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Tactical Fitness: Common Running Injuries – When to See a Doctor

Jogging on path.

There are many potential injuries that can pop up seemingly out of nowhere, especially when pre-training for and during actual Special Ops schools. If you are running longer distances than normal, swimming with fins for the first time, rucking, and carrying heavy equipment (logs, boats, etc.) it could only be a matter of time before you start to get inflammation in your joints and soft tissues. Here is an email from a BUD/S candidate starting to feel the effects of increasing miles of cardio during his preparation.

Hello Mr. Smith,

I ship out for basic on a SEAL contract this year. About three weeks ago I injured my IT band trying to run too hard. I have recently just started to recover and am slowly introducing myself back into running to get myself ready for my next PST February 16th. I have been cross-training for leg strength and core workouts in the meantime. My question is, while in BUD/S, what would be your advice to prevent this injury again, or really any injury for that matter? I know injury is bound to happen in some way or the other, but I just want to prevent the ones that will get me rolled back.

Thanks,
Kenny

Kenny –

Yes, the old Illiotibial Band (ITB). This is such a common injury at BUD/S. In fact it is so common at SEAL Training, ITB stands for "I Tried BUD/S." The volume of running, swimming with fins, rucking and carrying boats and logs can put a lot of stress on your lower extremities (joints, bones, tendons, ligaments). For now, you need to reduce your volume and follow these rules:

  1. If it hurts to run – stop running.
  2. If it hurts to walk – do not run.
  3. If it hurts doing nothing – go see a doctor.

Now that is a fairly liberal approach to seeing a doctor, and if you follow these steps it may help you avoid rule #3 if you are in the 1-2 stages of an overuse injury.

1. Reduce running at least 50%. Replace with non-impact options like bike, elliptical, more freestyle swimming if you feel no pain in those.

2. Take out swimming with fins for now. But continue swimming freestyle and working on pool skills (drownproofing, treading, knot tying) but if the knee hurts doing anything in the pool, stop swimming.

3. Take an over-the-counter anti-inflammatory. Ask your parents and doctor which one is best. I use motrin, ibuprofen with every meal when trying to reduce inflammation and pain in my body. Take it for a week.

4. Ice. Wherever there is pain after every day of training, apply ice or anything suitably cold. Do this for ten minutes on and ten minutes off for up to an hour.

5. Learn how to use a foam roller.  Get one and roll your hips, thighs, hamstrings, and ITBs. Video

Gluteus Medius

6. Work some glute muscles. Often ITB can be reduced by having a stronger gluteus medius. The glutes, specifically the gluteus medius muscle, is responsible for controlling thigh rotation, tracking of the patella (kneecap), and knee control.

A weak gluteus medius has been found to directly contribute to conditions such as ITB syndrome, patellar tendinopathy (runner’s knee), shin splints, Achilles tendinopathy, and plantar fasciitis.

Running injury

(From Special Ops Running Program)

Common exercises: dirty dogs, Donkey kicks, side leg lifts

7. Perform dynamic stretching before and static stretching after running. A dynamic warm up prior to running involving controlled movement through a complete range of motion for each joint is better before you run. After running, the usual stretching for 20-30 seconds per body part without bouncing is acceptable. Maintaining flexible hamstring and calf muscles will help with injury prevention.

If you are not feeling better by trying the above elements for a week, stop running, lifting weights and calisthenics (legs), and swimming with fins completely for an entire week. Keep using ice, motrin, and foam rolling. Several days of no running and swimming with fins is tough, but you can do non-impact options like swim without fins, bike, elliptical if no pain is felt.

At BUD/S, you do have medical professionals that can help you recover. There is a fine line between sucking up pain and pushing through an injury. You have to know what that is. Seeing gradual increases in your pain and decreases in your performance is a clue to when you need to see a medical professional.

Stew Smith, CSCS

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Contributor

Stew Smith works as a presenter and editorial board member with the Tactical Strength and Conditioning program of the National Strength and Conditioning Association and is a Certified Strength and Conditioning Specialist (CSCS). He has also written hundreds of articles on Military.com's Fitness Center that focus on a variety of fitness, nutritional, and tactical issues military members face throughout their career.

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