Recovery. And, Injury?
We all know recovery is important. But, what does that really mean? More to the point, how do you do it? Like everything I talk (write) about where training is concerned, it can be different from person to person. There are some generalities. Hydration. Drink plenty of fluids (non-alcoholic first, then you can enjoy an adult beverage or two). Nutrition. Depending on the length of the race, or training run, you have expended a large, to extraordinary, number of calories. They need to be replenished. Rest. After extra-hard efforts, your body needs time to repair. Sleep does the trick. Seems simple, right? Well, there are so many other things that can factor in to help with recovery. For example, stimulating blood flow. Not a whole lot of argument that this helps speed recovery of damaged muscles, but there are lots of thoughts on how . Massage. Rolling. Stretching. Compression . All approaches have some evidence that they help. So does good, old fashioned, walking.
As an example of what I do for recovery, I’ll walk through some of my time since the 50 miler. This is a bit of a unique situation because I had a nagging potential injury. I say potential injury because I make a strong distinction between “hurt” and “injured”. When I talk about it hurt is something that causes pain or discomfort, but there is no physical damage. An injury usually causes pain, but in my book, always, is because of something damaged. Torn muscle. Inflamed tendon. A physical problem that can be pinpointed and require some sort of intervention to be repaired. What I was dealing with was something that didn’t hurt, but may have been an injury. My knee. But, I’m getting a bit ahead of myself… we’ll come back to this.
After a race or long run, I like to cool my legs down, if I can do it soon after. I used to use ice baths a lot… until I got a pool. Even in the winter (remember I live in the southern US, so winter isn’t that cold), after hard efforts, I will wade in for a cold-shock. It feels good to feel the heat from the pounding of the road be pulled out of my joints by the water. During the summer, I dive in the pool. The cooler water (compared to the air) does the trick and I’ve found the weightlessness feels incredibly good on tired legs!! I also use compression gear to help keep blood flowing. Usually, recovery-specific compression socks. Sometimes, compression tights. In this particular case, I was so over-the-moon with the race, I sort of forgot about it. I changed into dry clothes and walked around for awhile, watching and cheering the other runners. And, hydrating. When we finally got back to the hotel and I got showered, then I put on the compression socks. I chose to walk to dinner (totally not hungry, but knew I needed calories) to help keep blood flowing. Every time I sat still for too long, getting up and moving again got more and more difficult. So, day of race recovery involved hydration, nutrition, compression, and walking.
Early to bed, not-so-early to rise was the plan. Didn’t work out that well. Sleep was more difficult because every time I moved, something in my legs hurt! I finally conceded and got up to do a thorough assessment. I always wait until the next morning to do this. So many little twinges clear up after the first night of rest. Left knee super tight. Right groin hurt. Everything else pretty standard “just sore”. Needed to get blood moving. Had the option of easy jogging or walking on the training schedule. With the knee not moving well, I opted for walking. A slow start, but things loosened up fairly nicely over the 20min. I re-assessed, and the knee was the only thing still bothersome. But, not painful. Tight. Still not hungry, but knew I was still in a large calorie deficit. So, nibbled on some breakfast. As usual, tried to keep moving during the day to keep blood flowing and loosen up the sore muscles. And, hydrate, hydrate, hydrate!! For me, the day after a big event is a great day for caloric drinks that I normally avoid. Helps with hydration and glycogen replenishment. Other than the knee and groin, legs were already feeling better by the end of the day. So, day after recovery involved hydration, nutrition, and more walking.
Was able to get a good 10h or so of sleep Monday night. In the morning, took off for a super easy run/jog to get the body moving and blood flowing. Everything but the knee, groin included, loosened up by the end of the 30 or so minutes. Iced the knee and took some ibuprofen. At this point, I was still not really concerned about a potential injury. It had only been two days.
In general, two or three days post-race, I feel my focused recovery is over and start easing back to my normal routines. In this case, after three days, I had very little soreness left anywhere except the left knee. That damned knee. But, it was getting better. Each day. Each run. It took longer to tighten up. And stayed tight for less time after the run. By the end of the first week, it wasn’t noticeable other than when I was running. And for a short while after. Nothing ice and ibuprofen couldn’t handle.
At that point, a little over a week out from the race, I was starting to get a little worried. I had this knee flare up before, but it always went away completely within 3-4 days. Not this time. But, it kept getting better. Slowly. So slowly. I’d feel it tighten up during a run and ask myself how I’m going to be able to get through these next races. I’d resolve to make an appointment to get it examined. Then, by the time I’d get to work, it was fine. I wouldn’t even think about it. But, finally, I decided enough was enough. I needed to know if I was injured. If so, I was being really stupid by continuing to train. Went to the local orthopedic group. The doc said my X-ray “looked just like a knee should”. That is a relief!! Diagnosis was IT band tendonitis. Apparently, severe enough to put tension on the outer part of the knee, which caused internal swelling and tightness. He gave me a prescription strength topical anti-inflammatory so I could get off the ibuprofen. And, a date with the physical therapy group.
That was a week ago. I am very happy to say that during my last two runs (10 and 13 miles), the knee/IT band was barely noticeable!! Stoked to know that I’m not seriously injured. I am keeping up with physical therapy. I have at-home exercises and stretches to do daily. And, two appointments a week for hip strength. The moral of the story: don’t be me. Keep focused on recovery until you are fully recovered. If I hadn't been so stubborn and had gone in earlier, I might have been able to get back to 100% quicker. At least I’m almost there now. And, hopefully will be by next week. I have five consecutive days of marathons to race!