Prehab or Rehab? How to Make it to the Starting Line at Your Healthiest This Year

Cross-posted at the PPG Wellness Blog

We’ve all been there. You’ve trained for months. You’ve gotten up in the dark to run your miles while the rest of the world was still asleep. You’ve bought stock in Gu, and your Garmin is your best friend. And yet, with your goal race just a few days away, you’re still nursing a nagging pain in the side of your left knee, your shins are sore, and there’s a twinge in your hip. Maybe you’ve come to accept this as inevitable – and now you’re standing at another starting line firing on less than all four cylinders, hoping for the best, dreaming of the ice packs and ibuprofen that await your finish.

A common misconception is that if you’re a runner, your body has to hurt, and some may even wear it as a badge of pride. But the vast majority of us are desperate to find a solution to our injury woes – after all, just think how much easier, faster, and more pleasurable running would be without that “foot thing”!  Maybe you’ve even followed all the conventional injury wisdom – rest, ice, 10% weekly mileage increases, stopped running altogether – yet you still hurt. The frustration mounts and you feel like you’re stuck in an endless cycle of having to back off your training and start again from scratch. If this sounds familiar to you, it’s not time to throw in the towel yet – there is hope! When you’re ready, commit to the following 3-step plan for more consistent, happier running.

Take a Step Back

The first step is to identify and work on any weaknesses and imbalances – is your right leg much stronger than your left? Nearly everyone is stronger on one side, but if all your aches and pains are on your left, your body may be telling you something. This leads straight into the second, and perhaps most crucial, step: do you even lift, bro? Make a commitment now to the right strength training – a program incorporating single leg strength and core work, including key functional movements your body goes through when running – and do it consistently! Does your opposite hip drop when you try to balance on one leg? Then it’s happening when you run, too, and you’re landing in that wobbly single-leg stance thousands of times every time you hit the road. Things like single leg squats, bridges to work your hamstrings and glutes, lunges, and step-ups are a solid starting ground. Hate the weights? Remind yourself that the time you spend building strength will pay dividends in your ability to run consistently without pain, and consistency leads to PRs.

When looking for imbalances, don’t neglect mobility – while being super flexible isn’t required (or even necessarily desirable) for running performance or health, one mega-tight hip flexor and an opposite tight calf can alter your biomechanics – how your body moves – enough to produce pain and eventually injury. A consistent 5 to 10 minutes a day of dynamic mobility work is better than one long stretching session per week.

While you’re at it, take a look at your running form. Are you running tall, landing with your feet under your body, and at a cadence of at least 170 steps per minute? Go through this quick mental checklist during each and every training session until this technique becomes automatic.

Run Smart, Run Consistent

How have you been approaching your training? Many runners perform every run at the same moderate-to-hard effort – or take this even farther, doing every run like it’s their last! Instead, make sure every run has a specific purpose. Even the best runners in the world do their easy runs minutes per mile slower than their normal training pace. Running intervals on the track? Now it’s time to throw down the hammer. Sit down each week and come up with a plan – which days are your easy recovery days, which day is your tempo run, and which day is speed work? Then hold yourself to those paces. Variety is the spice of life, and the savior for your legs – as well as your race times.

Stop Neglecting Recovery

Ok, so you’re doing the right training at paces and distances appropriate for your fitness level, building some strength, and working consistently on any imbalances and weaknesses you’ve discovered – the last piece of the puzzle is proper recovery. What are you doing when you’re not training? Sleep, proper nutrition, and life stress all affect how fast and to what extent you bounce back from that long run or strength session. Now, most likely you’re not a professional athlete – you have a full-time job, maybe a family and kids, and as much as you’d like to sleep 12 hours a night, it just isn’t feasible. What you can do is sleep better. Limit your exposure to bright light at night, turn off the technology when it’s getting close to bed time, and cut off the caffeine in the afternoon. Aim for more sleep if you can around your key workouts – if you go in physically and mentally fatigued, you’re setting yourself up for injury. Similarly, you don’t need to be a Puritan when it comes to nutrition – but trying to base the majority of your diet around whole, unprocessed foods means less inflammation and a decreased injury risk. Remember to refuel after training with some carbs and protein – find what works for you. Stressed at work or home? While a hard run may sometimes be a great way to blow off steam, psychological stress can also increase fatigue and injury risk – so proceed with caution.

If all signs point to needing to back off your intended workout – a niggling pain, an extra long day at the office, being up with the kids all night – cross training can be a great alternative (and one that should be part of any well-rounded training program). Cycling, swimming, and deep water running keep you moving, build aerobic fitness, and can even help you recover faster than completely taking time off. Running in the water can be a particularly effective workout, as it most closely mimics the demands of running on land – so grab a buddy and hit the pool!

There are no quick fixes, but with time and commitment, implementing these strategies can break the injury cycle and transform you into a healthier runner, one who is finally able to build a consistent training program and hit those times and distances you’ve been chasing. After all, healthy runners are happy runners, and who wouldn’t want to run happy?