Training Through Injury – Part 1: The Doctor vs. Self Diagnosis

Injuries are a part of endurance sports.  I’ve never met a runner or cyclist that hasn’t suffered through some sort of exercise induced injury, whether it be from overuse or form changes (the two are very different).  The question a lot of us face is whether or not to push through the injury or to rest and this is how I categorize them. 

Diagnosis of the injury is of the utmost importance.  The wrong diagnosis can lead to rest when it isn’t needed, or worse, detrimental.  It can also lead to active recovery when rest is needed.  The easiest way to navigate these waters is to consult a good doctor, but the choice of doctor can make all of the difference in the world when it comes to injuries.  The problem here of course is that, for those of us who have had to fight fat, we know that resting can lead to lethargy which leads to a fat ass yet again.  This is exactly the reason that I try to exhaust every option before I’ll rest through an injury.  To do this safely, the doctor I chose is a Kinesiologist.  My doctor, rather than simply prescribe rest and muscle relaxers investigates the injury with the idea of keeping me active rather than rested.  For instance, I was involved in a car accident several years ago in which I was rear-ended by a texting teen on the expressway.  I was going three miles an hour behind a semi in a traffic backup and he was entering the expressway at speed.  I saw it unfolding just in enough time to relax in the seat and let it happen.  I wound up smacking my head on the headrest with a short blackout, the force of which bent the seat to an awkward angle.  I called my doctor about six hours later complaining that my head and neck hurt and that I felt a little “loopy” or out of it.  He told me to pack up and either call an ambulance if I was too out of it to drive or head immediately to the emergency room.  On arriving, they got me into a bed immediately and checked me out for a concussion.  The testing came up negative so the doctor prescribed muscle relaxers and rest.  Being a recovering drunk, muscle relaxers just won’t do (I told the doc ahead of time that I was a recovering drunk and that narcotics were to be avoided at all costs) so I called my normal doctor up and told him the story.  He fit me in the next day, cracked my neck and back into shape and I walked out pain-free – and was running the next day.

Another fine example was an injury to my plantaris muscle.  I’ve read more than one post on this injury in which people were prescribed two to four weeks of rest…  My doctor had me cycling with an altered cadence (dropping my heel to stretch the muscle) and running the next day to stretch it out (after I did what I thought was right an rested for two days).  I was completely healed in about a week.

I saved three to six weeks on those two occasions alone, simply because I have a good doctor.

On the other hand, most of us (especially we men) have a tendency to try the self diagnosis route first.  That is of course, unless we’re talking something serious of course.  I do this quite frequently, as recently as last week with a sore hamstring.  I have also chosen, in this case, to run through it.  I thought the cause was running in the snow – stretching my stride out too far in slippery conditions.  This made a lot of sense and was absolutely part of the problem – but it wasn’t the whole issue.  I took last Saturday off from running and walked 7.2 miles instead.  Doing this helped me out quite a bit and I thought I was on the road to recovery until my hamstring started acting up on the bike as well – that’s when I realized that my saddle was up just a little too high.  Not high enough that I rock, but about a millimeter or two from that point.  I lowered my saddle a millimeter and a half in the middle of a ride and the pain started to subside.  I ran on Saturday and made it 4-1/2 miles before the hamstring started bugging me.  I turned back at that point and made it another two and a half miles before the pain became a concern and forced me to walk the last two miles.  I feel quite good today so I’ll give it a spin on the bike and see where I come out…  I’ve also got some stretches that I got from my doctor that I do to help stretch my hamstrings out.  Generally speaking, I go by severity when it comes to self diagnosis.  If this hamstring problem persists, I’ll see my doctor but having been through these things before I think that between the saddle adjustment and shortening my stride, I’ll be fine.

Self-diagnosis of an injury is a tricky proposition though and I’d never recommend it unless you’ve got a wealth of experience behind you.  I’d say I’m still wrong about 40% of the time (I was dead wrong about the plantaris pull).  The simple way to do this looks like this:  Know your bike shop guys, know your running shop guys.  And the key:  Get a good doctor who would sooner have you stretch and get your back cracked than pump you full of narcotics and prescribe rest unless you absolutely need it to recover from the injury.

Oh, and as a PS for all of the sue-happy people and their lawyers:  Just because I choose to self-diagnose minor injuries does not mean you should.  I know my fitness well enough, you may not.  Proceed with caution and at your own risk.  I won’t take responsiblity for your stupidity, as much as you may wish I would.