Trisutto recently received the following inquiry about running with injury:
How do you deal with run injury? Do you keep 'running through it' or is it best to stop all together?
Depending on what the injury is will determine the extent and type of training that can be carried out. Is it either bone, tendon or muscle injury?
Training with an injury should still be carried out but it will be dependent on protecting the athlete from further injury or re-injury. The aim is to maintain fitness while promoting healing.
The methods of exercise, depending on the injury can be either:
Walking / Slow shuffle
Shallow water running
Deep water running
Walking and slow shuffle replaces the longer non-stop runs. If the injury is not too severe then this can take the form of long hikes and to add resistance, the use of a weight jacket. This type of walking could have a duration of four hours. Chrissie Wellington when training for Ironman Frankfurt completed all her runs as hikes and finished the race just a few seconds off the World Record.
Track sessions are replaced with the injured athlete running in the outside lane at a slow run/shuffle. Speed component must be kept to below any pain discomfort. It is building mental strength by self-control while also inclusiveness of the athletes with the rest of the non- injured training group. The injured athlete keeps “shuffling” until everyone has completed the session. This type of training has been adapted from Kenyan runners training methodologies.
For many Kenyan groups, it is not even a debatable point on whether to 'push on' in continuing with the group track work. Injured athletes will often shuffle on the outside lane till their compatriots have finished. Very few carry the Western propensity to push on or hard when injured. The pace instead dictated by the 'no pain level'. I've seen sub-13-minute 5km runners slowing down to 6-minute 400m pace, while their colleagues belt out 55s on the inside lane. That is discipline.
Shallow water running is carried out in waist-deep water. This exercise builds strength while still keeping in touch with the ground. The run mechanics change, as this form of running forces the athlete onto the ball of the foot but the big advantage is the athlete can get back run form very quickly. By varying the depth of the water can assist with the rehabilitation of various injuries until transitioning back to normal running.
Deepwater running. While this type of rehabilitation is recommended by many, it is not one that Trisutto fully endorses but can be used if all else fails. It should be practised with a run belt and a stretch cord, so the athlete moves slowly up the pool. Interval work can be achieved in this session.
So firstly, evaluate the injury and then prescribe a rehabilitation program. It could be either of the above-mentioned regimes or a combination of all three. It is important to keep the athlete moving and motivated. Active rehabilitation keeps oxygen and blood flow to the injury and aids in a faster recovery.
Of course, increasing the cycle or swim volume is another method but not one that we recommend. Cycling can also increase leg stress as does swim when pushing off the wall in turning and kicking.
As a coach you have to make the decisions that best suit your athletes return from injury. Keeping fit with a run injury is possible depending on the injury, it's your job to make the judgement calls that will best suit full recovery with all the information and practical tools at your disposal.