How to Maintain Fitness While You’re Injured

Q: “As a longtime runner (30 years and counting!) I’ve had my fair share of injuries (knee, IT band, foot, hamstring)—both caused by running and by accidents. I’m sane enough to stay away from running while recovering, it drives me crazy to sit in one place. What are the best exercises a woman can do when she’s recovering? ~ Dawn

You’re a wise runner and it shows from your question and your years of experience. Although rest used to be the primary prescription post aches, pains and injury, the current methods for rehab include dynamic rest. Research suggests a modified plan of movement improves your emotional status, maintains fitness and aids in efficient recovery versus passive rest.

The key is to modify your exercise routine based on the four types of aches, pains or injury. The type of active recovery depends on the degree of the injury, and unless you’ve experienced an acute injury (car accident, sprained ankle…), most aches and pains progress in intensity over time. This is important to know because we can reduce the incidence of more serious chronic injuries by tuning into our bodies and modifying workouts when the yellow flag rises.

Once you feel the onset of an ache, use this chart to evaluate what type or level you’re at and modify your exercise routine based on what your body is telling you. In many cases investing in just a little dynamic rest decreases the likelihood of the ache turning into a full-fledged injury.

As you develop your dynamic recovery plan keep in mind that if anything hurts, avoid the activity and try something else. Pushing through pain can exacerbate the injury as well as cause new pain from compensating your form.

If the pain doesn’t heal, modify your plan progressively – for instance, if you have a Type 1 pain and modify your routine based on the recommendations below and still have pain a few weeks later, further modify to the Type 2 or 3 dynamic recovery plan.

If you are feeling the symptoms of a Type 3 or 4 injury, you’ve passed the tipping point and it is best to seek medical advice as a diagnosis is the fastest way to recovery.

Type I:

Feels like: Mild discomfort only after the run.

Dynamic Recovery: Continue to run on flat terrain with reduced intensity and distance as long as there isn’t pain present. Weave in lower impact cross-training every other day for higher intensity workouts as long as there is no pain present. Focus on light flexibility, muscle release (foam rolling, massage), and strengthening work.

Type II:

Feels like: Mild discomfort is felt during and after the run but it doesn’t cause you to alter your stride (limp). The symptoms are no worse post run.

Dynamic Recovery: Cross-train with lower impact activities at an easy to moderate effort levels for 5-7 days. If pain gradually subsides continue to cross-train until you can run without altering your stride and start back with easy effort running on flat terrain. Start back with short bouts of running to test the waters. One easy way to do this is to combine cross-training with 5-10 minutes of running in the same workout. (eg.Elliptical for 20 minutes + 10 minutes of running). This is an effective way to build running time back up with less risk of going too far too soon and aggravate the injury. Focus on light flexibility, muscle release (foam rolling, massage), and strengthening work.

Type III:

Feels like: Pain is present during and after the run and restricts activity. Runner can no longer run without pain or altering their stride.

Dynamic Recovery: Cross-train at easy-to moderate efforts with non-weight bearing activities. In some cases, non-impact, weight bearing activity like the elliptical machine or ElliptiGO bike are healthy options if no pain exists. When you cross this threshold, it’s definitely time to seek medical advice for specific treatment. They will also guide you in developing a recovery plan with exercises that will help build strength where there is weakness and flexibility and range of motion where there is tightness.

Type IV:

Feels like: Chronic, unremitting pain. At this point you may be in a cast and recovering from a stress fracture or muscle tear.

Dynamic Recovery: Consult with your doctor or physical therapist – go with activities that are non-weight bearing in the initial phase of recovery (swimming, water running, cycling, upper body ergometer, rowing). As you begin to heal, progress to non-impact, weight bearing activity like the elliptical machine. Several Olympic runners trained on the ElliptiGO while recovering from stress fractures and were able to maintain a high degree of fitness and heal relatively quickly. Working with your doctor on a dynamic recovery plan is the best way to find what’s best for you without risking further injury or delayed healing.

Suggested exercises for cardio, flexibility and strength. Start with gentle static stretches and light foam rolling (without pain) and as it heals, progress to more dynamic specific flexibility and strength exercises. The higher the grade of injury (1-4) the more gradual and gentle the recovery process goes.

Knee:

Flexibility – Foam roll and stretch hip flexors, quads, hamstrings, glutes

Strength – Planks, multi-directional lunges, squats,

Cardio – Upper body cardio(rowing, ergonmeter), pool running, swimming, (cycling or elliptical unless you have pain)

Hamstring:

Flexibility – None until pain-free walking, then gentle hamstring and gluteal stretches in pain-free range, foam roll quads, hips, and glutes

Strength – Once pain free, hip raise/bridge, hip extension, hamstring curl,

Cardio – Upper body cardio, circuit core work

ITB:

Flexibility – foam rolling the ITB, lower outside of the thigh and hips

Strength – include strength work for glutes and hips (squats, single-leg squats, hip raise/bridge, lateral band walks, single leg balance)

Cardio – Elliptical, swimming, rowing, cycling

Foot Pain:

Flexibility – Gently stretch calf, roll tennis ball under the foot and foam roll the calves

Strength – foot and ankle strengthening exercises, *AFX Ankle Foot Maximizer

Cardio – Swimming, rowing, cycling, and in some cases elliptical