Handling Injury
An Inquiry into the Ways of Dealing with Pain.
What is Injury?
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- An injury is simply physical pain.
- We measure pain as: Tender, Twinge, Ache, Sore, Severe.
- Injury exists wherever you experience pain above the tender level.
- Thus, for example, a twinge of sharp, darting pain is injury at the lowest level.
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Injury: Problems and Solutions.
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- This course is an inquiry into the causes and ways of handling injuries.
- During the course, you’ll learn how to deal with your specific injuries or, if you are a trainer, the injuries of those you train or coach.
- The course uses a case study approach, as you will follow the story of an “everyman” recreational athlete to learn how to handle injuries.
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The Brian Dote Injury Case Study.
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- Brian D. was training for the 2022 Honolulu Marathon when his training was set back by two injuries.
- The way out of the first injury was easy, but the way out of the second injury was complicated by Brian’s inability to truly understand what was causing his sore knee.
- By following Brian D’s story, you’ll learn from his experience so you can derive rock-solid ways of recognizing an injury, identifying its cause, and getting rid of it so you can continue training and racing.
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Part One. The Injury Rehabilitation Process.
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- The bigest mistake injured athletes make is to continue training in spite of serious pain.
- Continued training is often rationalized by the big race event that’s just around the bend.
- In our system, there is a 4-step potocol for getting rid of pain before it becomes chronic.
- The first step in the process is to stop “training” in favor of disciplined, active rehabilitation.
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Part Two. Understanding and Solving the Problem.
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- Inexperienced athletes often think they know what’s causing an injury.
- But their thoughts only distract them from the real underlying cause.
- Thus, they try doctors, extended lay-offs, and “therapy,” with no results.
- Until, with luck, they identify the real problem and its logical solution.
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Wisdom Topics.
The following wisdom topics represent the 50-year experience of BC Endurance Trainings on the subject of effective hill training.
The BC Endurance Injury Scale
The BC injury and pain scale. You can’t train effectively if you’re injured, meaning you experience pain at the twinging level or higher on the following scale: tender, twinge, ache, sore, severe. See about using the following protocol every time you feel the sudden onset of unusual pain.
- Whenever you feel a sharp twinge of pain, back off on exertion immediately. Slow down until the pain goes away, whether in that workout or over a period of several weeks. Better to lose a few weeks of training than to be saddled with interminable, debilitating injury.
- Whenever you experience pain, your highest priority should be to get rid of it through a concerted injury freeing process. First, until the injury goes away, see about changing your mindset from training to rehabilitation. Train under the pain, never through it. Tender only.
- Remember, all injuries go away if they’re treated properly. The most important thing is to slow down so you experience the pain at no more than the tender level. The pain will go away gradually, if you don’t continue hurting yourself with more painful exercise.
Injury Do's and Don'ts
Injury do’s and don’ts. Never train with soreness that causes limping, even minor limping. Limping means you’re going too fast for rehabilitation purposes. Whatever your training purpose, it’s not as important as getting rid of an injury so you can train enjoyably and sustainably.
- The don’ts of injury. Don’t try shoe inserts or pain pills. Don’t stretch, unless you do it gently. Stretching feels good, but often exacerbates an injury, as do strengthening and therapy exercises meant to work a damaged area that needs rehabilitation more than work.
- Begin with a regimen of active exercise at the gentle level. Use excruciatingly slow walking to keep the pain at bay. Do very-short, five-minute workouts to warm up and loosen the area, relieving stiffness and poor circulation. Afterwards, cool it with 10 minutes of icing.
- The pain should go away from day to day, enabling you to go a little faster. Consult with a coach before going to a doctor. It’s a coach’s job to get you out of the injury. Medical consultation will be recommended if this protocol doesn’t result in rapid rehabilitation.
Shoes and Injury
Shoes and Injury. Training related issues such as warming up incorrectly can cause injury. But there could be other problems. Shoes, for instance, can be a major cause of recurring injury. It’s often good to cover the new shoe base as one of your first steps in the rehabilitation process.
- Find expert advice before you invest in a new pair of shoes. Go to a reputable running shoe store where the salespeople know how to match your bone and muscle structure needs with a shoe’s intended function and features, and where they’ll let you try out the shoes.
- Running shoes wear out and compress much more quickly than street shoes. Often the uppers can look brand new, but the compression is hidden in the midsole. Even minor wearing compression can cause significant injury. So inspect your shoes frequently.
- A new shoe is as good as it will ever be the first time you take it out for a run. Once it starts to compress, it may feel broken in and comfortable, but it’s less capable of protecting you from pounding related injury, because the platform is no longer supple or level.
Changing injury-related Attitudes
Changing injury-related attitudes. Such as thinking I’m a bad person, this is the end of my running career. I’m so depressed. I have to train through this injury. These are unnecessary and counterproductive mental-emotional aspects of the injury phenomenon.
- You must nurture a positive mental attitude because that will lead to positive emotions that should drive your decision making. The first step is to become aware of your injury related mental conversation. What are you telling yourself about it and how does that feel?
- You’re ultimately responsible for dealing with the injury in such a way that you return to enjoyable injury Free training, your natural way of being in the world. Everything else should be rooted out along with unbridled ambition.
- My wife used to wag a finger at my injured athletes and say all injuries are rooted in ambition. She was right, of course, but only the bravest athletes are willing to examine their deep-seated motivations and the compulsions that dried excessive, injurious effort.
Insensitivity to Your Body
Insensitivity to your body can easily lead to injury. Pain is one way your body signals something is wrong. Yet, many people would deny the pain is there, and simply overlook it as necessary or inevitable. Becoming aware of pain is the primary requisite for effective rehabilitation.
- You may think you’re in charge of your body. But your body operates according to rules and processes that can be foreign to your mind, which is thrown to intuitive, habitual, and often incorrect decisions, without thorough assessment.
- Your physical self doesn’t think with words or concepts, but with pain and other physical sensations. Your body governs these sensations with forces beyond your direct control. It has at least equal claim to agency with your thoughts, emotions, and perspectives.
- Thus, the most you can hope for during a workout is to control your body indirectly through scrupulously correct exertion, such as a proper warmup, and by never overtraining. Our goal is to enjoy year-round, pain-free and sustainable fitness exercise.
The Transition and the Warm-up
The transition and the warmup. The warmup doesn’t actually begin until about 10 minutes into a running workout. That’s how long it takes the metabolic transition force to run its course. The transition decreases energy and increases the risk of injury.
- The transition phase of the workout energy cycle occurs between standing around before the workout and the warmup phase, which begins once you’ve walked or jogged very slowly for 10 minutes.
- The transition takes the form of a physical shock to your body. As such, the transition is a tricky part of the workout. If you go too fast, especially if you can hear your breathing, you can easily injure yourself or become prematurely fatigued. The transition can reverberate throughout the workout, so it must be handled carefully.
- Your transition pace should be excruciatingly slow. Some have said painfully slow, but that’s an incorrect term. If anything, it should be painlessly slow, meaning you feel no pain at all. Thus, your first training goal is to minimize the shock of each workout’s transition.
Body Scanning (Part 1)
Body Scanning (Part 1). Soccer champion Lionel Messi runs less during a match than his peers, but he scans the field 50 times a minute, far more than most. Similarly, great runners scan their body constantly and habitually for signs of distress, warnings that require their attention.
- Weird or unusual, sharp darting pain is the easiest to acknowledge, but not always the easiest to accept. The mind resists the obvious solution to slow down and let the pain subside, especially when your energy is good and you want to run as fast as it will let you.
- Nonetheless, your highest priority is to run injury-free. Injury precludes joyful running and is ultimately unsustainable. To be injury free requires freedom from whatever is driving you. Even novice athletes can be ambitious, about burning calories, if nothing else.
- Thus, body scanning is the prerequisite of injury-free running. Notice pain that lingers at such a low level that it hardly warrants consciousness. Tolerable pain is pain. And unsustainability develops from pain that isn’t treated seriously and expeditiously. So, scan often
Body Scanning (Part 2)
Body Scanning (Part 2). A full body scan only takes a moment as you have broad and immediate access to your entire body, from head to heels and from the skin to your deepest innards. All your bones and joints, but especially the working parts, should be regularly scrutinized.
- Think first in terms of your body’s painful messages. Does a pain require immediate adjustment to your pace or stride? How about your footfall? Are you compensating with limping or poor posture for some barely acknowledged discomfort?
- Where are the sensations coming from and is location, pace, or posture the main precipitating factor of an incipient pain. Remember, pain free exercise is our highest priority. Abundant energy is nice to have, but high-level exercise is not always advisable.
- Physical sensations are one aspect of how the body communicates with the thinking, observing mind. Pay attention also to the affective side of your experience. The feelings that give rise to tension, anxiety, and fear. Strive always to augment relaxation.
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