Training through injuries

To Rest or Keep Going

I have to preface this blog post with the following disclaimer:  I am not a medical professional.  Please realize that statements made come from my own personal experience and from statements, recommendations, strategies, and methods used by other professionals throughout my life.

        It seems as though injuries have always gone hand in hand with my athletic endeavors throughout my life.  I suffered though back issues in Jr High during basketball season.  I encountered a knee injury and tendonitis after slicing it open in high school.    In college, my running came to a hault after I acquired and couldn't beat IT Band syndrome.  Post baby, the injuries stacked up - Hamstring strains, knee pain, shoulder pain, Plantar Fasciitis, back pain, carpal tunnel, neck pain, hip pain, severe ankle sprains,  Piriformis Syndrome.  Seriously - name your injury - I've had it. 
         I've always wondered if something was wrong with me.  Maybe I trained too hard.  Maybe the alignment in my body was all wrong.  Maybe I wasn't designed for athletics.
         But I love to move my body!  I love to see how far I could push my muscles - my mind was willing.  I knew there had to be more to it.

Running with Strength Tape on my hamstring

         As a fitness professional, I know that I'm not alone.  I know that almost everyone around me has something on that list, and many don't know what to do about it.  And many spend 1000s of dollars with doctors trying to fix their problems
         At 33 years old, I feel like the knowledge that I've accumulated helps me to discern bad pain from good pain, and has given me methods to deal with injuries before they come, or even head them off all together.  I hope that some of these methods will help others learn to deal with their pain.  Here is a checklist that you can go through to discern what to do.

The initial pain

         You are out on a 20 mile run, or in the middle of a crossfit WOD, and you feel pain coming on.  Should you run/train through it?
Ask yourself these things:   Is it making me limp?  Am I altering my stride to accommodate the pain?   Did I feel a tug or actually hear a pop?  The answer to all these questions is - STOP.  They are indicative of a pain that will definitely get much worse if you continue and you will probably need help from a medical professional (a tug or pop indicates a strain that needs rest).  Does your injury feel deep (like in the bone) or is in the middle of your knee?  You may have a stress fracture, or ligament damage inside the knee.  These are pains you should not train through.
          If the pain comes on gradually, goes away and comes back throughout the training, is only present when you do certain things, has lingered for years, moves to different parts of the muscle as you move, or isn't felt until post-workout, you may have a pain that is completely manageable through methods listed below.  Even pain that is sharp and hurts from the beginning may fall into this category.

Figure out where the pain is coming from 
This one is not as easy as it sounds.   All of our muscles contain spots that can become highly irritable and form knots .  These are called trigger points and cause a muscle to spasm in one spot (spasm=pain).  Think of a fist clenching your muscle -that's what it acts like. 
Trigger points can refer pain to other spots in our body - You think it's your hamstring that hurts?  It may actually be a knot in your Piriformis (your butt muscle).  You have Plantars Fasciitis(feet/heel pain) ?  It may be caused by knots in your calf.  Shoulder pain in the front may actually be caused by trigger points in the back.  If the pain is not in a muscle/ligament/tendon, then skip this blog and see a professional.  If you feel tingling in areas, especially from the spine, it is most likely a nerve issue.  Go see a chiropractor. 

I highly recommend this book - It was my favorite Christmas present from my husband.  It really changed my life and I think it needs to be on everyone's book shelf. (This is not a paid endorsement) 

Click here to learn more

The author shows diagrams of pain spots, and then identifies where activated trigger points lie.   The best part is that he shows you how to manage and eliminate your pain YOURSELF through self massage.   If you can't figure out what is causing your pain, you may need to see a professional.  A good masseuse or chiropractor is a good place to start.

This book is a steal at only $15.

Another interesting article was written by Running Times that talks about the role of fascia (the web of connective tissue around all the muscles) in injury elimination. 

 Our goal for trigger point pain elimination is to push blood through the area, force the scar tissue fibers to realign in the correct direction, and stretch the muscle out at the localized point.  A deep tissue Massage from a skilled masseuse is AMAZING for this, and is my go-to for 99% of my injuries.  For all my Southern Utah peeps, here is my masseuse that has helped me through A LOT of would-be injuries.

Your massage will not look this relaxing

The injury elimination tool kit
  Once you have figured out what your injury is, you can take care of it.  Here are the essential tools that will help your muscle to relax and eliminate the pain.

GuaSha Tool

Purchase one here

   This is my favorite pain inflictor reducer.  Last year I had a hamstring (back of the leg) injury that just wouldn't quit.  It seemed as though my strain was just not healing, and my whole muscle would freak out whenever I walked around the house.  Thankfully a friend and certified masseuse turned me on to these babies, and I've been able to head off many injuries. 
    This tool is designed to bring blood flow to the area to promote healing (and will probably cause harmless bruising).  It will also break up scar tissue that causes injuries to continually return or not heal.  This is a deeper version of the Graston Technique that many Physical Therapists use.  This is my number one injury fighter. 
      The actual process of "scraping" is not typically painful (unless injury is present) and can be used on almost any body part.  You may feel "sharp" areas - That's when you know you've found the right spot.  Use these around your IT band to help separate the IT Band from the hamstring and quads.  I use it every other day on many of my muscles.

Watch my girl Josse demonstrate how to use one here.  She is a runner and gifted masseuse.
  Here is her blog - she always has great material
      You will find ones of cheaper material on Ebay, but you will drop this - a lot! Get one that will last you.  On this site, I would recommend the GOST 2. 

The Lacrosse Ball
 Why this ball you say?  Because it is just the right size - not too big, not too small.  It is hard enough to withstand any weight put on it. 
   A lacrosse ball can act like a masseuse's fingers and help stretch out the muscle at the localized spot.  You can use it everywhere!  Just get on youtube and type in lacrosse ball hamstring, or whatever your problem spot is.  Use it for a minimum of 5 min a couple times a day on that trigger point, and it will eventually release, stretch out, and stop hurting.  I could write an entire blog on how

to use this on your problem areas.
The trigger point workbook listed above uses lacrosse balls as a tool for self massage.  GET THIS BOOK!
For all of you crossfitters/ obstacle racers out there, here's a sample video to help eliminate shoulder pain using the lacrosse ball.
 
Moving the body part while the ball holds the muscle still is a form of active release and is highly effective.

 

VOODOO FLOSS
Strange name - great product!  I use this on my hamstrings to help force the muscle fibers to stretch out and realign in the correct direction.  It also helps eliminate muscle inflammation.

How to use it:
Wrap it extremely tight around the area that is hurting (do not do this if you have a severe strain as it can make the tear worse).  It will be so tight that it starts to holds back the blood flowing through (just for a minute).  Then, go through different exercises that stretch that muscle out. So for my hamstring, I will do nice wide lunges 10 times on each leg, squat 10 times, lunge side to side, and do front and back kicks.  It will start to hurt from lack of blood supply - that is when you remove the wrap.  Fresh blood will flood the area - which is our goal for healing!  Joints have less blood flow to them, and this is a great for them. 
This is definitely a technique that you will need to watch to learn, but you will hate love  it!



 Strength Tape
Also known as kinesiology tape, this is the ONLY brand that I have found stays on!  I am sponsored by this company, but I pursued them only after I became a believer.   

This product provides extra support and stability for muscles and joints.  It also keeps an injury warm, which increase circulation and blood flow.  For active trigger points, it can reduce and/or eliminate muscle spasms. 

I use this on anything that hurts so that I continue training.  It's especially effective on knee pain.

Find out how to tape different body parts here. 

This guy does a good review of the product.

Local Utahns can buy it at the St George Running Center.  Or you can buy it online

Watch Strength Tape being used against KT Tape, Rock Tape, and others on my obstacle course in Toquerville here!



When can I get out there again?
This is the biggest, hardest question at this point.  Experience plays in here a lot - The older you get the more you will be able to tell if the pain will take you out for even longer, or if it is bearable. 

Most of the time I keep going.
I say this with all the caution in the world, and encourage you to listen to any medical professional you may have gotten advice from.

In my experience though, they are not always right.
In 2009 amidst marathon training season, I encountered a pain behind my knee on the outside.  I felt it during a run - It was quite painful and got worse as I kept going.  I tried running a race with it, and didn't even make it a mile.
 So I did my rounds through the medical professional community.  Doctors, sports therapists, and physical therapists all told me I had hamstring tendonitis and that 6 weeks off was the only cure. I was then  referred to a gifted masseuse by a friend, and through massage found that I had huge knots in the middle of my hamstring.  After 2 sessions and  1 week of cross training (no fitness lost), the pain was eliminated.

After the second massage, she told me to go for a run the next day.  What!  I was told the opposite by so many professionals.  She said it might hurt, but as long as it didn't get worse the running would be good for it.  GOOD FOR IT?  That was music to my ears!

And she was right!

Blood = Good for healing!  Exercise promotes excess blood flow, stretches the muscle out, and will heal your injury so much faster.

Continuing to train without rolling, scraping, or wrapping will most likely result in more pain.  You can't leave steps out and you have to be consistent !  One of the worst things you can do for most injuries is sit and let scar tissue form incorrectly and allow the muscle to shorten.  If you do have a body part that has to be immobilized, such as with a stress fracture, exercise of the other part of the body parts will again, get the blood flowing and help it heal faster.

When I went through a hamstring strain, I did slow exercises with minimal pain.  The injury probably would have gone on much longer if I hadn't.

Educating yourself will be your best safeguard against future injury.  I haven't even touched on other tools that I use such as: Yoga, stretching, chiropractic assistance, foam rolling, extra sleep, bands for stretching, or nutrition.

You also need to find out what caused your injury initially so you don't repeat it. 

I would be happy to answer any questions you may have about how I've dealt with any of the above mentioned injuries.   I plan on giving a step by step for specific injuries in future blogs.