This article originally appeared in the June 2001 issue of UltraRunning Magazine.
by Jason Hodde, MS, ATC/L
How many times have you gone out for a long run, only to come back sore or injured for no obvious reason? You haven’t pulled a muscle or twisted an ankle, yet you get a feeling of pain the next morning that suggests you got hit by a truck?
You are not alone. The fact is, when it comes to ultrarunning, very few injuries are traumatic in nature. Even though it is possible to twist an ankle on the trail or fall down and break your arm on a rock, most of us will never experience an injury like that. We will, however, be the victims of overuse-related soreness, including a muscle pull that “just shows up” the morning following a run.
The most common cause of muscle injury is the contraction of the muscle itself. Most of these contraction-related injuries are caused by the “eccentric contraction”—the contractile force of the muscle that allows controlled movement while the muscle is getting longer. Think of the eccentric contraction as the type of controlled muscle tone in your quad muscles that holds you back when you run downhill.
Functionally, an injury of this type will exhibit the same signs and symptoms as a traumatic injury, although the pain is often delayed. These signs and symptoms include pain, decreased range of motion around the affected joint, earlier onset of muscle fatigue, and prolonged strength loss. Strength losses of 40 to 50 percent are not uncommon for this type of injury, and complete recovery can take in excess of four weeks.
What Causes Strength Loss?
Strength loss associated with muscle contraction is thought to result from damage to the muscle fibers (the contractile unit of the muscle), presumably because of the high forces produced by the eccentric contractions. It is thought that muscle cannot compensate for the forces that are placed on it while we arc-running hard, usually downhill.
In practical terms, what does that mean to us as ultrarunners? It means that often, in training or during a race, we work harder or longer than we are used to. We either overdo our training or participate in a race that is much longer than we are trained for. Intelligent and adequate training will help limit this type of injury from occurring.
Prolonged exertion often causes small tears in the muscle as the result of work. Even though you don’t realize it at the time, this muscle damage can be quite severe and can lead to pain and injury that “just shows up” without warning. You wake up the morning following your workout and are stiff (i.c., decreased range of motion) and sore, with tired muscles (i.c., onset of muscle fatigue) that feel weak (i.e., strength loss).
Recovery: Week One
Although there are many signs of contraction-related injury, the strength loss is the most widely recognized sign. Loss of
strength can force significant changes in your training and racing plan. Immediately after injury, the strength loss is quite severe and is often sustained for as long as five to six days. You should reduce your activity during this time while applying the principles of R.I.C.E. (rest, ice, compression, and elevation).
Rest: Rest can take many forms. For severe contraction-related injuries, complete bed rest might be indicated. For less severe injuries, cross training or non-weight bearing activities (such as pool running or elliptical training) may be acceptable. The degree and length of the rest period depends on the severity and specificity of the injury.
Ice: Ice limits swelling. To ice an injury, place crushed ice directly on the skin and compress it lightly with an elastic bandage or a layer of tight-fitting clothing, such as spandex or Lycra. Ice should never be placed directly on the skin if you suffer from poor circulation; skin should be protected with a moist paper towel or cloth. Ice until the skin is numb (about 20 minutes), stop for 10 minutes, and repeat twice. If this is done three times a day for the first three days after an injury, an antiinflammatory effect occurs that can effectively minimize the time away from running.
Compression: Compression sleeves, elastic bandages, or even Lycra spandex can be used to help minimize swelling and provide support for an injured muscle. When applying a bandage, however, be sure that circulation is maintained in your fingers and toes by continuously checking their temperature and monitoring their color (cold, blue-gray extremities mean the wrap is too tight and should be loosened).
Elevation: Contraction-related injuries usually occur to the larger muscle groups in your legs: the quadriceps or hamstrings. Thus, elevation is often impractical or impossible. If your injury is to your calf muscles, elevating your leg using a couple of pillows can reduce swelling at the site of injury.
Following the first week, strength will gradually return to normal, but you should expect some strength deficit for as long as four weeks after the first signs of pain. Following a hard effort such as an ultra, after which you wake up sore, tired, and feeling weak, you should allow as long as four weeks (many people will take longer, especially if new to the sport or the distance) to regain your strength. Gradually return to running as your strength improves.
Due to the sheer effort exerted by our muscles during an ultra, we should expect some muscle damage to occur as a result of our running. While some people will never wake up with a muscle pull that “just shows up,” many of us will. Knowing that this type of injury is a result of overuse—and not due to that “hidden rock” on the trail—will help us all realize the role that training plays in the prevention of injury and will help us be better prepared to treat it should this problem “just show up” tomorrow morning.