Training While Injured :Or How I Learned to Stop Worrying and Love Cross Training

Goodbye February, and good riddance.  If you are an endurance athlete in the American North East you probably feel the same way I do. But it's not just the sub-zero "Arctic Blasts" and feet upon feet of ice and snow that I'm looking forward to forgetting. I'm putting an injury behind me too. Technically speaking I had a minor case of "High Hamstring Tendinopathy" which is basically a sprain where my hamstring attaches to my glute. Its a real pain in the butt. My last post was a recap of my PR half marathon in late January. By February 1st, with the Boston Marathon quickly approaching I was officially not running. So what to do? Well this is my story of lots of cross training, strength and conditioning, physical therapy, diet, and rest. As of today, March 1st, I'm running well again, a little stronger, and hopefully a little wiser.
     I recently read an article that over 70% of runners will be injured at some point in their running career. Not having a major injury since a case of shin splints as a Sophomore track runner, I was beginning to think I would enjoy a lifetime of the 30% minority who ran uninjured. And I might have if not for pushing my luck. Here's my analysis of what happened to me, and some advice if you too find yourself one of the unlucky 70%.
   
1.) REST! I continually tell the athletes I coach that rest days are the most important days of your training week. All the other days we are tearing down our bodies, and pushing out of our comfort zone. This amounts to nothing if there aren't days for the training stimulus to be absorbed by the body. Many coaches believe that it takes 1 day for every mile raced for the body to be ready to resume hard training. One of the main reasons I got injured is because I jumped back into hard training right after my race. Worked before for me, but not this time. Rest can include reduced mileage, cross training, or can be as simple as getting more sleep. Instead of waking up pre-dawn on Sunday mornings for long runs, I would try to sleep in, and fit in my workouts around family obligations.
   
2.) Physical Therapy (PT). If you live in NJ, you do not need to get a referral from your regular doctor to see a Physical Therapist. The PT I saw is a runner, and has treated many athletes in my running club, so I trusted they would help get me back on the roads quickly and safely. Ask other athletes to recommend a good PT - they can be your best friend while injured. But overall make sure your PT understands your needs as a runner, and that above all, you feel comfortable with them.
   
3.) Cross Train! Yes you can maintain fitness when you can't run! While I took a few forced days off from running before my first PT appointment, I quickly set up my road bike on the indoor trainer. (Just make sure your PT clears you for this activity). While I would much rather have been outdoors cycling on the roads for hours, this February was a no-go for cycling outdoors. Here's some of the things that got me through my workouts:
         A) A few good pairs of cycling shorts. Try cycling for more than an hour without them and you will quickly see why this is the top of my list. You will probably need more than one pair, unless you plan on doing laundry every night.
         B) A cyclometer OR a watch with a heart rate monitor, and, if you can, a cadence sensor. It's hard work to get your heart rate up to the same level as it would be if you are running. I like to drop to a high gear and increase my cadence to above the 100 mark to make my heart get into the zone I need, rather than to use a lower gear with low cadence which taxes your muscles more, but not your cardio system.  If your schedule called for a 2 hour run, try to cycle for at least the same amount of time. Include a good warm up, and cool down. And yes, you can get interval workouts indoors. After a good warm up try getting up out of the saddle and changing into a low gear to really get your heart pumping. Switch gears, recover, and repeat. One workout I like is 10 x 3 minutes hard with 1:30 rest periods. Experiment or search for a specific indoor interval DVD.
        C) Something to watch. There are many great DVD's made specifically for indoor cycling. Do an internet search and then go to your local bike or triathlon shop and purchase one. It will help you keep your sanity. The days I wasn't watching a cycling workout on DVD, I would stream YouTube videos to my Roku player and watch old stages of the Tour De France, various past Spring Classics, or even more free indoor cycling workouts.
        D) Various extras. There are hundreds of products to spend money on if you are cycling indoors, here are some various other things that helped me out: An extra shirt or jacket to help get your core temperature up, which will aide in getting your heart rate into the proper zone,  2-3 Cold bottles of water, at least 1 large towel for all the sweat (wait and see), a hat, (again to absorb the sweat), remote controls within an arms reach, phone with ear buds already attached - for that mid workout call which you will want to take,  and maybe a stool/table to place your various things.

4.) Strength and Conditioning. Again, talk with your PT or coach to design a program that is right for you. The last thing you need to do is to further injure yourself because you suddenly started doing new exercises. I had been strength training regularly long before my injury so all I did was up the amount of times per week up to 4 sessions per week. Most of my exercises are body weight exercises augmented with a medicine ball, and some small free weights. I added my strengtehning sessions immediately after getting off the bike to lengthen my workout, and keep my heart rate still working. If done right, your strengthening sessions can be a light cardio activity. With my PT's supervision we not only worked upper body and core, but worked to strengthen my hamstrings (and lower body) to make them more resilient to the stress of training for and racing a marathon. Some days we worked on agility and balance, but after several sessions, I learned to correct form to strengthen areas of my body that were being neglected, and probably led me to injury in the first place.

5.) Diet/Nutrition. I made sure to watch what I ate since I was burning less calories than I would be if I were running full time. Most athletes could benefit from cutting out or adding certain things in their diet, and a time of injury can be a perfect time. For starters I cut out all sweets - no cookies, cakes, or foods with extra added sugars. Secondly, I didn't need the Saturday night pasta dinners. If I bonked on the bike (I never did) the kitchen was never more than a short walk away. I also upped my protein intake as my muscles needed the protein to help rebuild the damaged tissue. You may want to consult a Doctor about adding vitamin/mineral supplements into your diet. I weighed myself daily to make sure I wasn't gaining weight. At the end of February, I was exactly where I was before the injury because I made smart choices about caloric intake.

6.) Rebuilding Mileage. All this cross training and strengthening probably didn't result in any huge fitness gains, but I'm confident I didn't lose much either. When I did start running again towards the middle of February it was for 3 miles on a flat course. My first successful run was in the pitch black in 7 degree weather, and I loved every minute of it. I made a pattern of run/cycle repeat. Soon I was running 5 miles, then 8, then back to back days, and today I'm up to 15. What I like best is that aside from my legs getting used to the pounding again, I'm running the exact same training paces as pre-injury. My heart rate is exactly in the same zone(s) as pre-injury too. With a good mileage base my next step is to slowly reintroduce the intensity. With The 2015 Boston Marathon now officially 7 weeks away, I'm still optimistic of a good race. I know I'm not where I wanted to be, and the time I thought I was going to originally run is doubtful, but I'm feeling more and more confident that I'll be at the starting line in Hopkinton, and maybe more importantly feeling good and smiling as I'm coming down Bolyston Street to complete my 5th Boston Marathon.

7.) Support Team. I probably would have given up trying and taken an extended rest from running if it weren't for my support team. From my wife, who would refill my bottles mid-ride, to my Mother-in-Law, who would babysit for me while I was going to PT, to my friends and training partners, who I managed to avoid seeing face to face, but traded phone calls, emails, and texts. Everything from watching film clips for the soon to be released documentary about the Boston Marathon, and reading articles like this, zipping up past Boston Marathon jackets as I head out for runs, and even visiting the B.A.A. website has been giving me the motivation to get out there, run and train smart, and wait for this winter to be over with and get one of my favorite Rites of Spring under way.