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The Top Reason Injuries Won't Heal

Photo of a physiotherapist working on a knee

Take time for conditioning

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[27/04/2021]

The majority of runners get some kind of an injury each year. The more serious ones can take a long time to heal, yet there's an impatience to get back running as soon as possible. And THIS is the number 1 reason why injuries just won't heal.

With anything other than a minor problem, the runner will be prescribed some kind of exercise regime which is designed to strengthen the injured area. They feel stiff and sore, but this gradually goes away and everything feels quite normal. Feeling better, they try a gentle jog, then a short and gentle run. It still feels fine, so the runner returns to a full running schedule.

But here's the problem. While everything feels fine, the body has only started the healing process. If a muscle has been torn, new fibres have to be grown. Then they have to become strong. Without giving time for strengthening AND building up the load to promote strengthening, the miles start to build up before the fibres are ready.

It's a classic case of doing too much too soon! So obvious, and so well understood. Yet we all keep doing it. Time after time. Injury after injury. Day after day and month after month, the injury keeps coming back.

So what do we do about it?

First, we need to give the body the extra time to come to terms with the injury and to start the healing process.

Next, we need to give the body time extra time to COMPLETE the healing process.

Then we need to take time to get the body re-accustomed to the stresses that we want to put on it.

Time to heal is straightforward - it's just time. Conditioning the body needs a little more thought, because the nature of the conditioning will depend both upon the type and severity of the injury. The essence, though, is to work out what stresses you place on which areas. This depends on the kind of running you do and, for example, the amount of effort you tend to put in. A jog around the local park induces different stresses to a 100 metre sprint or a half marathon.

So you need to look for exercises that will stress the injured area.

Now you have to make a plan which starts with a low level of stress and builds up to the levels that you expect in normal running.

Say you have an Achilles problem. The injury heals, and you move into the conditioning phase. You might do some heel lifts. That's fine, but remember that doing heel lifts at a controlled pace is entirely different to running uphill at speed. That means you need to add extra stresses - probably by wearing a weight pack. Start with a kilo or two - a weight that you can manage comfortably. Then gradually build up the weight until it's around 20% of your body weight. This gives the repair both the time and the stresses that it needs to heal fully.

Of course, every injury is unique, and different areas of the body need to be conditioned in their own specific way. In many cases, you can work out a plan yourself just be finding out the basic information you need. In more complex cases, you probably need to get advice from a physiotherapist. They'll be able to assess your injury properly, recommend a proper recovery programme and monitor your progress up to the point where you get the green light to return to your normal schedule..

diagram showing the anatomy of the leg

“Time after time, the injury keeps coming back”