild achilles soreness or you can have the lightning bolt that’s currently streaking down my left calf whenever I put weight on it.  Achilles tendons recover slowly because the tendon has a limited blood supply. When you start to feel any type of pain here treat it as if you’re injured. If this injury worsens then you’re looking at a 6+ months of recuperating. See rule #2. Risk outweighs reward.

Shin splints: Hurt. Repetitive trauma has accumulated and every step sends strikes of pain up and down your shins. Pain is dull and on both sides. You can keep running but your runs suck.

Stress fracture: Injured. You ignored your shin splints and they steadily got worse until one side just had enough and the pain became unbearable. You could probably make it 100 yards if your life depended on it, but every step would be blessed agony.

Plantar fasciitis: Hurt. You feel fine once you get going but the first few steps after you’ve been off your feet awhile are agony. Those first few steps out of bed. Or after you’ve been at the desk. It’s like walking on shards of glass. In rare cases when this occurs on one side refer to rule #5.

Ankle sprain: Injured. There was a traumatic moment and one ankle got creamed. There is swelling.

Sore knees: Hurt. Chondromilatia. Both knees are bitching at you every step of the way. You can push through and sometimes the discomfort even subsides after a mile or two.

Sore Knee: Injured.  You could be hurt, but if it’s on one side proceed with caution.

This brings us to Injury Report rule #5: Pain refers out.

Point to where it hurts. The problem is usually above or below, and the mechanical dysfunction at that point is disrupting the kinetic chain at the site of your pain. Case in point: your knees. Tight hip flexors (too much sitting and weak glutes) are pulling on your quad muscles. The quad muscles are in turn yanking the knee joint out of optimal position.

People without hip flexor tightness are like four leaf clovers. I know they exist, I’ve heard about them and though I have trained thousands of hours and taught thousands of yoga classes I have seen very, very few.

IT Band tendonitis: Depends. One side or two? If you have IT band discomfort in both legs then check your shoes (and read my upcoming guide to buying Running shoes). If one IT band is troubling you then refer to rule #5. The IT band is a long strong piece of tissue. You could hang a piano off it and it will not stretch. So look above and below your point of injury: knees and hips to find the cause of the problem.

We’ve covered a lot. Let’s recap.

Key Questions:

One side or two?

Sharp pain or dull pain?

Is there swelling?

Can you keep playing?

If injured stop. If hurt proceed with caution.

Key rules:

Rule #1- Don’t panic.

Rule #2- Assess risk vs reward.

Rule #3- Listen to your body.

Rule #4- Two sides bad, one side worse.

Rule #5- Pain refers out I realize that one side vs two is mentioned twice. I’ll leave it as is because it’s important.

Check back soon for what to do when faced with these common runners injuries.