Injuries, aches, and pains are the enemy of any committed athlete. Most endurance athletes would consider themselves Type A and these setbacks just make the itch of feeling accomplishment every day even more difficult to obtain. For the past 4 years, I’ve experienced a fair share of aches, pains, and injuries. Whether it was a season-ending injury like a pinched sciatica nerve during my senior year of high school track or a strained back muscle that kept me from running for 3 days, I made sure to take note and evaluate the potential reasons that might have led to such an issue. Over the years, a couple of main points have stood out to me. First, something like foot pain does not automatically mean it is a foot injury. Take plantar fasciitis, for example. This foot pain is 99% of the time caused by something other than a weakness in the foot (It’s often a reflection of tight or weak calves). Second, along the same lines, pain is a symptom of the injury, not the cause of the injury. Calf pain does not mean weak calves caused the injury. While it definitely could be, there are a handful of other muscles that play a crucial role in the function of the calf. Lastly, rest or time off is not a promise to fix-all possible injuries and pain issues. I used to believe that time healed everything but over time learned that is not the case. Time will heal things when you take action during that time but simply throwing the shoes in the closet and disregarding any habit changes over that time will most likely not treat the underlying cause. Today conventional medicine treats the symptom, not the root cause. Cortozone shots, NSAIDS, and topical creams are just a few “conventional medicine” treatments that often easily remove the symptoms (pain) but leave the root cause left behind. There are four categories that I believe are the most important areas to examine when digging to uncover the root cause of the injury.
1. Inflammation – It is important to first understand the two different types of inflammation. First, there is acute inflammation. Acute inflammation is considered “good” inflammation and is often revealed by the presence of sore muscles. This inflammation occurs when muscles are broken down from any kind of hard training session. The everyday grind of training is a long strung out process of acute inflammation (muscle break down) and build up. That progress is made in the gym, on the road, or on the field. Acute inflammation can be a cause of injury when the body is exerted much further than it can handle. For example, you take two months off running and the first day back you run 15 miles. This is a recipe for an injury caused by acute inflammation. The body is not ready for that kind of volume dropped onto the neuromuscular system. These kinds of injuries are probably more common in sports such as soccer, football, or baseball where just one play can cause a torn muscle, ACL injury, or concussion. Acute inflammation injuries are much less common in the world of endurance because training is often made up of lower exertion and higher volume. Long runs, bike rides, or swim sessions are usually not going to result in acute inflammation injuries but they can easily build up to be a part of the second kind of inflammation. Secondly, there is chronic inflammation. Chronic inflammation is developed over a much longer period of time of weeks, months, or even years. Examples of chronic inflammation can be caused by a nutrient-poor diet, high volume training without adequate recovery, exposure to large amounts of pollutants, heavy metals, pesticides, or even a high fasting blood sugar. A diet high in processed foods like sugar, grains, and industrial seed oils over time will come to pay its dividends. The problem with a diet high in these foods is not necessarily the “empty calories” but the amount of inflammation they cause in the body. Training should not be a free ticket to gobble up more of these foods. They aren’t just empty calories. They are bombs of inflammation that will slow recovery, negatively affect your hormones, and put you on a path to chronic inflammation. I’ve had my fair share of processed foods but until you redefine what a reward food is, it’s not easy to get rid of it. Rewards shouldn’t negatively affect metabolism, hormones, and muscle recovery. Believe it or not, you can drastically change your taste buds to appreciate healthier foods. I don’t mean that unhealthy food won’t all the sudden become a temptation you don’t have to battle. I simply mean that whole food (unprocessed meat, fresh fruits, vegetables, and raw nuts & seeds) will become much more appreciated. A great deal of this has to do with the food environment. Willpower is not something you should bet your health on. The presence of fresh-baked chocolate chip cookies and hyper-palatable snacks like chips and popcorn around the house makes it near impossible to pass up on, especially if your like me and hate wasting food. Learn to cook and surround yourselves with nutrient-dense whole foods and your body will appreciate it.
2. Muscle imbalances/weaknesses – A weak core can cause a calf injury. I am no expert when it comes to kinesiology or human anatomy but I can tell you from experience that I’ve had aches and pains when running in muscles I didn’t even know had to do with running. A strained neck muscle can make running miserable. The more I studied plantar fasciitis the more I realized it had to do with weak calves. The more I’ve worked on strengthening and stretching my calf muscles the more relief I have felt in my foot. It is important to establish strength routines to ensure the hip flexors and core are strong enough to support the rest of the leg muscles. Creating daily habits like a core routine, band strengthening exercises for hip muscles, and 2-3 strength training sessions with weights a week can go a very long way in enjoying a sustainable and successful training block.
3. Tightness – Alongside muscle weaknesses, tightness can become another issue that causes injuries and fuels chronic inflammation. Obviously, focusing on quality static stretching can help remedy this issue but there is also a handful of other tools that can be established to help tight muscles. Foam rolling, a lacrosse ball, and muscle gun can all go a long way when it comes to breaking down knots, scar tissue, and allowing blood to more easily flow throughout the muscle. I personally focus on static stretching after a run and or in the evening before bed because research has shown static stretching before endurance exercise is not helpful, in fact, it could be doing harm.
4. Nutrition (Deficiencies) – Nutrition in the world of committed endurance athletes is a big one. Many factors from this lifestyle can lead to under-eating, overeating, and or eating disorders whether unintentional or intentional. The temptation to lose weight to run faster can undoubtedly lurk around. The temptation to devour a large meal after long miles can also lurk around. The temptation to mask those two (eating disorders) is also lurking around. Wisdom plays a big role in establishing a healthy and sustainable nutrition protocol. It takes time and experience to learn how to navigate this piece of becoming a successful athlete.
Regarding this topic and injuries, I mainly want to focus on nutrient deficiencies. Over the years as my nutritional protocol has evolved, I’ve focused less and less on calories and more and more on nutrient density. Nutrient density (Vitamins, minerals, amino acids, and fatty acids) is what creates a sustainable diet that will control inflammation, hunger, and help you bounce back for tomorrow’s workout. Whole foods are going to be the most nutrient-dense but it is important to consider bioavailability and digestibility. For example, take spinach. It is often touted as one of the best sources of iron. The problem is that research has shown the iron found in plant foods (non-heme iron) is much less bioavailable than the iron found in animal foods (heme iron).
The digestibility of foods is also another crucial factor in ensuring the nutrient-dense foods your eating is actually being used. Nuts, seeds, grains, and even leafy greens are all rich in antinutrients which can negatively affect the absorbability and even cause other critical nutrients to be bond to these compounds preventing minerals like calcium and magnesium to be absorbed. I personally focus on healthy fats, specifically monounsaturated fats found in foods like macadamia nuts, salmon, almonds, avocados, and olive oil. Without adequate dietary fat, intake hormones can suffer and essential fat-soluble vitamins cannot be absorbed. Another critical nutrient I focus on is protein, specifically collagen. Collagen is a protein that is responsible for rebuild, repairing, and strengthening joints and ligaments. This is so important for preventing injuries like Achilles’ tendonitis, knee issues, and many other ones.
Conclusion: In order to have healthy, sustainable, injury-free training it is important to continue examining the root causes of what might be causing aches, pains, and injuries not just masking the symptoms. I’ve written a handful of other related topics regarding what I personally do to ensure I can put in miles day after days in a healthy manner.