A question I often get asked is, ‘can I keep training with this injury?’. Many of my patients are passionate about their fitness pursuits, and the thought of missing a week or more of training is upsetting to them.

 

I can sympathise with this because I love to train too. I am currently training for an ultramarathon, and during my plan, I have had three niggles that I was convinced would stick with me until the race.

 

Well, thankfully, the short answer is, ‘yes’, you can train through injury. In my case, I made a few adjustments to my plan, and I was able to keep up with my weekly mileage whilst the injuries recovered. I am now back to running injury-free and I didn’t take any rest.

 

Before we get into it, I want to make a little caveat to this article; the advice here should be taken carefully. Some injuries should be rested, and I do advise this from time to time. I will try my best to explain how to train through pain, but if you are ever in doubt, seek advice from a professional.

 

With that said, yes, you can train through (most) injuries. The reason for this is that science is starting to realise that recovery from injury largely happens in the brain. There are cellular changes that need to happen locally in a damaged tissue, which is facilitated by the nervous and immune systems, but the way the brain processes what has happened and how it coordinates the body in response to the injury is perhaps a more important factor in one’s recovery.

 

When you are training, you are sending information up to the brain that helps it reconfigure your movement patterns, and this also helps coordinate the response from the immune system.

 

The other important benefit of continuing to exercise is that you are staying strong. Strength (or lack of it) is the number one predictor of one’s risk of injury. It’s important to note that strength is task-specific, so if you are a runner, it is important to stay ‘running strong’, and the best way to do that is to run!

 

The way I think about problems in the body is that if we are taking two steps forward and only one step back, we’re winning. So the goal when training is to not aggravate the system so much that you’re taking two steps forwards and two steps back.

 

If you are injured, I have a few rules to follow which should help you win the battle:

 

  1. Try to find a way to adapt your training to not aggravate the injury. With gym work, this is easy because you can always take out the movement patterns that aggravate the pain. For example, if you have a shoulder injury that doesn’t like overhead press but can cope with bench press and pull-downs, you can keep training your shoulders by avoiding the overhead press movement. Often, strengthening the joint with planes of motion that don’t cause pain will help the plane that is struggling.

    You can play with other variables too. Reducing the load, the speed and the range of motion can activate the muscles and joints in a way that is safer. Over time, you can increase these variables back to their original levels.

    With running, this can be a bit trickier. One of my injuries was a foot problem which caused stabbing pain in the ball of my foot each time it hit the ground. This isn’t ideal as a runner because my feet often need to hit the floor! I found a way to manage it, though, by changing my gait to more of a ‘waddle’, running on trails instead of roads and reducing my speed. Although this was a much slower run, I was getting the miles in, which helped me stay on track for the ultra.

 

  1. Pay attention to the first few minutes of your session, and things should get easier. If they progressively get worse, that is probably your body’s way of asking you to stop. Most problems get a bit easier when you are warmed up, and this is a sign that you can continue, but listen to the language of your body and stop if you need to.

 

  1. Get treatment and do the rehab. Getting a good diagnosis, hands-on treatment, and personalised exercises from a professional can help accelerate the recovery process. The body is a healing machine, and anything we can do to enhance the body’s natural power will increase the likelihood that an injury will recover even if you are training on it.

 

Are there any times that you shouldn’t exercise through injury? Yes, of course! Everything I have spoken about above involves adapting your training in a way where you manage the pain to prevent it from getting worse. This often involves reducing the intensity significantly to find a level of training that works for you.

 

Sometimes, however, this isn’t possible. This is why I often advise my patients to avoid matches, races and team events where the intensity is out of their control. It’s one thing to train on your own in an intelligent, controlled way, but another to ramp up the intensity and put your body at risk.

 

If pain and injury are holding you back, we can help in this clinic. We also like to discuss lifestyle factors, not just to get you out of pain but to live a healthy life with well-being as a priority.

 

Plantar fasciitis is a relatively common condition which causes pain underneath the heel and foot.

The plantar fascia is a thick connective tissue which passes from the heel to the tips of the toes and it provides attachment points for the many muscles of the foot and it creates elastic energy in every step we take.

It’s a super helpful component of our foot mechanics … until it gets inflamed. People tend not to thank it much when that happens!

Common symptoms of plantar fasciitis are pain when putting the foot down, particularly after rest (the first few steps in the morning or after sitting for a while can be agonising), stiffness in the foot and ankle and even pain at night.

It can be caused by poor footwear (pounding the pavements in heels or smart office shoes can be the culprit), overuse in sports like distance running, and in the non-athletic population the most common cause is excessive weight.

In treatment, we often notice other correlating factors like a tight hip on the same side or restricted pelvic and lower back mechanics. This is because in every movement we make we work as a CHAIN. The feet help the hips, the hips help the feet. If this chain is inefficient, some parts of the body get overloaded.

In any diagnosis, it’s not only important to know WHAT is going on, but also WHY it is happening, and this is where treatment is so important with things like plantar fasciitis.

 

 

Here are some things you can do yourself though to take control:

  1. Stretch the calf

Our plantar fascia has connective tissue attachments which are continuous with the Achilles tendon, which in turn becomes the calf muscle. Stretching this muscle can be your best ‘way in’ to releasing the plantar fascia

 

  1. Roll the plantar fascia

When sitting and relaxing, you can roll your injured foot on a ball to create pressure. I’ve heard many people say to use a golf ball, but I think that’s a little mean for something that can be so tender and I don’t think a golf ball gets the right traction in the tissue either. We find a lacrosse ball is better. It has the Goldilocks-zone of firmness and traction in the tissues!

 

  1. Gentle calf raises

There is evidence to show that using something known as an ‘eccentric load’ in the calf muscle can help the plantar fascia. An eccentric load is where one puts stretch into a muscle while working it.

In the calf, the way you would do this is rest the ball of your foot on the edge of a step and slowly lower your heel below the level of the step. Use your ‘good’ foot to support you as much as you need to, but try to take some weight in the injured foot. Slowly push yourself up from this position using the bad foot as much as you can without pain. You can do as many reps as feels comfortable, somewhere between 5 and 20, depending on what stage you are at with things.

 

  1. Stretch the hips

Working higher up the ‘chain’ to create flexibility can help offload the foot when walking and moving. We have plenty of hip stretches on our YouTube channel and Facebook page.

 

  1. Lose weight

If it has not been overuse through running or bad shoes that has caused your plantar fasciitis, it may be your body’s response to excessive weight.

I often find that pain and injury can be the catalyst someone needs to make the lifestyle changes they know they need to make, but never found the time.

I always say, our bodies can’t talk to us in English, they can only talk to us in signs and symptoms. Sometimes pain is our body’s way of telling us to make change. In this case, losing weight won’t just help the plantar fascia, but it will also help all the other body systems too.

 

  1. Gel orthotics

Basic off-the-shelf orthotics can be helpful in the short-term to take the pressure off the heel-strike in walking and to give a little support to the arch mechanics.

Although this is not getting to the root cause of the issue, it can help relieve the symptoms initially.

 

  1. Get treatment!

Plantar fasciitis is notoriously stubborn, but getting treatment can help accelerate recovery by dealing directly with the tissue strain and helping the whole mechanical chain above. By having hands-on work and using unique and personalised exercises, you can speed up the tissue healing and reduce the inflammation.

 

As always, if you have any questions, get in touch by emailing [email protected] or using Facebook.

Have a healthy month!