Training around injury

  • Creator
  • #44477
    Lee Mackintosh

    Just after some advice around training around injury. My questions may have already been answered somewhere

    I have a patella tendentious and also a TibioCalcanael ligament strain (on the same leg), presumably from an increase in volume over the past few months where I have been doing around 10-12hrs per week of Zone1-2 alone and around 3-5000m vert.

    I have a long history (10 years+) with Endurance training. I’m a vary active Mountain enthusiast of various forms, predominantly alpinisim and Mountain running and generally train between 8 and 18hrs per week depending on the objective and my recovery periods.

    As I am no longer made of rubber being the ripe age of 37, I’m conscious that I need to back waaaay off to ensure that I can continue running well into the future.

    I am just unsure of how (if possible) to hold onto the hard earned years of base that I have. I have been doing ME and strength workouts with an upper body focus since the injuries occurred a week or two ago, but no running or weight bearing leg exercise at all for obvious reasons.

    I’m also highly fat adapted and also would like some advice around the best nutrition protocol during my recovery/rehab. I have reduced my caloric intake accordingly and continue to adhere to an 18-6 time restricted eating as this works well for me and has done for over two years now. I’m just not sure if I’d become less fat adapted given that my Z1/2 work is currently non existent at the moment.

    Sorry if that’s a little long winded. I’d greatly appreciate any advice you can offer.

    Thanks in advance.


Posted In: Injury & Rehab

  • Participant
    Pete Dickinson MS,PT on #44492

    Methods for training with less impact but keeping up hours of activity would include biking, and deep water running when possible. Substituting a long bike ride instead of hours of pounding on the legs goes a long way to keeping running viable. Patellar tendon injuries tend not to do well with high load cycling, but level 1 should be doable. After a brief rest, you want to return to progressive loading of the leg extensor complex, or you dig yourself a very deep hole to climb out of. During injury periods I recommend picking an upper body or core fitness goal to pursue, keeps you less crazy.
    Just general comments as requested, hope it goes well.

    Lee Mackintosh on #44615

    Peter. Thanks for getting back to me. It’s great to get some advice from you.

    I have been diligent over the past few weeks and limiting my loading to the basics. I have had a session aqua running but I found it to be more of an arm workout even though I had watched several videos on correct technique. I switched to lane swimming which I have some experience in but it’s no substitute for running huh!

    I am seeing an osteopath this week so with any luck I’ll get some scans done to discover the extent. I’m hopeful that I’ll be able to return to cycling on the flat again soon then I’ll move on to the loading exercises as you’ve suggested.

    If you have any resources you think might be of interest I’d be really grateful to hear them.

    Also what are your thoughts on using a skierg from a kneeling position? Do I sound desperate???

    Thanks again for your input.


    Pete Dickinson MS,PT on #44758

    I would just ski erg normal, I don’t think you need to kneel unless there is a fracture or you are in a boot for the tib/calc sprain…..Give deep water running another chance, trust me, it can be hard!

    briguy on #44901

    I have some experience with deep water running and I can vouch for the benefits, but it is one of the most mind-numbing of all the cross training pursuits.

    A few suggestions:

    – Use headphones (bluetooth connected to poolside phone is best, but I’ve used wired headphones plugged into an mp3 player tucked under a headband for a decidedly uncool-but-effective look)

    – Floatation belts are great in the beginning and I will take away those if I am wanting a more strenuous type workout

    – I keep my arms a bit more compact to my body than I would when i run, it makes me use my legs more to stay afloat – using the legs is kinda the point of the cross training

    – if possible do “laps” of the deep section of the pool you’re using – it’s silly but feeling like you’re going “some” where helps

    – find a partner or make friends with others doing the same – suffering shared is suffering less

    Good luck!

    Lee Mackintosh on #45740

    Hey thanks for the tips. Apologies for the delayed reply. I have been using the deep water running tips and have recently started hiking again. I’m now able to do some zone 1/2 for up to a couple of hours and zone 3 for around an hour. I’ve been taking the poles but only using them if any discomfort begins, which it hasn’t so far. Next week I’ll start some bw loading exercises in the gym. It’s actually been good to have a long rest and I’ve focused on my upper body (climbing specific) strength. Having consistently trained for nearly fifteen years without injury I’ve never really had to start from scratch so this will be a valuable opportunity. Thanks for the support. This forum is extremely valuable, especially to those of us who train alone.

    ppeddi on #45903

    I have been dealing with patellar tendinopathy and in rehab . I started 24 wk plan after I have been able to running in zone 2 for 4 hrs a week but after starting the plan my knee dint do well with two days of back to back running this week and I am afraid to push as I want to be able to keep running . Instead I decided to give one day break in between . I am so bummed !!! Tendon rehabs are very ticky with finding the right load . This is the latest research .

    Pete Dickinson MS,PT on #45937

    This article is well done and repeats the drum we’ve been beating about tendinopathy….exercise is the most evidence-based intervention. Progressing into heavy loaded strength, with evolution to dynamic and sport movements in a gradual fashion, using the 10% rule where applicable. Tendon is helped by good fascial mobility as well. PRP and other injections/interventions are missing the boat on how the tendon evolves out of injury.

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