(Not) One size fits all

It’s been nine days since Manchester, and I’ve managed just one short run so far. I’ve walked quite a lot – as required by my job and commute – and I’ve been swimming once as well. But my foot is still not entirely happy with me, so today I bit the bullet and visited my physiotherapist.

Like many runners, I am prone to self-diagnosis. There is a huge amount of information online about running injuries and rehab, and if you add my medical background to that, it’s easy to feel like I should be able to figure out what’s wrong and how to treat it without any external help. Experience has taught me that this isn’t necessarily the case, and today’s visit has once again confirmed that!

The problem with looking for injury advice online is that it mostly covers the more common running injuries – things like plantar fasciitis and ITBS – but it can often be very tricky to identify less common injuries. And crucially, even if you can correctly work out what’s wrong, without the experienced eyes of a physiotherapist, you won’t necessarily be able to work out why it’s wrong, and therefore what best to do to fix it.

Even common running injuries can arise in many different ways. Everyone has slightly different anatomy, and a slightly different running style. To properly treat an injury, you need to know why it’s happened. Your treatment can then focus on two things: the immediate rehab of the injury, and the more long-term alterations that prevent it recurring.

Which is why today’s visit was so beneficial. The first thing I learnt was that my foot pain isn’t plantar fasciitis. My online research hadn’t been able to provide me with any other suggestions for the pain, but my injury didn’t quite fit with the descriptions. My pain was on the bottom of my foot, but more along the outside edge than under the heel. So when I was told I had a peroneal tendonitis, I wasn’t really surprised. The explanation of why it happened also made sense: my right leg has always been stronger than my left leg, and this, combined with the fact that I’d struggled with a hamstring problem in my left leg earlier this year, meant that I’d been favouring my right leg and consequently overloading my right foot. So I’ve come away with reassurance (that this injury should clear up relatively quickly) and a plan of action. More strength training and a gradual return to running, and hopefully I’ll be upping my mileage again soon.

The major lesson from all this? If something hurts, don’t rely on the internet, or even the well-intentioned non-specialist (my doctor friends are not particularly helpful when it comes to running injuries!). Your best bet is to visit a good physiotherapist, who can give you the right advice for you. Like most of medicine, running injuries are not one-size-fits-all, so don’t treat them as if they are.

Marathon Blues

The week after a marathon is a bit like the week before: frustrating. If you’re anything like me, you find yourself spending a lot of time wishing that you could go for a nice long run but aware that it’s a really bad idea. Every article I’ve read about marathon recovery drums it into you: a long run like a marathon damages your muscles and stresses your immune system. It is important to take time off to allow these to recover, otherwise getting back to running will take even longer. But it’s not easy.

Last time I ran a marathon, I gave myself a stress fracture in one of my metatarsals. I blame running in the wrong shoes, with a poor running technique. As soon as I crossed the line, my foot was in excruciating pain and for the next two days I could barely walk. The final result was 6 weeks in an air cast and no running for nearly 8. I hated it.

This time round, I finished feeling fine. My quads and hamstrings hurt, but no more than expected. And then Monday was fine. I walked to and from work, which is just part of my usual routine. I felt sore but ok. On Tuesday, I started walking to work and my foot started hurting. The idea that I may have another stress fracture made me want to cry, the thought of missing out on weeks of running was almost too much to bear. A clear x-ray and a quick assessment from one of my colleagues did little to reassure me. And now, three days later, it still hurts, though not quite as much.

The period after a big event is always a struggle to get through, because so much energy and time has gone into planning for it – Marathon Blues is not an unfamiliar term to anyone who runs them! Adding potential injury to that makes things even more stressful. But I’ve got enough time as a runner – and a doctor – under my belt to know that, no matter how much I want to just go for a run and see how it is, that will only lead to more heartache down the line. So the plan for now is this: rest from running. Walk a little, because that’s unavoidable. Swim if your desperate. And if it still hurts by next week, see the physio. But no running until the pain is gone.

Maybe I’ll just start looking at which race to run next instead…