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Dear Team Chaski,

I just got the unfortunate news that I have tendonitis in my ankle and I have to take a few weeks off from running. This is the first significant injury I've had and I'm wondering if you have any tips to make sure I come back as soon and as strong as possible?  

Sincerely,

An Injury Newbie

On September 11th, 2018, I answered the phone call from my doctor, friend, and former Duke University teammate and heard the dreaded words that no runner ever wants to hear; “You have a femoral stress reaction.” For once, I would love to have heard “You are completely dreaming of the pain, it’s a negative MRI!” or maybe even something like “It’s just a mild hip flexor strain.”

Unfortunately for me, I am 5 for 5 with positive MRIs in my femur. The femur is the largest bone in your body and pretty difficult to fracture. However, I am probably on world record pace for fracturing that bone. I try not to perseverate, so I have to play the cards I was dealt.

Enter. . .cross training! In my 1,000 hours of rigorous research (plus or minus a few hours), I found that there is actually very little information out there on how to cross train and recover properly during more serious running injuries. I am not a doctor, but there are a few things I have learned throughout my history of rehabbing injuries that I wanted to share:

• Take some time off before resuming cross training. This means complete rest for at least a few days. I typically take 3-7 days completely off and then lightly build into a cross training regimen. This is critical to let the healing process begin. Also, make sure to allow yourself a 24-hour pity party if your sentence is longer than a few days (trust me, this is critical for the healing process but no longer than 24 hours!).
  

• Establish your end goal. What is the purpose of your cross training? Are you trying to maintain fitness, stay sane, recover, or do you even care? If you are reading this article, I am taking a wild guess that is probably isn’t the last option. It’s important to think about what you actually want to get out of the next few weeks because this determines the duration and frequency of your cross-training.
  

• Try to determine the root cause of the injury. Think of this as a puzzle that you need to put together before your return to running. If it’s a bone injury, get a Dual-energy X-ray absorptiometry (DEXA) scan to determine current bone density and check out vitamin/mineral levels (ferritin, vitamin D, calcium, etc). For most injuries, running form, shoes, training surfaces, increases in mileage or volume, and overuse can be common culprits. Review your training log and see if there’s anything in there that sticks out as well. This can prevent the injury from re-occurring when you return back to running in the future.

• Build your cross-training plan like you would build your mileage. You can stay fit while cross-training if you let your body heal before going too hard. Progress into the cross-training like you would with running. Start with 20-30 minutes easy and build from there. There are many options - swimming, pool running, elliptical, biking, hiking - so find one that doesn’t hurt or make your pain worse. For bone injuries, swimming or pool running is generally the best place to start and then slowly progress to the bike/elliptical. For muscle injuries, testing out all options to see which one doesn’t mimic the running pain will give you a good idea of which route to take.
• Listen to your body. This isn’t as easy as one may think especially if you start having phantom pains (pains that mimic the initial injury). Your body knows best and gives you signals that you may have ignored before. It knows when it needs more nutrition, sleep, rest, and blood circulation. Listen to it and don’t be afraid to back off to let the healing progress faster.
• Stay positive!  Happiness and mental wellbeing are directly linked to the healing process. If you continue down a path of depression and anxiety, you are putting extra stress on your body that will slow down the healing process. Your body treats all stress - both mental and physical - as just that. Stress = stress. Rediscover some past hobbies, hang out with friends you haven’t seen in a while, have a beer with your co-workers, and do things to keep your mind off of running and the injury for a little while.

Able to do yoga? Check out 5 Yoga Poses For Runners

Again I am not a doctor, but I can tell you that listening to your body and trusting its signals during the recovery process is critical for healing and progressing back to running on those trails as quickly as possible.

— Ashley Brasovan