10K Training (Part 1: Rehab and Hills)

"Mind is everything. Muscle - pieces of rubber. All that I am, I am because of my mind." -Paavo Nurmi

I started my 15-week specific training for 10K racing on 30th of December. This 15-week training period aims to peak at 13th of April. The goal race is the Fila Race 10K in Buenos Aires, Argentina. The original training plan could be roughly divided to three phases for their emphasis on different training elements: Introductionary period (2 weeks), Hills training (4 weeks), and Race Preparation (9 weeks). But since starting with the program I had to make some adjustments because of injury, rehabilitation and to fix a weakness I found in my current state of fitness. 

Figure 1: Training Load during part 1 of 10K Training.

In this post I will explain what I did in the first 7 weeks of 10K training, what I learned, my adjustments and how I plan to go on from here. All this aims to run a good 10K road race on 13th of April, almost two months from now. Seldom the route to the starting line is straight and that makes training much more complex and interesting. My Training Load development is presented in the Figure 1.

Introductionary Period

Introductionary Period was planned to last for the first 2 weeks of the 15-week 10K specific training. Prior to the Introductionary Period I had been doing 8 weeks of Base Training and now was the time to crank up some intensity. The plan was to start running Easy Fartlek twice (monday, wednesday), and 6x200m relaxed wind-sprints (friday) once per week. I was feeling all right until the first wind-sprints practice when I strained my left leg hamstring. More details about the injury can be found in this post. So, my plans were forced to change drastically.

Rehabilitation

Figure 2: Finishing one of my runs in
the mountains during rehabilitation.

I maintained my aerobic fitness during early part of the rehabilitation by riding bicycle. One hour bike ride every day to elevate the heart rate makes sure that the built aerobic fitness is not going away while being sidelined from running. I did strength training exercises for the hamstrings and stretching. It took me 13 days to return to very easy running. First I ran very easy and shorter distances than usual, and then I started running hilly courses maintaining low effort level. After 25 days of highly adjusted training, I got back to the original training plan. I had lost three and a half weeks because of the strain, but I had gained a lot of information about my weaknesses. Some of the training I did at altitude (mostly at 1800 m).

I learned that the best thing you can do as a runner (or athlete in general) is to run hills when your hamstrings are the weakest muscles in your legs. And they usually are. I think running hills is way better than working with weights in the gym. One needs strength to not get injured and the muscle that is the weakest (at its' functional work) will get injured first. Running hills builds strength in the right places and then makes it possible to run faster. Retired athletes get injured very easily when they are not maintaining their strength anymore. The brain has learned to give orders and signals through nerves to the muscles to act and run fast, but the muscles are not strong enough to execute those orders anymore and that's why the muscles tear.

Hills

Figure 3: After rehabilitation. Colors in bars represent
time spent on Heart Rate zone in practice.
Red line = Average Heart Rate in practice.

I had to cut down the original 4 weeks hills training phase to 3 weeks. That will also shorten the following Race Preparation phase by one week. I experienced by first hand the utility of hills training and I will not drop all the hills work anymore in my training. My training after rehabilitating my left leg hamstring is presented in Figure 3. 

I think my hamstrings are the limiting factor at the moment in my progress and I intend to do sharp short hills sprints on my easier days. To maintain the strength I think one time per week is sufficient and if I feel I still need more strength I will do twice a week. I plan not to drop out the hills practice in my next Base Training phase either. Also, my circulation practice just got easier because the hills sprints will do the lower body strength work for me. I will only do abdomen, back and upper body strength in my circulation strength practice.

My typical hills practice was a Hilly Run with 100m long medium steep hills. I run a 0,9 km course that has two of those hills, up to 24 climbs per practice. Emphasize is on the uphills, close to sprinting. You can check my week 7 training log in Figure 4. That is the most running I have so far done any week in my training.

Figure 4: Week 7/2014 Training log.

What's Next?

After the rehabilitation phase I have been running all the time stronger and stronger thanks to the hills training. My weekly kilometers have gone up again, even though the intensity has climbed up slowly as well. Last week I exceeded 100 km weekly kilometers for first time in my career. This week I did it again running 113,7 km in total. At the moment I feel confident moving on to the Race Preparation phase that will make me ready to run a fast 10K. I have the fitness in me, next I need to get used to my target 10K pace, which I don't even know yet.

PS. Yesterday was the 1st anniversary with my wife. Thumbs up for her for tolerating me inside and outside the running shoes.

Hamstring Strain

January 3rd, at 8 am in the morning, on fourth rep of 6 x 200 m relaxed wind-sprint repetitions. Weather was sunny, temperature at pleasant 23 C, and I had a slight back wind while running my reps. That's when I strained my left leg hamstring: I felt a "pop" and sudden sharp pain at the back of my leg. I was running too early too fast in my training. Prior to that day I had been running 60 consecutive days without much warning (except once I felt something in the hamstring) of an upcoming hamstring injury. The hamstring pulls or strains strike suddenly usually when you add intensity and speed.

The next day I went out really slow trying to feel the leg and I slightly pulled it again after running 1 km. That confirmed it: original training plans out of the window, and suddenly my new priority and short-term goal was to get well. It's important to stay positive and see the injuries as a challenge and as a chance to learn. The injuries can point out imbalances in the training.


Diagnosis

My personal diagnosis was that I had a mild to moderate hamstring strain in the middle part of my left leg semitendinosus muscle. The severe strains hurt a lot and I have had one in the past in my right leg hamstring. A hamstring strain is a common injury involving a tear in one or more of the hamstring muscles. This one was just a little "snap" or "pop", but it still disables you from running for some time. This is the first time my left leg hamstring strained. Mild to moderate hamstring strain should heal on their own, but one can speed up the healing. The recovery time depends on how badly the hamstring got hurt.

The hamstring strains can be graded from 1 (mild) to 3 (severe) by the severity of the strain. My injury is a grade 2 injury:

"With a grade 2 hamstring strain the athlete's gait will be affected and they will most likely be limping. Sudden twinges of pain during activity will be present. They may notice some swelling and pain will be reproduced when pressing in on the hamstring muscle as well as trying to bend the knee against resistance."

Healing

The recovery treatment for hamstring strain should start immediately following the injury. The most important phase for treatment is the first 48 hours. The leg needs to be iced as often as possible, preferably 15 minutes per hour for the first day and keep on icing 2 to 3 days. The injured leg needs rest for the first couple of days. Putting weight on the leg should be avoided during this time. Compression with an elastic bandage is used to minimize intra muscular bleeding and swelling. When laying down or sitting one can elevate the leg on a pillow. Anti-inflammatory medicine, such as ibuprofen, might be used for short-term to reduce pain and swelling. Personally, I try to avoid medicine, because I feel that if I can stay natural I feel and am healthier. I believe in preventing sickness before it happens.

It is important to stay patient. I was a bit in disbelief and tried to run very easy the next day, but it was not possible. One could try to return to the old level of physical activity when

(a) the injured leg can move as freely as the uninjured leg,
(b) the injured leg feels as strong as your uninjured leg,
(c) one feels no pain in the leg when walking, jogging, sprinting, or jumping.

If one returns to the physical activity before the hamstring strain is healed, the risk is re-injuring the hamstring and developing a permanent muscle weakness. Like I have developed in my right hamstring.

Sports massage can be used to speed up recovery, but not in the acute phase (from 48 hours up to one week in severe cases). The massage on hamstring muscle injuries helps to correct new muscle fiber realignment, minimize scar tissue and increase blood flow to the injured area. Also, MRI scan can be used to ascertain the amount of damage sustained. I didn't have any of this at my disposal at the time of the injury.


Rehabilitation

Strengthening

Strengthening the hamstrings is the best protection against hamstring strain. The strengthening exercises should always be done pain free. Basic static exercises are to be done in the early stages and as the muscle strengthens move on to more demanding exercises.

Stretching

Stretching exercises should be done when the pain allows it. It is likely that strengthening exercises will be possible before the leg is ready for stretching. Hamstring stretching begins with very gentle stretches. As the injury heals the stretching will move on to more dynamic stretches.

Aerobic Training

While being sidelined of running because of an injury, it is important to find ways to maintain fitness. A couple of days of rest doesn't do harm, but after that one has to start looking for activities to maintain aerobic fitness. If my injury were more severe, I would probably have to buy a gym membership to use their stationary arm bike, rowing machine, cycle and cross trainer. I did cycling outdoors until I could start jogging again. In Finland I would have done aqua running. Neal Reynolds (a Premier league soccer physiotherapist) has made a good list of activities that one can use at different stages of recovery from hamstring strain injury. One can move on each stage when pain is not felt during nor day after the exercise.

Stage 1 - Arm bike
Stage 2 - Rowing machine
Stage 3 - Stationary cycling
Stage 4 - Arm only swimming
Stage 5 - Stepper
Stage 6 - Cross Trainer
Stage 7 - Slow jogging (2 x 10 minutes with a rest in between)
Stage 8 - Slow jogging (up to 25 minutes continuous)
Stage 9 - Half pace running, 6 x 50m strides
Stage 10 - Shuttles: 100m at 30s (3 x 6 mins), 100m at 27s (3 x 6 mins), 100m at 24s (3 x 5 mins), 100m at 20s (3 x 4 mins)
Stage 11 - Sprints: 8 x 50m (twice)


Why this happened?

Figure 1: Hamstring muscle group.

The hamstring muscle group consists of three separate muscles: the semitendinosus, semimembranosus, and biceps femoris. The hamstring muscles work very hard during sprinting to decelerate shin bone as it swings out. Just before the foot strikes ground the muscles are working hardest at the same time as they are approaching their maximum length. This is when the hamstrings becomes injured. One or more of the hamstring muscles gets stretched too far when hamstring strain occurs. The muscles might even start to tear. Surgery to attach the muscles might be needed in severe cases where the muscle is torn.


Prevention

Athletes should work hard to avoid injuring their hamstring in the first place. The hamstring strains can be nasty. Healing a hamstring strain is much harder than preventing it:

- "Stretch before and after physical activity." But don't stretch when you are cold.
- "Always increase the intensity of your physical activity slowly." This is exactly where I went wrong this time.
- "Stop exercising if you feel pain in the back of your thigh." When hamstrings give signs you better believe it right away.


How I got back

First week

3/1 Left leg hamstring injured while doing 6 x 200m wind sprint repetitions. Icing started right after getting back home.
4/1 Easy jog was interrupted after 1 km by sudden pain in the injured hamstring. Icing.
5/1 Rest and ice.
6/1 Rest and ice.
7/1 Rest
8/1 Walking outside: still feeling the hamstring, one time sudden impulse of pain, at end the hamstring started to get stiff. Strength: Standing Knee Flexion, Hamstring Catches on the bed, Bridges (both legs and single leg).
9/1 Riding bike: for 55 minutes, don't feel a thing in the injured hamstring. Strength: Standing Knee Flexion with more intensity, Hamstring Catches "running".

Second week

10/1 Riding the bike can be done completely without pain in the injured hamstring. Strength: Standing Knee Flexion full speed, Single Leg Hip Extensions.
11/1 Strength: Single Leg Hip Extensions with better control, Single Leg Ball Pick Up snapped slightly the injured hamstring. Icing was needed. Riding a bike is still possible.
12/1 Walking can be done without pain. Strength: Standing Knee Flexion, Bridges, Single Leg Hip Extensions.
13/1 Same as yesterday
14/1 Back to the 11/1 level
15/1 Riding bike
16/1 Very Easy Run 3,5 km without pain.

Third week

17/1 Easy Recovery Run 6 km without pain.
18/1 Rest: Traveling
19/1 Easy Run Hills at 1400m elevation.

Since 19/1 I got to run hilly courses on my vacation. I decided to continue to follow my original 10K Training Program on 28/1. That's 25 days after the injury occured initially. I also had a very light "sports massage" at beach one time during the rehabilitation. From here on I will increase intensity and speed in my training cautiously, while trying to run a lot of hills and do strength training for the hamstrings. The injury pointed out that my hamstrings are my weakness at the moment, and now they are the point of emphasis on my training.

Figure 2: Happy to be back running.
And greetings from the trails near Cerro
Aconcagua (6962m), Argentina.