I’m posing this question because I’m heading towards my own record for the longest injury. I recognise that not all injuries are created equal, some are short and decidedly not very sweet, some are prolonged and irritatingly niggly. Mine have nearly always been chronic and have severely limited my running. My current injury is also long-term and seems unsolvable. I first noticed a pain below my kneecap in March 2023. I hoped it was nothing. I never thought I’d be here 21 months later, still playing the injury waiting game.
As the self-proclaimed Perpetually Injured Runner, I’ve had plenty of practice at being injured. I’ve also had plenty of opportunities to figure out how to stay motivated. I still grumble and groan, but I’ve learned that wallowing in self-pity doesn’t get me back running any quicker. Quite the opposite. I’ve tried different strategies to combat the injury blues but it’s not until this current injury that I’ve finally found a few ways to get through it.
Start walking
The idea of lacing up your running shoes and heading out for ‘just a walk’ might seem a little bit boring and even a bit insulting for your average runner, but it is a palatable substitute when you can’t run at all. And I don’t just mean an amble to the local shops, I mean pacey power walking where you swing your arms and engage your glutes. There are both physical and mental health benefits to walking that are similar to running and this approach helps you to continue to reap at least some of those benefits that you might be missing from not running.
I suggest planning your routes just as you would for a run and walking at the same time that you might have gone for a run. Wear running gear, although perhaps with an extra layer, and set your running watch. I keep myself accountable by recording my ‘not-running walks’ on Strava and I aim for at least 5k, which I can do in about 50 minutes.
The uptake and encouragement of ‘parkwalking’ at parkrun has been hugely helpful with this strategy. It’s meant I’ve often had the company of other injured runners (and non-injured runners just taking it easy) when parkwalking. I was once a volunteer pacer for 50 minutes at parkrun, which I did whilst walking!
It’s also likely when you return to running from injury it will start with a run/walk approach, so if you walk during your down-time, it will feel like a natural transition. I appreciate that not all injuries mean you can walk long distances, but with many running injuries you can, so keep your legs moving and heart pumping by putting one foot in front of the other.
Try cycling and swimming
Far too often non-runners, including some very qualified medical professionals, will say to an injured runner: “just take up cycling instead.” I give them a measured reply but inside I’m shouting expletives. I like running so that’s what I want to do, why don’t they just get it? During this very long-term injury, however, I decided to give cycling another chance.
I’m not afraid of the bike, I’ve been cycling to get around for years now and used to cycle commute to central London every day. The aggression from some drivers and the 59 sets of traffic lights (yes, I counted!) was already starting to become wearisome by the time the Elizabeth Line came along. With the substantially reduced journey time by train. I found I was cycling less and less.
When I realised this injury was settling in for the long term, just like I did with walking, I treated cycling like running. I bought some new gear, I went for cycle rides, switched my Garmin on and recorded my rides on Strava. After all, that’s what Strava was originally made for! I’d head out to Richmond Park (no traffic lights – very nice!) and even the Heathrow perimeter ring-road. I started trying to beat my times and look at my performance on Strava segments. I’m a better cyclist for it now too.
I used to find swimming even less interesting than cycling but I found a way to love it. I have talked about how I did that in a previous blog so I won’t repeat too much here. I will say that it’s about finding the right location and just like walking and cycling, treating it like a sport rather than a mildly distracting diversion. We make time for running, we buy nice running gear, we measure our runs, we look for ways to improve and I think that is the secret to enjoying other sports too. Once you see progression, motivation naturally follows.
Join a gym
We all know that we should do it but many of us don’t. Through my many injuries I’ve come to realise the importance of strength training in both prevention and injury rehabilitation, and I’ve written about it in previous blogs. Despite this, it’s still often the first thing I tend to drop when I’m running happy and injury free. And I suspect I’m not the only one.
Not all injuries will allow you to do strength work, and it’s important that you check with your physiotherapist what you can do, but many injury recovery plans will typically include some strength work. With my current injury I have specific exercises I must do, and I prioritise them. However, I also work my hamstrings, adductors, glutes, calves, and core as well as doing the occasional upper body exercise.
Strength work can be done in the gym or at home, but I recommend joining a gym if you can. I resisted for years mainly because of the cost and knowing I’d probably never use it enough, but I’m glad I changed my mind. My local council gym is very affordable and whilst it’s not at all salubrious, it has more than enough equipment for what I need.
Similar to my suggestions above, I recommend creating a strength routine that takes place when you would normally run and doing it in your running gear. Keep a record of each session, watch your progression and work to improve your technique. I’ve never been a gym person but doing all of the above has made exercising indoors much more enjoyable. All that strength work should, in theory, make you a lot less injury-prone on your return to running.
But that’s not all. I believe gyms hold a secret weapon that all runners should know about – the cross-trainer. I admit I used to think that it was a bit of a silly machine and not for people who actually went running outdoors. I saw it as rather pointless, a bit like a treadmill but worse, with silly stuff for your arms. I now apologise to all cross-trainer users. I was wrong, it’s actually a genius bit of kit. It’s way more interesting than a treadmill, it’s still a bit like running, without actually running, and most importantly it’s low impact. This means that I can plod away on it to my heart’s content without putting anything like the pressure on my tendon that running would. I’m never going to pretend it’s a serious alternative to running outside, but right now, I’m happy I have it.
A final update
I’m currently suffering with plantar tendinopathy, which manifests itself in pain underneath my left kneecap. It hurts a little during running if I don’t run far, and a lot after running and is worse the faster I run. All I’m realistically able to manage is a slow, short run. Sometimes the post-run pain means I can’t do my crucial rehab exercises, which is obviously counterproductive so running itself has become a little problematic.
Although I’ve barely ran for such a long time I don’t feel as unfit as I usually do when I’m injured. Nor do I feel that my mental health is impacted the same way as it used to be when I couldn’t run. Running will always be my preferred sport, and whilst I’m more aware of that than ever, I don’t feel quite so beholden to it, thanks to my newfound coping strategy.
The injury itself is up and down. Last summer it seemed to be improving as I managed two 10k runs, but now I’m barely running at all after it worsened a couple of months ago. The physiotherapist, sports doctor, and I have looked for patterns, reasons, and explanations. I’ve had numerous scans, injections, plus shockwave therapy and most recently some high-dose anti-inflammatories. Everyone admits they are running out of ideas.
This time last year I was expecting to start London Marathon training but I barely got underway due to this injury. I deferred my place, believing I would be running in 2025. Even now, in early January 2025, I know I won’t be on that start line. I have run less than 10k in the last month. Even if I suddenly make an incredible recovery, the pressure to increase my mileage significantly will be too much to resist and I will almost certainly pick up another injury if I try.
I’m disappointed, I’m a little sad, and of course, I’m frustrated at what might be my longest ever injury. But I’m not completely demoralised. I’m walking, cycling, swimming, I’m at the gym and feeling strong. And sometimes I am even smiling a bit on that cross-trainer.
Thanks for reading. Happy running - or whatever it is that is keeping you moving.
You certainly never run out of content Rachel. I'm so sorry. But your resilience is inspiring. I hope that it heals quickly now, but glad the other options are helping a bit. Good luck x