How to minimise time off running with injury

5 WAYS TO AVOID INJURY

1/ Avoid these pills

Last year the US Food and Drug Administration issued stronger warnings about a class of antibiotics – fluoroquinolones – linked to a risk of tendon tears. ‘Fluoroquinolones affect proteins that regulate tissue repair – and can be directly toxic to tissue,’ says Dr Susan Joy, director of Community Sports Health Network at the Cleveland Clinic, US. Ask your doctor about safe alternatives, including penicillin.

2/ Buy a second pair of running shoes

A Scandinavian study reports that runners can lower their injury risk by rotating between two or more pairs of shoes. ‘Changing footwear alters your running pattern and varies the forces on your legs,’ says study author Laurent Malisoux. Wear a more supportive, cushioned shoe for distance runs and a lighter, flexible shoe for speedwork. Bonus points for picking up a third: ‘The more shoes in your rotation, the better,’ he says.

3/ Get iron

Iron is essential for shuttling oxygen to muscles,’ says Connie Diekman of Washington University in St Louis, US. Having low levels can hurt your muscles’ ability to repair themselves. Women need 14.8mg per day; men need 8.7mg. Iron-rich foods include lean red meat, fish, dark poultry and beans). If you experience ongoing fatigue or a sudden decrease in performance, ask your doctor to check your stored iron levels.

4/ Drink up

Taking a few swigs of water before a summer run is a no-brainer, since dehydration can increase your risk of heat-related illnesses. But fluids are essential for all physical reactions – including muscle functioning and joint cushioning, says nutritionist Marni Sumbal. Women should take in 2.6 litres of fluid per day and men should get 3.5 litres, which can come from water, sports drinks and water-rich fruits and veggies.

5/ Sack off the flip-flops

If you’re prone to plantar fasciitis or Achilles tendinitis, don’t spend your summer in flip-flops, says sports podiatrist Stephen Pribut. They offer no arch support and having to clench your toes to hold your foot in place can cause Achilles tendinitis. But most worrisome: ‘The repeated rise of your heel off the back of the flip-flop can alter your gait when you walk – and possibly when you run,’ says Pribut. Try sandals with a moulded arch.


5 WAYS TO BOUNCE BACK FASTER

1/ Keep moving

You can continue to run if slowing down allows you to log miles without pain and with proper form, says Lewis Maharam, a sports doctor in New York City. ‘Running while recovering from muscle strains or tears brings blood flow to the area and helps the muscle heal properly,’ he says. However, don’t run if an injury changes your gait, or if you have a stress reaction or fracture. In those cases, keep up a routine with no-impact cross-training, such as pool running or swimming.

2/ Stay flexible

By foam-rolling and performing dynamic stretches you pump healing blood to injured tissues and improve range of motion, says physiotherapist Michael Conlon. ‘Runners often think that they don’t have to do these things because they are not hitting the road while an injury heals but it’s almost more important to make them part of your daily routine now,’ he says. Roll then stretch, before and after a cross-training workout. Skip any stretches that aggravate your injury or feel painful.

3/ Eat up

If you’re logging fewer miles, scale back on dietary indulgences such as pizza, ice cream and chips to avoid gaining weight. But don’t crash-diet: your body burns calories to heal, so you may need more than you think, says a 2015 study. Taking in enough protein is especially important: ‘Protein is broken down into amino acids, your body’s building blocks, to repair muscle tissue,’ says Maharam. Include a healthy protein source, such as eggs, fish or beans, in every meal.

4/ Manage pain

Some studies have found that NSAIDs such as ibuprofen inhibit healing by interfering with the process that causes inflammation and tissue repair. Others say that occasional use won’t hinder muscle repair. Sports specialist Dr Nathaniel S. Jones prefers the middle ground: pain can disrupt sleep, and over-the-counter pills may help you get the quality sleep that’s needed for the night-time healing process. But limit anti-inflammatories at other times – taking them long-term can cause kidney damage.

5/ Lessen stress

If you run to blow off steam, you’ll likely need to find another form of physical activity to manage your stress. ‘Not only does stress cause the body to release hormones that affect healing and recovery, but having an injury in itself can cause stress,’ says Jones. Try meditation, yoga or gentle hiking in a quiet, scenic setting – a 2015 Stanford University, US, study found that a 90-minute nature walk reduced negative thinking more effectively than a walk in an urban area.


HOW TO MANAGE THE MENTAL ASPECTS OF INJURY

1/ Treat recovery like training

A runner with a goal race looming will have a training plan that includes all the ingredients to prepare. When that race is no longer an option, one way to deal with the low mood is to treat the rehabilitation process just like training. ‘[Try to see] rehab as a form of training, rather than an impediment,’ says Chris Carr, a sports and performance psychologist. He encourages athletes to set goals related to cross-training or strength exercises on the rehab journey.

2/ Flex your mental muscles

Studies have shown practicing ‘mind over muscle’ techniques can help with recovery. Carr suggests using relaxation training, mental imagery and self-hypnosis to help reduce stress and increase positive thinking. Lie in a comfortable position and concentrate on one muscle area at a time, breathing calmly. Clench the muscle area for a few seconds, then relax the area; repeat twice before moving on to the next muscle group. This can be especially important because the added muscle tension tied to stress and anxiety could hinder an athlete’s ability to recover.

3/ Report pain and discomfort

Runners coming back from injury face a new set of psychological issues as they return to regular training – working out what’s acceptable pain and pain that should stop them from running is difficult. Many are hyperaware of the injury and afraid of getting hurt again. Experts recommend conferring with somebody who can use facts to calm any anxieties. ‘Understand that being ‘tough’ and underreporting pain could lead to further injury,’ says Carr.