Recovering from Running-Related Injuries

by Ross Gentry
featuring Chris Wolfe, PT, Cert MDT, OCS,
Owner and Founder of Wolfe PT

For most runners, being injured at some point is a reality. Sometimes reality stinks. Devoted runners know that running helps you stay fit, it helps you stay sane, and can be a defining way of life. When the thing you love brings you heartache, or worse, knee pain, it can be immensely difficult to navigate the path back to where you want to be, which for many is running more distance in less time with no pain.

The road to recovery is arduous and many people don’t know where to start. Others may think they know where to start but end up heading in the wrong direction. Here to get injured runners back on track is Chris Wolfe.

Chris Wolfe is a different breed of running specialist. He isn’t the type of expert who will hastily tell you to “stop running”. He isn’t the running coach who will make you adhere to his cookie-cutter performance program. He isn’t the salesman with “5 Quick Tips”. Chris is the guy who figures out what matters to you most and gives you the tools to get there. And it surely helps that he knows a whole lot about running.

Local to Nashville, Chris is a physical therapist who spent years doing PT the traditional way before setting up his own clinic, Wolfe PT, located within PhysioFit, a gym in South Nashville. With experience in running as a Boston Marathon qualifier and Ironman finisher, Chris has devoted himself to evidence-based treatment and people-centered care. As one of the top minds on running in our city, Chris recently shared some of the principles he utilizes to ensure his patient’s success.

What do injured runners do that may make healing difficult?

1. Not approaching running as a higher-level skill.

People usually start running with the best of intentions. You want to be more fit and there happens to be a sidewalk nearby. Running is incredibly accessible. However, many novice runners sooner find themselves in pain rather than at the finish line they signed up for in January.

Chris makes the case that running is a higher-level skill. Skills require practice, intention, and time. Signing up for a half-marathon three months away when you are yet to see the high five at the end of a fun run doesn’t allow for skill development. A would-be weightlifter doesn’t decide one day that they will clean & jerk two times their own body weight in a few months. Having the right mindset toward training may help you get where you are going.

2. Putting your body on mute as race day approaches.

It takes time to learn how to listen to your body’s cues in training. In order to get better, there are absolutely certain pains and thresholds you need to push through. Other pains are red flags for a recovery day or two. Making unscheduled changes to your training program can be irritating, especially when race day is a few weeks away.

As he discussed this idea Chris laughed and said, “Recovering and showing up in a non-injured state to the race is better than showing up somewhat trained but hurt”.

3. Quitting running to get better at running?

The one phrase a runner never wants to hear is “stop running”. Take my wallet, take my keys, but do not take my running. Breathe easy, runners. Nobody here will tell you that without truly understanding your situation. Quite the opposite, in fact, do what you can to stay out there.

Chris took time to really hit this point home. He explained that the body is catabolic. This means that without any external intervention the body is in a constant state of breaking down. The only way to “build up” the body rather than “break it down” is to load it. Load means weight, force, and stress. If you stop running, you are taking away your body’s load. Under-loading leads to breakdown over time, so the more time you take off the less ready you are to run. “If you send an under-loaded person back to running, they will break again. Maybe not the exact same injury, but something will break”.

This starts to make sense when you think about a runner with plantar fasciitis or IT band issues who take a few weeks off to let pain settle down just to lace backup and dishearteningly find the pain readily return with a vengeance. Rest is not an intervention; it’s a window for intervention. We’ll have more on that later.

What can injured runners do that helps lead to success?

1. Follow the 80/20 Rule.

To be good at running, you need to go running. That’s a given, but with that said, running isn’t enough. When Chris talks with his patients about requirements outside of running, he offers the 80/20 rule. 80 percent of your time investment should be doing what you love most; getting out there and putting one foot in front of the other. The other 20 percent is what takes your 80 percent to the next level. There are plenty of items that can count for that 20 percent.

Many of you may already have visions of rest days, foam rolling, and yoga sessions filling your mind as you dream up your 20 percent. When Chris thinks about his runners’ 20 percent, his mind is filled more with barbells, kettlebells, and resistance bands. Have you ever seen those articles online with 3 to 5 handy exercises for runners? A lot of them give a few quick bodyweight movements to throw into your cross-training. This isn’t wrong, but Chris explains that in order to create a true adaptation in his athletes, he has to load their bodies with more than the bodyweight they are accustomed to. Each time a runner takes a stride they strike the ground with roughly 2.5 times their own bodyweight. It makes sense then if your cross-training is going to be effective, you need to get well above bodyweight to adequately prepare for the loading demands of running.

2. Get creative.

No, this doesn’t mean to use swimming as your new running. With emphasis, Chris tells runners to get creative. Can’t run long distances without a flare up? Run some shorter intervals at a quicker pace. Your body doesn’t hold up to a fast pace? Do some alternating walk/runs. Do what you can. Continue to challenge your body. Find a coach or doctor who understands the physical demands of running and the facets of your injury. An injury isn’t a death sentence to your dream of completing a half-marathon or your long-term career as an elite athlete, it is part of learning and adapting as you figure out the discipline of this high-level movement.

3. Remember the Injury Ground Rules.

Chris wouldn’t let the interview end until this was clear. If you need a quick way to interpret the pain you’re feeling during and after a run and how to be smart about it, here you go.

Ground Rule #1 If an injury or pain noticeably alters your stride, you need to modify something. Try a change in your cross-training, recovery, running mechanics, or find someone with more experience who can take a look.

Ground Rule #2 Running pain that hurts and disturbs your daily life for longer than 24 hours means you need to modify something (see above). If the pain goes away in less than 24 hours and doesn’t get progressively worse, they are likely normal stresses from a challenging run.

Ground Rule #3 Running pain that requires medication means you also need to modify something (see above). Try a change in your cross-training, recovery, running mechanics, or find someone with more experience who can take a look.

4. Understand that your running is composed of many factors.

Your body is crazy smart but it’s not smart about everything, particularly about stress. Your body doesn’t always know the difference between a hard run, a bad day at work, or not getting enough sleep, it just knows it feels beat up. Becoming an elite runner isn’t only about nailing down the perfect training regimen and executing it week after week; it’s also about understanding that you are a whole person. A whole person has a lot of stressors, both good and bad. Accounting for stress can help you interpret and organize your training. Notice you were able to keep up a slightly faster mile time today? It may be the result of your success at work yesterday. Do your knees feel like they are made of glass? Maybe the kids are getting you up at 1 am, 2 am, and 3:47 am could partially be at play.

Chris encourages each of his runners to keep a journal. Nothing fancy, just rate your day, run or no run, on a scale of 1 to 10 in three categories: Energy, Fatigue, and Soreness. When you look back on your week, try to see if you can pick out some patterns. Maybe runs on Mondays feel great because you had Sunday relaxing with family, but Wednesday runs always feel off because you aren’t able to get a full breakfast before heading to an early weekly meeting, and so on. More simply put by the man himself, “Go beyond running to help your running”.

What makes Wolfe PT different?

When asked what sets him apart from any other traditional PT, chiropractor, or coach who has “running injuries” listed as a bullet point in their brochure, without hesitation Chris remarked, “I actually watch them run”. There are lots of people who can check hip alignment, test strength, and pop your back, but somehow completely miss the main thing. Chris invites his patients into the process. He calls this the “brainstorming approach”.

With this brainstorming approach, you have ownership in your own treatment rather than being a bystander. Chris figures out what matters to you – why you run, how your injury affects you – and brings that to the table to design the intervention. Not every runner runs the same. Wolfe PT takes this into account. You don’t need to run correctly, you need to run how you are made to run.

We love running and want to keep doing it. If you are struggling with injuries, try out some of Chris’s principles. Reach out to Wolfe PT and Chris himself for help if you’ve hit a wall in your healing or would like to avoid that wall, especially if you are looking for programming and advice on your current regimen. If you’d like to get some time with Chris yourself, you can find him at Now, go forth, and run-along.

NFM Staff
Author: NFM Staff

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