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Training — Dealing with late season injuries before a marathon

Coach Joe English

Coach Joe English

A reader named Lucy wrote me last week asking a question that reads in part:

Last Thursday, I was pushed off the road by a truck and slightely twisted my left ankle. I ran 2 more miles following this incident and did 10 on Sunday, without problems. Yesterday I had to run 6, but just couldn’t deal with the pain on my ankle, calf and shin. It only hurts when I run though. I can walk, bike, or water-run with no pain. Here is my question: until I can run again, hopefully in 10 days or so, can I simulate a long run by doing time on the elliptical, or bike for 4 consecutive hours?

Although Lucy’s particular injury is unique, this situation comes up every season. Lucy explained in her question that she is about six weeks away from her next marathon and she’s looking for help in deciding what to do in the mean-time. I would frame this problem like this: when a runner injures herself just before a marathon for which she’s been training, what should be her strategy in the closing weeks before the race?

There are three areas that I would look at in answering this question for a particular runner: 1) how bad is the injury, 2) how many weeks are there until the race, and 3) how fit is the runner?

How bad is the injury?
The first factor to look at is the severity of the injury. If the runner is only injured to a minor extent and can rehab the injury in a 1-2 weeks, then chances are that their marathon plans are not going to be badly disrupted. Often when runners hit their peak mileage, overuse injuries like shin splints and IT Band issues pop up. In many of these cases, taking a week or two to let the injury heal will put the injury behind the runner and then they can continue on with their training or — if this is really close to the race — just extend their taper by a couple of weeks. In these cases, the runner may want to consider backing off their pace goal somewhat, but they should still be able to compete in their target race.

If the injury is more severe and takes more than a couple of weeks to heal, then the runner is most likely going to have to change their marathon plans. What I’ve often done with runners injured within a few weeks of a race is to have them pick an alternate race 2-3 months from their current race date; take the time to let the injury heal; perform a few short weeks of training (3-5 weeks); and then start their taper toward the new race date. The key to making this work is that the injury really needs to be healed and then the 3-5 week training period that follows is usually enough to bring back their fitness to pre-injury levels.

If the injury is severe enough that the runner needs more than six weeks to get back on track, then they will most likely have to pick a new race 4-6 months out and restart their training after they rehab the injury. There might be cases in which a runner might consider walking or run/walking their marathon, but attempting a marathon with any kind of serious injury could lead to a much more serious problem and could potentially be career ending — so why risk it?

How many weeks are there until the race?
The next critical factor is how much time the runner has until race day. As you’ve seen in the discussion above, the amount of time needed to rehabilitate the injury will drive how quickly the runner is going to be fit to race. But with seasons that can stretch on for six months, the timing of the injury is a complicated one.

Let me give you an example: if an injury occurs on the last long run of the season, with say three weeks to go before the race, then the best course might be to simply consider that time a taper and then attempt the race on those two-to-three weeks rest. I’ve used this method with fit runners in the past who have suffered an injury just as taper is beginning and they’ve had to lay off running until race day. Although this is often a mentally challenging thing to do, in almost every case the runners have finished their marathons.

More difficult timing comes when an injury happens in the window of about 5-8 weeks before the race. In this time period, the runner will be hitting their highest mileage and laying off running during this period means they miss many of the critical long runs leading into the race. Once the runner gets within the final three weeks of the race, then it will be too late to get the long runs in and have time to recover from them before the race. So getting injured in this period is often one of the worst times to do so — it often means postponing the race or greatly changing their race strategy.

An injury more than say 6 or 8 weeks before the race, gets back into a range where there is enough time to recover from most injuries, perform the last long trainings and then taper — perhaps using a slightly shorter taper. Runners often are very “freaked out” when they get injured in this period of time, because it feels like the race is right around the corner, but in truth, there is often enough time to work through an injury (2 weeks), get in a couple of good runs (3 weeks) and do a short taper (2 weeks) — you can do all of that for example in seven weeks.

How fit is the runner?
The third factor to explore is how much training or how fit the runner was before the injury. As an example, Lucy who asked this question, told me that she had run multiple marathons in the past and had completed one 20 and two 17 mile runs in the past few weeks before the injury. This level of training suggests that Lucy will have the training base needed to work through her injury and then taper without much more training.

As an opposing example, a first-time runner was has never completed a 20 mile run would be in a much more difficult situation if she were to injure herself a few weeks before the race and prior to completing her 20 mile run. In this case, after working through the injury, the runner most likely won’t have the necessary level of fitness to pick up again for this particular race.

The bottom line is often that runners benefit from their long distance training for a substantial period of time. If they have made it through their 18 or 20 milers and then need to rest and taper for more than 3 weeks (4-5 weeks total), they most likely will be able to finish the race without doing more long training. They will likely have to slow down their pace goals to make this happen, but they can still race. On the other hand, someone who hasn’t been able to get in any of their long runs is going to have a much more difficult time making it through the race.

Picking a strategy
If you’re faced with an injury in the last few weeks before a marathon, the first thing you need to do is get to work rehabilitating the injury. Your focus needs to stay on getting the treatment that you need to make that broken part of the body better. Whatever training you do — cross-training or otherwise — is secondary to making sure the injury is healed. If you don’t take the time to heal up the injury, it will either come back when you resume training or — even worse — during the race itself.

So, first things first: go see a sports medicine doctor or physical therapist. The clock is usually ticking and the faster you get in to see someone, the more quickly you’ll be back to training.

Once you’re in treatment, then you can weigh your options of what to do in the mean-time that won’t aggravate your particular injury. If you can get in workouts that focus on maintaining or increasing your cardio-vascular fitness, then you’ll be in a good position to re-start training once you’re healed from the injury. Workouts like cycling, spin classes, swimming and water-running are all excellent ways to get in aerobic workouts without pounding on the running muscles.

With that said, you won’t get the benefit of running in the training of your running specific muscles by cross-training — but maintaining aerobic fitness is critical in preparing for the marathon, so it should be emphasized during a lay-off period from running.

There are two things to stay away from in this period: 1) the “I’m running just a little bit” syndrome — in which you shorten down your runs and only run a little bit — which just results in keeping your injury from healing and 2) over-training in another sport where you don’t have the physical capability to handle the training. In the later case, I would worry about Lucy trying to do a four-hour bike workout if she hasn’t cycled much before. That might just cause more injuries.

Summary
The trick with a late season injury is to get to fixing the problem as quickly as possible and then adjusting plans based on the amount of time that you have left before the race and the length of time that it will take to heal the injury. In most cases, minor injuries in that last month before a race don’t completely side-line marathon runners. They may slow down their pace goals, but they can often get through the race despite the set-back. Remember to be proactive in dealing with the injury and look realistically at your plans. The worst thing that a runner can do is to continue training through an injury just before a marathon and “hope for the best” on race day — unfortunately the marathon distance doesn’t often bring out the best when it comes to injured limbs.

If you have a question, please post it on my “Questions” page just like Lucy did.

Coach Joe English, Portland Oregon, USA
Running Advice and News
www.running-advice.com

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4 responses so far, want to say something?

  1. 1. Dealing with Late Season Injuries Before your Next Marathon | trailrunningSoul.com May 20th, 2008 at 9:07 am

    […] fit is the runner? Read more at coachjoeenglish.wordpress.com Written by coach Joe English If you liked this, you may want to subscribe to the RSS feed and […]

  2. 2. Spark Wellness Launch Party « Fitness NYC October 8th, 2009 at 3:34 pm

    […] to Get You to the Finish Line–focus nutrition and fueling!  In the meantime, I found this great article on pre-race injuries.  Have a great Thursday […]

  3. 3. Training — Injuries before a marathon revisited « Running Advice and News December 15th, 2009 at 11:42 pm

    […] with an injury in the weeks leading up to a marathon. In a popular earlier post called “Dealing with late season injuries before a marathon“, I gave several scenarios along with advice on courses of actions. Also, in our video […]

  4. 4. Steph June 5th, 2010 at 1:43 am

    Thanks for this! I hurt my back last week and have a marathon next week. I visited a PT and 2 different chiropractors, and they think I'll probably be able to run. I wanted to do a trial run tomorrow, but your advice maybe knocked some sense in me – perhaps I should just cross-train until I'm healed, although I might just hop on the treadmill to see (and be able to stop anytime I need to). I had a marathon 3 weeks ago, plenty of 20-milers, so I guess I am okay to run the full even though I'm not doing any running right now. It is SO HARD mentally!

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