Wednesday, July 26, 2017

Return to Running After Injury and Pregnancy

In 2016, I went from running 1 mile with pain to running 13 miles without pain.

The past 2 years have taught me a lot about running, injuries, and recovery. Like many of my fellow runners I was plagued with a chronic injury preventing me from peak training and performance. My most recent injury was traumatic, and it took me 6 years to recover. Years of seeing physicians, getting injections, exercises didn't help.

A little background... In August 2009, I slipped and fell on my back. Like most runners, I continued to run despite having pain in my right side sacrum (tailbone). I remember running on the Great Highway and thinking "ouch", some times out loud, each time I stepped on a patch of sand that had washed onto the path. I decided to change my form so my sacrum wouldn't hurt so much, and it worked for a very short period of time. About 2 months of pain free running into my training I suddenly started having what I call "dead quad' syndrome. My right side quadriceps felt like a brick. From there I had countless MRIs, x-rays, injections, chiropractic work, physical therapy unfortunately none of it helped. Flash forward to 2015. I started seeing an osteopath for prolotherapy with mixed results. One day he decided to check my glute strength in a way I never have seen. While on my stomach, with a towel roll under my ankle, I had to straighten my knee using my glute, and I couldn't do it on my right side. I had been performing clams, leg lifts, bridges...the typical glute strengthening exercises. It was at that point I realized I wasn't weak; I had trained my body to not use my glute muscles.

Once injured, we all want to resume our normal running routine as quickly as possible. Then we end up with injury after injury. I was one of those runners who felt fully recovered from my injury and returned to my "normal" running routine. However, my injury would just return in a matter of weeks sometimes only days. This was not good for the body (or the wallet with countless race entries that went unused). An injury, chronic or acute, changes our movement pattern, which in turn stresses our muscles differently. This quickly leads to imbalances and overuse injuries. Starting slow and focusing on form will help the body relearn the appropriate movement patterns, thus reducing the chance of re-injury.

In 2016, I decided to start at square one.  This was a huge investment of time into my physical and mental health. At the beginning I always wanted to run more than the 1 or 2 miles I limited myself to. However, by the end of my program, I felt the best I ever had. The discipline was worth it! I even ran several cross country races, continued running during my pregnancy, and was able to quickly return to running post-partum.
Cross country race in San Francisco

My Plan

- Run 2 miles 6 days a week.
- Pick a pace 1 minute slower than comfort level for a 5 mile run.
- Focus on FORM.
- 1st week, no faster then 9 minute mile pain.
- 2nd week, no faster then 8:40
- 3rd week, no faster then 8:20.
- 4th week, I was able to run at 8 min mile pace.

- Up mileage to 3 miles 6 days per week but slow pace down to 9 min miles
- Followed the progression above with adjusted times

- I was able to transition to a more traditional running program.
- One long run, 3 easy runs and 2 challenging runs ranging from 4-6 miles.
- I increased my long run by 1 mile every week ( with a month vacation in June) so by September I was running 13 miles.

During this time frame I felt the best that I ever have! Even running in college I had a lot of aches and pains running that distance.
The fitness gained from the first 9 months of 2016 set me up to be able to run 8 of the 9 months of my pregnancy.
Running at 8 month. I could not avoid heel striking!

Post Partum 

Month 1- I'm not going to lie. When I started walking 3 days post-partum, it was HARD. My neighborhood has slight inclines ( ~2-3%) and my legs were tired walking "uphill" and shaking when going "downhill". I kept my plan. Walk for the 1st month. There was no minimum. Just get out and walk what I felt like.

Month 2- I was released to run at 4 weeks post-partum. My goal was to run every day of June. I start running 1 mile for 10 days, then 2 miles for 10 days finally 3 miles. Then I transitioned to a traditional training program. My goal was to run in a race by the end of July ( 7 weeks of training). That first mile was a challenge. I was sore. But my focus was on my FORM. After about 4 days, my soreness went away and the runs felt good.
Then came 2 miles. I thought it was going to be painful but to my surprise my 2 mile pace was faster then my 1 mile pace. Running 2 miles felt great. I felt my body get stronger and there was better control of my body. I was even able to join my team mate part of her easy runs.
Last, I had 3 mile runs planned for the final 10 days June. There were certain days that I had to slow down to focus more on form. It was most likely the days which the baby was up during the night crying. I adjusted my workout to make sure I was able to maintain my form at the pace I was running.

Month 3 - Over the next 20 days or so I ran 3-5 miles a day making sure I didn't increase my mileage too rapidly.
The week before the race I was able to comfortably run 5 miles in 8:30 pace. So I set a goal of running the 6 mile course in under 50 minutes.

Race Day

It was a long night with the baby the night before the race. My plan was to start slow so I can focus on my form and allow my muscles warm up. I gradually picked up the pace.  With the help of a couple of ladies who I coached while they were in college I was able to push my last 2.5 miles. A couple days shy of 12 weeks post partum, I finished 6 miles in 48 minutes! My time was 2 minutes faster then my goal time. I also negative split the race ( 8:10, 8:07, 7:59, 7:55, 7:47, 7:28). My body wasn't sore. But, it's better to test my body then to go all out with the possibility of being so sore I couldn't run for a few days.

Post race sweaty cuddles

What I learned was a slow return to running with a focus on form was the best way to recover from an injury. All the times of jumping back into a running" once I felt better" made it so my recovery was longer. It took months of slow, controlled running to get back on track. I wish I knew this years ago!
Please let me know your thoughts on recovering from an injury and return to running.

Stay tuned. Next blog post is on the core exercises.