Acute Injuries Happen to Runners
- by Sarah Richardson |
- Runner's Healthstyle, Running Mindset, Sarah's Running Journey
Even the best of plans can be interrupted due to an accident. Here’s a few things to keep in mind when your training comes to a screeching halt due to an acute injury. I’ve been fortunate enough, since learning how to ChiWalk and ChiRun, to only have one overuse injury (self-inflicted) during the past 8 years. My sound practice was interrupted in March 2022, when I slipped on ice and broke my fibula in two places.
Acute Injury vs. Chronic Injury
As defined by Google, acute injuries happen suddenly, such as when a person falls, receives a blow, or twists a joint. These are accidents and happen in an instant.
Chronic injuries usually result from overuse of one area of the body and develop gradually over time. For runners, the following are considered overuse injuries: runners knee, shin splints, or plantar fasciitis.
With good form and body strength, excellent body sensing skills, and adhering to the principal of gradual progress, most chronic injuries can be avoided, and it’s one of the reasons I love ChiRunning so much. It kept me running smart and safe for many years!
It also prepared me to deal with, and recover safely from, an acute injury. Here are a few of the biggest lessons I’ve put into play for a smooth recovery…
Know Your Body
I can honestly say that knowing my body has made all of the difference in the world with my course of action, treatment, and recovery time.
In 2009 I fell in a pothole causing an acute injury to my left ankle. Back then I was a conventional runner and was not at all in touch with my body. Because it happened during a race, I literally got up and kept running on it to finish that leg of the adventure relay race. I rested over night and completed my last leg of the relay the next morning despite the pain.
I share this because that acute injury took me almost 4 years to return to running “normally.” And many more years to get back to long distance running. I had to deal with so many compensatory injuries that could have been avoided had I known and listened to my body at the time of the injury.
But I chose to sweep it under the rug, call it a sprained ankle and “rest.”
Fast forward to 2022 and I’ll share with you my completely different approach to a very similar injury to the same ankle.
The minute I lost grip of the road and slipped on the ice, I knew I couldn’t save it. I relaxed into my fall and heard a faint crunch.
I let my friend Meg know I was OK and needed a minute to “check things out and breathe.”
I did an immediate self- assessment and rated my pain level at about a 5 while still on the ground.
I got up to standing without using my injured ankle and hopped to the side of the road.
Meg then went for her car, which was less than a quarter mile away. I was grateful for her calm demeanor, and that she could pick me up.
While she was going for the car, I continued my self-assessment.
I noted:
→ My ankle was swelling.
→ The joint felt tight and I was experiencing a pain level of about 6-7.
→ With even a touch of pressure to the toe, the pain level shot up to a 9.
→ The rest of my leg felt fine.
→ I could move my toes.
→ Although my ankle was hurt, the rest of my body was fine.
→ My heart rate and other vitals seemed slightly elevated, but normal given the circumstance.
→ I was feeling anxious and wanted to make sure I took care of this ankle in the best way possible.
I was able to submerge the ankle in some snow while I waited for a ride. I did some very deep breathing and came up with a mantra, “I’m OK. I’m OK. I’m OK.”
Seek Out Help
While Meg went for the car, I also called my husband, who happened to be right around the corner heading out to go skate skiing. He intercepted Meg, she went to work, and Mike was able to bring me directly to the Emergency Room.
I was careful not to put any pressure on the joint and continued to breathe deeply and recite my mantra.
The ER staff checked my vitals and sent me for a series of x-rays on my ankle. The doctor then confirmed that my fibula was broken in two spots. A spiral fracture on the lower outside part and a sharp split on the lower rear part of the fibula.
I was so grateful for the choice I made to first talk with Meg, then get a ride straight to the ER, and get the information I needed to set me on the correct course for recovery. Although it was still the beginning, it was not without a plan like the 2009 episode.
As you continue to read, you’ll note that it truly takes a village to care for an injury. From the help getting a ride to the ER, help getting dressed and fed, to the professionals at the ER and orthopedic specialists, each person and professional played a role in my healing.
Manage Your Mindset
In 2009 I was irate when I fell and twisted my ankle. Who knows what I actually did to it at the time because I never had it looked at. I used sheer grit, will power and force to continue running and “finish” my legs of the race.
I put my ego over my body. I let my perception of being a failure for not finishing get in the way of healthy healing.
Even after the race I used justifications to pretend that running in pain and then resting when I needed to was a good thing, and that it would just heal on its own, over time.
In fact, it wasn’t until I started ChiRunning 4 years later that the true and complete healing began. And it was because I finally learned how to get my mind and body to work together.
I used this to my advantage and took an entirely different approach after my fall in 2022.
I trusted the messages my body sent me via the whispered crunch and the immediate pain.
I used my mantra to calm my body and nervous system.
This allowed my mind and body to work together to bring ease while I waited for help.
I reassured myself that I was doing all of the right things. I knew this time was different because I was different. I had evolved my running over the past years and transformed it into a practice of self-respect versus a challenge of my wits.
I knew the minute I fell that I was on the road to healing, and this was in essence my “Great Do-Over!”
My mindset allowed me to open up and receive all of the help and healing possible. I just went with it and set up the conditions for healing to happen.
Trust the Process: Embrace Patience
The process for me included a number of things:
→ Reaching out to a local legend PT and asking for her top orthopedic referrals (Thank you Donna Smeyers!!!).
→ Getting a first opinion.
→ Getting a second opinion.
→ Choosing the route that fit my lifestyle, goals, and supported my mindset and future as an athlete and running coach.
→ Following the protocol as prescribed by my trusted professional, while listening to my body.
→ Adopting a receiving mentality and embracing patience.
I was thrilled with my second opinion, who happened to be Donna’s first choice. They were well informed and took my circumstances and future goals into careful consideration.
I don’t look like an athlete, but I am an athlete… And living my runner’s healthstyle is of most importance to me. They listened and offered up solutions. I felt like I had a team to rely on.
When I left Mansfield Orthopedics, I was elated.
They took updated x-rays with loading and gravity weight when laying down to assess for joint dysfunction. They determined my break was on the edge of surgery vs. no surgery. The joint was acting stable, but they wanted to make sure it would remain that way as the swelling subsided.
My doctor asked me to begin to put some weight on the ankle joint and test the stability over the next week. I was very careful to use what I knew from ChiWalking to help me:
→ I Stayed aligned in my feet/legs, which kept me in the zero pain zone. Thank you ChiWalking!
→ I Made safety a priority. I kept my scooter beside me in case I ever needed it. I did not want to move into pain or push through fatigue.
→ I used gradual progress with anything I did that was related to my ankle. I was increasing the time on my foot very gradually and always assessing based on my discomfort/pain level.
→ I rested and iced between. Just because I was feeling good while walking short distances on flat, paved surfaces didn’t mean resting, icing and elevating my leg was no longer part of my protocol. I stuck to it knowing it was beneficial for my overall healing.
Make Informed Decisions
After spending a week walking safely on my leg I went back for another round of x-rays. This time the swelling had subsided and we added some manual manipulation to the joint to view its stability under pressure.
With pressure coming from the top, as in walking in alignment, the joint was intact, aligned and strong. I was not surprised as this was my experience while engaging in weight bearing activities.
With pressure from the sides, the x-rays clearly showed unnatural gaps due to the new placement of the fibula from the breaks and was deemed unstable. The discomfort was another tell-tale sign that my ankle was compromised when side pressure was applied.
My doctor actually gave me the choice to choose or decline surgery and provided the research associated with either choice. He carefully showed me the difference in function between my sound and injured ankle. I could visually see how much further he could shift my injured ankle in comparison to my sound one.
After taking the x-rays, the manual manipulation of my ankles, the pain levels, and discussing the the research he provided, I decided to opt for the surgery for the following reasons:
→ I love to hike and run on trails. I live and train on gravel roads and other uneven surfaces making stable ankles a must (in my humble opinion).
→ The research for non-surgical healing had not been conducted long term enough to determine if there was further deterioration of the joint cartilage.
→ The research for non-surgical healing had not been conducted long term enough to determine if early onset arthritis was considered likely or even a possibility.
→ I had a potential pre-existing condition in that ankle and wanted to give it the best chance for stability over time.
In Conclusion
Acute injuries can happen in an instant. We get the choice on how to react to that situation, which can lead to a smooth or bumpy recovery.
In comparing my 2009 and 2022 acute injuries I can say without a doubt that I have learned a ton and came at it with a 100% different approach, which I’ve outlined above.
When we know our body well, seek out the right help, keep our ego in check, trust the process and make informed decisions, the road to recovery can be informational and healing for your mind, body and soul.
In 2009 it took me more than 4 years to get back into running without pain. This time, I have a plan in place and within two weeks from my surgery I’ll be walking again. Armed with proper alignment and relaxation, gradual progress, and the body sensing I’ve learned from ChiWalking and ChiRunning, I know I’ll come back with a stronger and more confident running practice than before.
Hi, I'm Sarah!
I help struggling runners ditch excuses so they can get consistent, feel good and love running again.
Learn more about me and how I can help you here.
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You can read how Sarah got back into running after an injury and learn the exact framework she uses to help other's do the same.
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Sarah Richardson
Sarah Richardson, M.S., M.Ed., is a certified educator, Master ChiWalking/ChiRunning® Instructor and co-owner of ChiLiving. She is also the best selling author of From Sidelines to Start Lines: The Frustrated Runner's Guide to Lacing Up for a Lifetime and has been published in Chicken Soup for the Soul: Running for Good. In addition to teaching and running, Sarah loves to travel, write and take photos.