The First Step

It’s simple: Don’t treat the name. Too often we want to affix a label to a symptom or condition. And then with that information, we rush to have the “name” treated instead of looking at underlying causes. This approach often comes up short because up to half of initial diagnoses are incorrect. In fact, assuming the serious medical problems have been ruled out and there’s no need for first-aid care, such as surgery for a meniscus tear or a cast for a broken bone, most endurance-related problems are relatively minor and easy to correct. And they often don’t have a name to attach except for what really is the cause, such as muscle imbalance.

While most injuries—95 percent or more—are of the less serious nature, there are still significant imbalances causing them. This also doesn’t mean a minor problem won’t cause pain or keep you from training—it can. Even a relatively minor muscle imbalance, for example, can be debilitating, and if not corrected by your body or a health-care professional, can potentially end your athletic career. Yes, even minor problems can lead to serious consequences—a common cause of frustration in athletes who sometimes go from one health-care professional to another without obtaining relief from a very painful condition.

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Most injuries are functional, meaning that the problem is much less serious than say, a torn ligament, because the injury is without significant damage. For this reason, even extremely painful conditions can be resolved very quickly—sometimes during one visit to an appropriate healthcare professional. Or just changing shoes, when that’s the primary cause of serious knee pain, can return the body to pain-free function by the next day. An analogy is your car not starting. It just might be due to a faulty battery contact or a spark plug that needs replacing. A good mechanic can make a repair in minutes; you certainly don’t need a new engine. (This is not to say that all injuries can be corrected with one magic treatment by some sports doctor—they can’t.)

Functional problems can often be softtissue injuries, such as simple muscle imbalances. These types of problems can be cured with more conservative measures and quite often by the athlete. Let’s discuss what you can do to help your body correct its own problems. After all, that’s what your body is supposed to do. And you will be pleased to know that most injuries also have simple remedies.

One problem with an injury is that it can restrict your training. Aerobic activity is very therapeutic: it improves blood flow and immune function, and significantly helps support bones and joints. Consequently, being unable to train can prevent your injury from self-correcting. So the first consideration is to find an aerobic activity that does not aggravate the problem, and do it. Walking is a great remedy if it doesn’t hurt. Running in a pool is also effective—the shallow end of a pool will provide some but not too much gravity stress. Stationary equipment, such as a bike, sometimes works well, but it’s important to make sure it’s set up or adjusted to fit your body.

There’s no need to spend the same amount of time performing these activities as your previous schedule; just maintain some level of activity that does not aggravate the injury—when in doubt, do less. This active recovery is powerful, so don’t underestimate the benefits. Even a twenty-minute jog in the pool or a half-hour easy walk can stimulate the aerobic system providing many benefits for the body to correct problems. Consider these activities as a workout, and perform a warm-up and cool-down each time—even if the entire workout consists of warming up then cooling down! It’s also most important to avoid stretching during this period, as discussed in section I. Many injuries are the result of over-stretched (weak) muscles, with tightness developing as a secondary problem. The combination of both is muscle imbalance.

If you are experiencing pain, use that uncomfortable sensation as your guide. Ask yourself: Does the workout lessen the pain? Not affect the pain? Worsen the pain? The best rule to follow regarding pain is that if it lessens as your workout progresses, it’s generally a good sign. This is what will often happen if you already have a great aerobic base. (Of course, having a great aerobic base is one of the best ways to avoid injuries.)

If the pain isn’t exacerbated following the activity—immediately or the next morning—that’s a good sign, too. But if the pain gets worse with activity, avoid it. In this case, you can try another activity, one that is easier and lower in stress. This might include swimming.

An effective option is to take three days off and try to work out again. Occasionally, whenever an athlete could not get to my clinic, I would recommend that he or she take three days off as therapy. Most often, this “rest” approach is done before an injury has become extreme, especially during its early stages. This gives the body a chance to recover and possibly correct its own problems. Resumption of training should be cautious for about a week or two to make sure the problem does not recur.

I can’t emphasize enough that both warming up and cooling down have significant therapeutic effects on your entire body—from your muscles to your metabolism. In many cases, lengthening your warm-up and cool-down time can also greatly help.

Keep all your workouts strictly aerobic until your injury heals. Be even more conservative with your exertion; train below your maximum aerobic heart rate. Avoid all weight lifting, anaerobic intervals, and other hard workouts, and of course competition.