Why Am I Always Injured?

Why Am I Always Injured?

By Cat Fitzgerald PT, DPT, CSCS

Why am I always injured?! I can’t get through a single training cycle healthy! 

This question is one I hear all too frequently. I suppose it does come with the territory of working in the running physical therapy and performance space, but still! In an ideal world, we’d meet someone who was injured, get them back on track, and then focus 100% on performance from there on out. This is not always the case.

Many runners have multiple injuries over their lifetime. For some, it can be the same constant recurring injury. For others, it’s a slew of different injuries happening over a shorter period of time. When these things happen, we describe it as a runner getting stuck in the injury cycle.

Here is one example of how the injury cycle works.

A runner gets injured–let’s use IT band syndrome. She develops ITBS six weeks out from a goal race, let’s say the NYC half marathon. She focuses on rest and gets through the race relatively unscathed; perhaps the ITB started flaring up during the last few miles. Next up she has the Brooklyn half marathon in May, about eight weeks away. Given the timeline, she doesn’t have time to get her IT band up to 100%, but again is able to make it through the race. However, this time at the end of the race she feels some pain in her heel as well as the IT band flaring up. She takes some time off of running for these injuries, but wants to start training for the NYC marathon in the fall. She gets a month or two into training before the heel pain is really affecting her running and the IT band pain is coming back into play. This runner decides to get serious about her recovery – and searches for “NYC running physical therapy” on Google. This is when we typically meet someone at Custom Performance! (Ideally we’d meet a runner at the first sign of a first injury, but that’s not always the case, especially if rest alone has worked in the past.)

This runner’s injury cycle has been perpetuated by her race calendar. She always seems to be floating around 80% healthy at best. Often, I will work with this situation to help a runner get through a race successfully, but it is crucial for us to establish when the runner will be ready to switch her priority to getting 100% healthy, or else we’ll be constantly playing whack-a-mole with injuries.

This is the other common injury cycle scenario.

A runner has a nagging injury, such as achilles tendinopathy, but it’s “manageable”. In this case, being manageable often means that he can still run how he wants– however far and often.  The catch is that there are periods of flare ups, and how frequently the injury flares can vary quite a bit. It can be every few months, once a year, only with certain types of training… it’s incredibly dependent on the individual.

Because this runner has been relatively successful keeping the injury “manageable”,  he’s often satisfied getting out of the flare up, but not to full recovery. This perpetuates the injury, leading to chronic pain and secondary problems over time (we’re talking months and years here).

I love working with athletes stuck in the injury cycle – often they say that they are ready to give up running altogether. I can commiserate, I’ve been there. I’ve cycled through plenty of injuries in my time and have learned what I need to do to stay injury free.

How can you break out of the injury cycle?

The key to breaking out of the injury cycle is that something has to change. A lot of runners will say they’re willing to make changes and do what they need to to stop these injuries, but putting that into practice is SO hard! It makes sense– you’ve spent a lot of time injured and often have figured out a way to at least run a bit.

It’s scary to try something different, because doing it differently can feel like you’re putting the running you can do in jeopardy. But that’s where we come in. We’ll go through every step with you, explaining the whole process along the way. I want you to question what we’re doing! Asking questions is the only way you can learn and start to build confidence in the process. 

This is going to be an ongoing blog series exploring the injury cycle and some strategies to break out of it. Stay tuned! 

By Cat Fitzgerald PT, DPT, CSCS

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