? Getting Fitness Back after Injury ?

[Z-Knight]

I need some advice on how to get back my endurance and speed back after being down for a few weeks. Apparently I'm not very good at this running thing because I've been either injured or sick for most of my races this year. Marathon weekend I had 3 injuries, dark side weekend I had the flu and had to have an doctor visit me in my room because I had 105+ fever, and recent marathon I had a cuboid bone stress fracture. I've gone from being able to run 8 min/mile down to 9:40 min/mile after being forced to not run for 8 weeks. I had a 1:49 half marathon over the 2nd tallest bridge in Texas 9 months ago, but now that seems like a distant dream

BTW, elliptical does nothing for your - nothing! I used it for 4 weeks when I was allowed to put pressure on foot and after my first run I was huffing and puffing and felt my quads in pain again.

In the past 4 weeks I've been allowed to do slow, slow runs - which is why my pace is slow, but even if I was allowed to go faster I don't believe I could. I'm currently struggling through my slow runs as is with average heart rates in the 145 or 150 or higher. I've run over 171.5 miles these past 4 weeks but it has been a struggle. Initially I thought I was overtraining but my morning heart rate is 40 bpm and it is not higher than normal so even with 6 days of running per week I am getting my rest.

I'd like to get some advice from people that have been hurt before and ask how long it took you to get back to form. I can't believe at week 5 I am still struggling with slow runs. This past week I ran 8 miles each day and only three of the six runs I could completely finish at the same slow pace - the others I had to partly walk and do intervals.

btw, I run on a treadmil at my work gym. I did notice that maybe I'm overheating a bit in my runs. Last week I went to a hotel gym to use the treadmill and it was the exact same type I had in my work gym. The only difference was that I had an air vent blowing very cold air on me the entire time and I had two straight days of runs of 8 miles each and had an average heart rate of 130 bpm for both runs. Same distance runs at the work gym, at same pace, etc, were usually 140 bpm or higher. The work gym has very little air moving around the treadmils so I could just be overheating and this causes me issues now and causes me not to regain my endurance.

I plan on adding the stair stepper to my exercise routine after each run - that should improve my endurance a bit. If there are any other suggestions for getting back into form then please let me know. I'm basically behind my fitness level of last year and likely will struggle through another marathon as a result.

 

[Keels]

Does your gym have a pool? If so, I would get in and start lap-swimming STAT. That will help your endurance, and also help strengthen your lungs again to keep up with what you want to do. Doesn't have to be anything fancy like Olympians do - just swim "fast" freestyle/breast stroke laps for 45-60 minutes. You'll work all of your muscles and be surprised how it can help while also taking pressure off of any areas or pain/injury. It will also help your upper-body.

Also, get on a bike - recumbent if possible, but upright works too if that's the only one around. Up the resistance on the bike and pedal HARD, again for a good 30 minutes minimum. I say recumbent because it will keep pressure off of your quads and the other areas you typically use during running while you try to build up muscle endurance again. If you're feeling pain in your quads when you run, it's likely going to be the same on an upright stationary bike.

Third - A.R.T/Sports Massage. You've probably got some muscle tightness places that are keeping you from jumping right back into your old routine. It hurts like a B, but is incredibly restorative.

Do you just do cardio? Or is there any other form of workout you incorporate - weights, etc.?

 

[Z-Knight]

My gym has no pool so that's out. At one point i was looking into aqua jogging but time and distance to a pool were not worth it.

For the first 4 weeks being down (so 12 weeks ago) all I did was leg weight machines. After 4 weeks I moved to 1 hour of elliptical and 1 hour or recumbent bike 6 days a week. So those first 8 weeks I did do the cross training but after my first slow run I found that all of that work during my down time didn't seem to help.

Thr last 4 weeks has been 6 days of running with some days with 30 mins of extra biking, but bikinh in slow heart zone and not fast. So right now only cardio.

I think you may be right on the tightness because the last 2 weeks, I have tight ankles and shin pain for the first 3 miles of the run. After 3 miles they are loose and running isn't bad. There just have been so many days lately where I can't even fathom how I can run at 7.5 mph, when I'm struggling right now at 6.3 mph. Maybe the massage would help - or I'm just getting old.

Technically I'm allowed to do speed work again but unless I'm in a cart going downhill, I don't see me getting faster soon. I had my training all planned out for the Marine Corps Marathon and now the hope is just to "beat the bridge".

Thanks for the advice - lots of good ideas.

 

[Keels]

Are you doing any PT for the stress fracture? Your body could also be holding you back to compensate for the stress fracture and that could be a real barrier for you getting back to where you need to be.

Have you noticed a change in your gait or stride at all since the stress fracture?

 

[Z-Knight]

No therapy. Per doctor he saw it healing nicely so he has allowed me to run normal now. But you are very astute because I have favored the foot a little, but in the last 2 weeks I'm mostly making sure I don't land flat-footed. The cuboid stress fracture was likely from bad form to begin with.

Most of my issue seems to be with getting winded. I'm wondering if it could be as simple as that overheating I mentioned. With summer ending, the interns will be going home so maybe the gym will be less populated and cooler.

I'll know bettet this week when I try to go for 9:20 min/mile and try to stretch out the ankle or foam roll or something. I think my biggest frustration is that it is taking me a long time to get back in form. That happened after the January marathon as well - it took close to 3 months just get to about 90%. Well, maybe for Dopey I'll be in shape.

 

[Keels]

No therapy. Per doctor he saw it healing nicely so he has allowed me to run normal now. But you are very astute because I have favored the foot a little, but in the last 2 weeks I'm mostly making sure I don't land flat-footed. The cuboid stress fracture was likely from bad form to begin with.

Nine surgeries to foot, knees and hips because of a clubfoot make it easy.

As for the winded part - just hear me out ... do planks. Early, often, everywhere. Start one day doing 15 15-second planks, and then up the time and the amount each day - like 16 16-second planks and so on. You'll be shocked at how it forces your body to center AND how it helps with your breathing. You may not be breathing as deep as you think you can and you need to open your lungs up.

 

[FFigawi]

Adding to all the great advice given by @Keels, I don't think the problem is overheating or the gym being too warm. I think the problem stems from the fact you're running too much and running too much of the same thing. Running 8 miles a day six days a week is not a good way to recover from an injury nor is it a very effective training plan. You should be mixing it up with a variety of shorter and faster runs, longer and slower runs, and plenty of recovery time. Running six days a week does not leave you time for plenty of rest and recovery. That kind of frequency is fine when you're healthy and able to handle the workload, but it's not wise when you're coming off a fairly significant injury. I recommend going back to basics - get a copy of Higdon's Novice I or Novice II marathon plan and start following it. Don't worry about pace. With two months before your marathon, you should be focused on getting the appropriate miles and rest in. No more running 8 miles a day nearly every day. Follow a proven plan, one that has worked for hundreds of thousands of runners over the years, and get the miles in without subjecting yourself to further injury. Your pace will take care of itself as your body adjusts to a regular routine of run, rest, and recovery. Focus on the now, not where you were, and you'll be back there eventually.

Also, and this is not related to your injury question, you should really do some of your running outside. Running on a treadmill all the time weakens your ankle, foot, and lower leg muscles because you don't experience the shifting terrain and variable surfaces like you do outdoors. This muscle strength and stability becomes important during a marathon, and without it, you're likely to have a tough time in the last 8-10 miles and even come down with shin splints like several people I know who ran indoors all the time before their marathons. Going from a soft treadmill to hard pavement for 26 miles is a big shock to the system.

 

[Z-Knight]

I don't disagree about using a running plan, but for the past 4 weeks I was not allowed to do anything but slow runs. I was not allowed to do speedwork, etc till now so that's why it has only been long slow runs. Also, I was not allowed to do varied angles anyway so as not to strain the peritoneal tendon, which could have been the cause of my fracture.

I'm not so much concerned about speed, per se, but more concerned that my slow runs thus far have been so slow and yet tiring. I would have expected that by 4 weeks the slow speed would have been easy already. So I'm asking if others coming off a long downtime had such a slow recovery or did you do something specific to overcome it.

 

[BuckeyeBama]

As you probably remember, I broke my foot last November. I lost 3 months of running, then had to start from scratch. My first concern is that you are already running 40+ miles/week after 2 months off. My base is 45-50 miles/week, but it took me 12 weeks to get back to that base after I was allowed to run again. You should not add miles and increase speed at the same time. Your legs muscles really can't get better at both at the same time. Now that your base is this high, you should start to gain speed automatically.

In other words, I wouldn't worry about it. You pushed to regain your base too hard (IMO), but you managed to accomplish it without injury. So now just continue to maintain that base for a few weeks, then start some speed work. It is summer. Running will get easier soon as it starts to cool - just in time for you to start pushing your pace.

 

[DopeyBadger]

While everyone loses fitness and gains fitness at different rates, I thought you might be interested in this article from runners connect (link). It looks like your 8 weeks off from running alines pretty closely with the data cited in the article (losing 19% in 9 weeks, or dropping from 8:00 down to 9:40).

Here's an article about returning after a stress fracture (link).

From my understanding of mitochondrial development, cardiovascular improvement and bone strengthening, I feel like you are looking at the following time frames -

Cardiovascular Improvements - Takes 6-8 weeks to rebuild.
Mitochondrial Development - Takes 8-12 weeks to maximize density and volume from a single training cycle. This is where your power/energy comes from.
Bone Strengthening - Takes 12-14 weeks to maximize bone gains in a single training cycle. You will not notice this one based on outside feedback. That's why I urge caution before trying to do too much too soon regardless of the pace.

So you're still at week 5 of returning to running. You should start to notice cardiovascular improvements in the next few weeks, then regaining energy and power, and then lastly your bones will become stronger and more capable to handle the workload. I'd agree with @FFigawi, @BuckeyeBama, and @Keels, it will come with time.

 

[Z-Knight]

I shouldn't have brought up speed in my question - I was trying to relate it to effort. I've been slowly ramping up my running to the current base - started with 5 mile avg the first week and then only jumped 1 mile/day avg per week so that I could build a base. I've not increased my speed at all, but just noticed that if I tried then I would not be able too. I guess I thought that with 4 (5 now) weeks of slow running would have gotten me farther by now, but I guess maybe I'm not too far from what would be expected after a long down time. Thx

 

[opusone]

Over the past 12 years, I have had various times where I took time off of running (some shorter due to injuries, some longer due to life), and I have been similarly frustrated when I have returned to running. It really does sometimes feel that you are going nowhere, but trust me, it does eventually improve, and it can be quite a step-change when it happens. In any case, I agree with a lot of what has been said above, and I think quickly getting back to 40 mpw is probably pushing it a bit. However, I also believe that the overheating can be part of it as well. Even in good health, I have the same issue when running on a treadmill with no air circulation. That is why I choose to run outside. Now, in your part of the world, running outside can be just as big of an issue as running on the treadmill with no air circulation, so you don't have a great option in the summer months. Any chance you can get a fan by the work treadmill? Also, try to stretch and do strength exercises everyday because the muscles oftentimes have shortened and weakened during the time off. BTW, I am also coming off an injury (had 3 weeks off of running), and the stretching/strength work is really helping me get back into it.

 

[opusone]

Thinking about it a bit more, you may have several things going against your heart rate/effort. Every one of these will cause an increase in the amount of work your body needs to do (and therefore an increase your heart rate):
- general cardio loss over 8 weeks
- possible running gait change
- overheating
- loss of muscle flexibility/strength
- possible slight overtraining

So, although the four weeks back have started improving cardio and muscle strength, there are likely other issues that continue to keep your heart rate elevated during the runs. I would try to work on all these fronts using the many options that people have discussed above. The running gait change is the most problematic because it's hard to convince your body to not favor the foot and get back to an efficient stride. You just need to try to trust the body's healing ability and run normally.

I know you've had a rough year with one thing after another, but again, it will all come together, and you will be back to your speedy self.

 

[Ariel484]

Take this with a grain of salt...

At the beginning of this year I had to totally stop running for a little over 2 months due to a back issue (injury, whatever) and some nerve pain. My back had been bothering me off and on for years, and after years of my not actually taking care of it, the sh*t hit the fan in January, so to speak. I started back SLOWLY...like slower than slow. Like below the level I was when I first took up running. It was a triumph for me to walk 10 minutes on the treadmill.

I slooooowly worked my way up to walking for 30 minutes, 3 times per week (was also lifting during this time) - this took me a month to get to this point. My first few runs in late February were about a mile - using intervals - and I slooooowly worked my way up to the 10K distance by May (with my doctor's blessing), using a Hal Higdon training plan. Now I'm slooooowly working up to 10 miles, then will sloooooowly get to 13.1 again, etc., and I've replaced the lifting with yoga - which I think has helped my core strength, flexibility, and I think has made me more calm in general, so maybe something for you to look into, especially if you feel tightness.

Anyway...during this time, I made the decision to defer both my 2016 Glass Slipper and Pixie Dust Challenge entries to 2017. I was incredibly upset to make the decision to defer GSC, but once the deferral went through, I was relieved not to put so much pressure on myself to feel "better" quickly. By the time the PDC deferrals opened up, I knew for sure that I had made the right call. If it were me in your position, I'd probably defer my MCM entry to next year - you could take your time building your mileage back up and not panic when runs don't go as well as you'd hoped.

In general I think that I approach potential injuries way more cautiously than others - not saying that it's a bad thing, just personal preference, I guess - and the pace that I was running pre-injury is nowhere near close to what you were running. But I've been in the situation before where I've had to take time off and then re-injured myself by coming back too quickly, often worse than before (though nowhere near close to what I'm currently recovering from). Maybe it's because I'm older and wiser now, but I'm thinking big picture at this point: I want this back problem to go away FOR GOOD so that I can finally get healthy and happily continue running for years and years (something I am sure you can relate to since you have been having some issues), and if that means I need to put off some races to next year, slowly build my mileage back up, and deal with my pace being "slow" for awhile, that's what needs to be done.

 

[Z-Knight]

thanks for all of the advice - very much appreciated and helpful.

as for deferring - at this point it is kind of too late and was back when I got hurt too because I already had booked rooms, etc so I resigned myself to the fact that this will just be a "fun" run and not a POT run. As long as I beat the bridge then I should be fine - 14 min/mile limit. Hopefully I can get my base upto long runs of at least 16-18 miles in the next 2 months - currently my longest is 11 miles so I should be able to get there.

 

[Z-Knight]

So I just did another 8 miles today at 9:40 pace. I had yesterday off so that probably helped a bit because it was a super easy run. I even went faster the last mile and could have easily run a few more miles at that pace. My heart rate was a calm 140 bpm average - steady the entire run.

But, I think the biggest difference, besides the day off, was the temperature in the gym was much better. I went later and 80% of the people were gone, so I could feel some wind from the distant fans and our weather outside is cooler in Houston. I think I am highly susceptible to temperature - like most people are, but I might be worse. I usually sweat buckets and today there was no puddle (no exaggeration) behind my treadmil. I just need to avoid all of the fake workout people who go to get dates and overheat my gym.

 

[WhereInFlorida]

Coming back from injury and time off as well. This is what I feel like in the first weeks...

 

[Z-Knight]

Coming back from injury and time off as well. This is what I feel like in the first weeks...


View attachment 188040

How did you get that video of me running?