Dealing with Injury – A Step by Step guide

Runners are typically awful when it comes to dealing with injury. It’s fair to say that for us, running is an addiction, thus we find it hard to admit to ourselves that we are actually injured and we can pretend that it will just ‘go-away’.

I have a personal experience that I’d like to share with you, walking you through my rehab process so that it may help should you ever be in that horrible position of being injured. The first thing to say is that we’ve all been there and we all know how frustrating it can be. You suddenly go from running strongly and running each day to having to sit on the sidelines. Runners are not good at resting, so let me take you through what I did.

Step 1 – Admitting you’re injured

As I said above, this is the bit most of us find difficult to actually come to terms with. We should all have the ultimate goal of running without any pain or niggles, so if you have been persevering and trying to run through the pain for a while now, then it’s time to admit you’re injured and decide to do something about it.

Step 2 – Consult a professional

This can include physiotherapist, sports doctor, sports massage or chiropractor. Make sure it is someone you trust, follow their advice 100% and commit to the plan they prescribe as you would to a new training regime leading up to a major goal race.

It’s quite a relief knowing that the injury you have can be diagnosed and more importantly, having a plan to fix it does lift a huge burden from your shoulders. It’s a fresh start, a time to strengthen your running mechanics and eliminate any imbalances or weaknesses.

I have recently been through this and missed one of my ‘A’ races for the year, the North Face 100. As I found out, there is no middle ground.  You can never be “half injured”, because if you are you’re not training pain free you’re only making yourself more injured.

The goal of training is to become stronger, fitter, faster or have more endurance. None of these will occur if you’re training through an injury, so there is only one course of action to follow, see Step 1.  What have you got to lose? You can spend four to six weeks of dedicated exercises to make you fresh, strong and refocused. Or you can trudge through 3 months, 6 months or years of ignoring niggles without any improvement in times, distances or race performances. Any sane person would choose the former without question!

But I hear you say… “I’ll lose all my fitness.”  At this point you’re not going to get fitter training through an injury so see Step 1 again.

Tour de France winner Andy Schleck is currently using simulated altitude training to get himself back into peak fitness

“Pain isn’t the injury itself, pain is not being able to play to your full ability”

So with this in mind what did I do?

I worked as hard as I could with one of my sponsors, Sydney Altitude Training along with the advice from sport scientist Allan Bolton and physiotherapist Clint Frazer. Between us,  we set about dedicating myself to running pain free again without losing any fitness. With my list of exercises and my rubber strengthening band in hand, I have spent the last 4 weeks doing everything right.  I’ve done all the exercises, maintained my cardio on the state of the art Velotron bikes and rowing machines at the centre.

By doing everything in my plan with Allan and the altitude team, I have come out the other side. Within two weeks I’m hitting training targets that I usually only hit during the final few weeks of taper before a big event, plus I feel fresh and refocused for the second half of the year. One of the benefits of training in the altitude centre is that your muscles and heart get a terrific training effect without the need for a gruelling training session.

Allan says, “High mechanical / structural loading comes with the turf for ultra-endurance runners. It’s a requirement for peak performance and at the same time can be the runner’s nemesis. The high volume mechanical stress of ultra-running often results in injury and, of course, every runner fears a major loss of fitness if they rest an injury. This combination frequently sees many carrying unnecessary injuries to the start line, inevitably this leads to sub-optimal performance and extended down time.”

He goes on to say, “At a recent full day presentation to the Sport Authority of Thailand at Kasetsant University, Kathryn Archbold and Kenneth Graham from the NSW Institute of Sport summarised evidence from recent research literature. It showed that there are performance advantages to the application of simulated altitude (hypoxic) training. One advantage identified relevant to this conversation is that training in hypoxia allows athletes to achieve sufficient cardiovascular stimulus for maintenance of fitness with a reduction in mechanical loading. An example they gave was exercising at 150bpm in normoxia (sea-level) may require an effort of 250W vs 200W in hypoxia, thus resulting in a smaller mechanical loading on the body.

“If our athletes suffer an injury, we immediately replace normoxic with hypoxic training. We find the reduction in mechanical stress delivers a quicker return to normal training and better maintenance of fitness”, said Allan.

So if you’re reading this and you know you have a few niggles to sort out before the big events in the second half of the year roll around, consider a few weeks of low impact cardio and strengthening exercises in an altitude environment as a way to set you up for the big races coming up

Background: Presentation title: How does training at altitude increase physical fitness? Support article: A Review of the Application of Simulated Altitude (Hypoxic) Training to a Range of Athletic Adaptation. By Kathryn Archbold and Kenneth Graham for the NSW Institute of Sport.

*The declaration bit: Andrew is sponsored by Sydney Altitude Training

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Andrew Vize
Sydney based Ultra marathon runner.

16 thoughts on “Dealing with Injury – A Step by Step guide

  1. Whereas I appreciate the underlying measage of this article, I am unsure as to whether the joe blogs runner has the facilities available that you suggest!

    I’m glad you got through your injury.


    1. Sure Conor, and as you rightly point out, step1 and step2 are the starting point.

      The thing is this facility is available to anybody, it’s not as though I’m saying head to the AIS for 4 weeks. Give the guys a call, sessions are less than an hour with a personal trainer at any gym and if you’re self motivated and focused – a much better use of your time.

      Thanks for replying AV.

  2. We’ve been using Sydney Altitude Training Centre as part of our 4 Deserts Grand Slam training this year ( and it has definitely been beneficial. Illness levelled us last week running the Gobi Desert in China, but back to road training this week I’m already running times that have me on track for a marathon p.b. And over the last few months, breathlessness just hasn’t been an issue on runs. Recovery after long runs and also during long runs coming out of hard climbs just seems better too. I reckon you start to feel the benefits after 3 sessions, and can probably measure the difference after 6 – 8. Definitely worth checking out if you’re already committed to improvement through training.

  3. One thing I also noticed about injury is coming to terms with the cost (financially I mean!) physio, sports-massage, scans, altitude, rehab equipment etc can all add up pretty quickly.

    Once I asked myself ‘how much would I pay to be able to run pain free?’ it helped change the mindset from a ‘cost’ to an ‘investment’ I’ve also found that ongoing ‘investment’ on things like massage or a ‘tune-up’ to the physio even when you are not injured has helped to have a decent block of pain-free running and can help catch early niggles long before they turn into months out.

    Ultimately $80 on a 1 hour sports massage every couple of weeks is an investment I’m happy to make if I can keep running. I certainly spend more than that on servicing the car so doing the same on your legs seems pretty logical!


  4. Nice one Andy! I appreciated the stern warnings against running through injury that you gave me at TNF, I didn’t realise that you were having issues of your own.

      1. Ha. In racing I agree, if a bone ain’t showing just keep going. But, in training we need to be sensible, otherwise it’s not training.

      2. no your right Andrew, i totally agree. i dont think twice about taking a week of here or there to let a niggle settle down. Not much fun running when in pain.
        Hope your recovering well mate.

  5. Pretty honest article. After having a few issues, I too find it important to get them checked out early otherwise you will suffer too long with minimal gains. Maybe I can’t do the altitude thing but maybe a few runs at the Barrington Tops at 1500m might suffice somehow..

  6. Spot on, must say I struggle big time with Step 1, or maybe the definition of ‘injured’. I have run through plenty of ‘niggles’ and come out the otherside still reaping the benefits of training. I guess you truly know you are compromised when you fail to meet your training targets or it just hurts too much. 🙂

    Great article AV.

  7. I think the best thing about that article is that you should always have a definitive plan with every injury. This includes an acurate diagnosis as that will determine the amount of rest required (if any) and the level of treatment required. Also with athletes the most important thing with your rehab is that the intensity matches your end goals. If your not running your rehab sessions may be 1-2 hours in duration just like you would be if you were training. If you treat your rehab like your training there is always an end in sight.

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