The running population, myself included, puts an inordinate amount of time and energy into designing our ideal workout program.  This may be periodized with a specific race in mind or varied with a few key races built into a training cycle.  We assess, re-assess, and often times over-analyze whether the amount of mileage planned is too much or too little and whether the paces for workouts are realistic.  We spend money on training shoes, racing shoes, running gear, and travel to destination races.

However, we often de-emphasize or neglect the aspects outside of the actual running that can help us get the most out of our training plan and race preparation.  Below I have listed what I consider the top 5 things every runner should have or consider outside of their actual running plan.

1.  Injury Fund:  Running by nature is a repetitive activity. If you perform the sport long enough, an overuse injury should be expected.  The sport is also addictive.  We use it as a stress relief, a means to stay healthy, an avenue to fulfill our competitive drive, and a way to explore.  When we admit that something doesn’t feel right or is actually painful, we automatically assume that a prescription of rest is on the horizon.  This assumption prevents many runners from seeking help because they worry their training cycle will be interrupted.

However, our fears could be alleviated and a properly estimated time to recovery given, if we had an accurate clinical assessment/diagnosis from the beginning.  Delay to diagnosis will significantly affect the treatment outcome and healing time-frame.  Seek qualified advice from an orthopedist, physiatrist, physical therapist, or certified sports chiropractor that is knowledgeable and versed in your sports’ training demands.  Imaging (Xray, MRI, CT, diagnostic ultrasound, etc) can play a key role in assisting with the injury management plan (5).  If imaging is recommended, make sure it is justified and is being ordered to confirm a clinical suspicion.  For an overview on certain running injuris where early imaging is the preferred course of action, please review to Dr. Bergman and Dr. Fredericson’s post on the topic:  MRI finds runners’ overuse injuries.

2. Walking Boot – I know, I know, it’s the scarlet letter for an athlete.  Wearing a walking boot is like begging people to ask the question “What happened to you?”.  But, the walking boot can be a key recovery weapon for your arsenal.  Keep it for rainy days, when the long run didn’t go as well as you would’ve liked because your foot started tightening up or you felt a “weird twinge” in your achilles during your last 400m repeat.  Having a walking boot on hand can also be a saving grace when you start feeling a hot spot on the top of your foot or inside part of your shin before it turns into a full-blown stress response.  Additionally, after receiving aggressive soft tissue therapy, a partial weight-bearing walking boot for 24-48 hours during normal daily activities can help take the pressure off the lower leg musculature for more efficient recovery as it creates an evenly distributed foot loading pattern. (9)

3. Post-run mobility routine – I’ll preface this by saying I’m not a big fan of static stretching, yoga, or foam rollers (I’ll get out a post soon as to why).  With that being said, I am a big fan of dynamic stretching and/or joint capsule mobility exercises.

With running being a ballistic, repetitive, and unstable form of exercise, it’s natural for muscle tension to build and joint stiffness to occur as a result.  Our body is a system of levers (muscles) with pivot points or hinges (joints) that allow us to move.  Increasing the speed of that movement requires balanced efficiency within joints.  They need to have both the freedom to glide while being dynamically supported.  Maintaining capsular mobility without compromising stability is important to ensure normal muscle firing in the tissues that support the joint so that excessive strain isn’t being placed on the levers guiding the movement. (8)

The hip in particular is the centerpiece of the movement symphony.  It guides the angles and loading patterns for the joints below and absorbs much of the force for the joints above.  Synchrony and efficiency can go a long way in reducing injury risk and increasing running economy.  (3,7,12,13)  For a simple 5 min example of some dynamic hip mobility exercises, view a simple routine I give patients:  hip mobility routine.  These exercises would be performed 8 reps each side in slow controlled motions after workouts.

4 . Access to a Swimming Pool –  This one relates to the concept of the post-run mobility routine, but has a twist.  Walking in the shallow end of the pool for 10min a couple times a week after workouts or long runs can help create joint movement in a less than 100% weight-bearing environment.  This creates similar benefits to dynamic stretching routines, where imbibition takes place (a pumping of the joint to help clear old fluid and bring in new fluid that keeps the joint lubricated and pliable).  Additionally, there is a pressure gradient that forms helping to move lymph fluid.

For example, if you are standing  at a depth of 4.5 feet of water, you are creating a pressure gradient equivalent to 77 mmHg at your calf (approx. 3.5 feet below the surface), which is over 2x’s greater than standard graduated compression socks or sleeves (which are usually around 22-32 mmHg).  Now add motion to that pressure gradient by walking and you create an efficient way to clear excess inflammation post-workout without blocking the adaptive response.

In contrast, ice bathing post-exercise can block the adaptive response of the workout by creating excessive vasoconstriction (a tightening of the blood vessels) in the tissue preventing the inflammatory response, key component for tissue adaptation (read more about this from an earlier post here), from occurring while also delaying fluid clearance.  The big negative here is time.  I understand that it’s tough to get to the gym, change, get wet, change again, and get home.  But, adding this component in 1-2 x’s per week, especially in the evenings following hard workouts or long runs, can help reduce your injury risk by providing an efficient means of soft tissue recovery and lymphatic fluid clearance. (1,2,4,6)

5. Ancillary Strength Routines – Strength work is important for every runner.  The high school aged and younger competitive runner will develop proper balance, coordination, mobility, stability, and core endurance by incorporating a properly designed “strength” program to teach them how to move efficiently.  The experienced and older athletes will maintain aspects of power, speed, tissue elasticity, and joint control by utilizing strength work to support their adrenal system and and promote recruitment of both local and global stabilizer muscles. (7,8,10)  But, in both cases, the program must be progressive and timed depending on the goal of the workout stimulus and the phase of training.  For a simple and generalized strength training progression, read this post from Coach Jay Johnson on the topic: progression of strength training for runners.

These 5 components can carry significant weight when trying to optimize your training and recovery.  We place a ton of emphasis on getting the most out of our performances and dwell on the ones that don’t go as well as we like.  Rather than being stubborn or neglectful of these components, be attentive and do the little things that will enhance and possibly salvage your training cycle.

References

1. Bleakley, Chris M., and Gareth W. Davison. “What is the biochemical and physiological rationale for using Cold Water Immersion in Sports Recovery? A Systematic Review.” British Journal of Sports Medicine (2009): bjsm-2009.
2. Dorit Tidhar, B. P. T., Jacqueline Drouin, and Avi Shimony. “Aqua lymphatic therapy in managing lower extremity lymphedema.” Journal of Supportive Oncology 5 (2007): 179-183.
3. Heinert, Becky L., et al. “Hip abductor weakness and lower extremity kinematics during running.” Journal of Sport Rehabilitation 17.3 (2008): 243.
4. Jakeman, J. R., R. Macrae, and R. Eston. “A single 10-min bout of cold-water immersion therapy after strenuous plyometric exercise has no beneficial effect on recovery from the symptoms of exercise-induced muscle damage.”Ergonomics 52.4 (2009): 456-460.
5. Johansson, Christer, et al. “Stress fractures of the femoral neck in athletes The consequence of a delay in diagnosis.” The American journal of sports medicine18.5 (1990): 524-528.
6. Leeder, Jonathan, et al. “Cold water immersion and recovery from strenuous exercise: a meta-analysis.” British Journal of Sports Medicine (2011): bjsports-2011.
7. Leetun, Darin T., et al. “Core stability measures as risk factors for lower extremity injury in athletes.” Medicine & Science in Sports & Exercise 36.6 (2004): 926-934.
8. Mann, Douglas P., and Margaret T. Jones. “Guidelines to the implementation of a dynamic stretching program.” Strength & Conditioning Journal 21.6 (1999): 53.
9. North, Kylee, et al. “The effect of partial weight bearing in a walking boot on plantar pressure distribution and center of pressure.” Gait & posture 36.3 (2012): 646-649.
10. Nadler, Scott F., et al. “Hip muscle imbalance and low back pain in athletes: influence of core strengthening.” Medicine & Science in Sports & Exercise 34.1 (2002): 9-16.
11. Peiffer, Jeremiah J., et al. “Effect of cold water immersion after exercise in the heat on muscle function, body temperatures, and vessel diameter.” Journal of Science and Medicine in Sport 12.1 (2009): 91-96.
12. Powers, Christopher M. “The influence of abnormal hip mechanics on knee injury: a biomechanical perspective.” Journal of Orthopaedic & Sports Physical Therapy 40.2 (2010): 42-51.
13. Souza, Richard B., and Christopher M. Powers. “Predictors of hip internal rotation during running an Evaluation of hip strength and femoral structure in women with and without patellofemoral pain.” The American journal of Sports Medicine 37.3 (2009): 579-587.