Injuries & Recovery with Corrine Malcolm, Sarah Scozzaro, & Stephanie Howe | Koopcast Episode 147

Hello, trail and ultra people. Welcome to another episode of KoopCast. I am your host today, Stephanie Howe. Jason Koop is out traveling the globe on an athlete project, so you get to hear from me and two of my colleagues and friends today, Sarah Scazzaro and Corinne Malcolm. And we're going to talk to you a little bit about our personal experiences as athletes who have been injured. We all three of us have had major injuries in the past few years, and we're going to share with you today what we've learned, how we navigated through it, what we did well, what we did maybe not so well, and give you some advice for dealing with your own injuries. Because let's face it, as runners, we're all going to get injured at some point.

And we are able to kind of steer our path one way or the other, depending on our actions, especially early on. So we're going to share with you a little bit about our experiences. And then as coaches, how do we help our athletes navigate this time? Because it is really tricky, and it's pretty emotionally charged. And it can be really hard because you have your head telling you one thing, your heart telling you something else, and then you're comparing yourself to other people on Strava, Instagram, et cetera. So how do you get through this time? What are things you can actively do to help yourself when you're injured? What should you not do? We're also going to break it down into our areas of expertise. So Corinne is going to talk about training architecture and some overtraining under recovering information. Sarah is going to talk about strength training and rehab. And I'm going to talk a little bit about nutrition and what you can look for to help you recover and get back to running on the trails. So I hope you enjoy this episode.

It's really, you know, us putting ourselves out there to share our personal experiences, knowing that we are not perfect as coaches and as athletes, and hoping that our information will help you in the future to navigate through an injury or a niggle or time off for whatever reason. So enjoy this episode of KoopCast with myself, Corinne Malcolm, and Sarah Scazzaro. I'm really excited to have you both here today. We're going to talk a little bit about our personal experiences as athletes and as coaches dealing with injuries and kind of go through what we've done and what we've done well and what maybe we learned from our experience. Because everyone who's a runner gets injured at some point and it can be a pretty tough process to navigate, but fortunately, you're not alone. And many people have been there before and gone through it and come out the other end.

And within that process, I'm sure we've all learned a lot. I look back at some of the things that I did and I'm kind of cringe. And there's some things that I did really well. So I wanted to bring you ladies on today to talk a little bit about this process because all three of us have had pretty major injuries. They've all been very different injuries. So I thought it would be kind of interesting to walk through that process and talk about it a little bit and hopefully shed some light and maybe some guidance for someone who is dealing with an injury that is going to require some prolonged time off. And so we'll share maybe some of our mishaps and then talk about as coaches as well, how we use our experiences to help our athletes, because that's something that you do come across as a coach as well. Your athletes get injured and using our personal experience can help us shape how we navigate through that with them. So it should be a fun conversation.

Let's start with Corinne, because you've had, we'll go in order of most recent to least recent. So Corinne, you had a major injury. Was it about a year ago that set you, I guess, the diagnosis? And just explain, I guess, what the injury was, and then we'll kind of talk through it a little bit. Yeah. And it's kind of ironic that we're recording today because I've got kind of a recurring issue with said injury that I'm actually going to go see a sports med physician about in about a week. So when this comes out, I will be going to see a sports med doc to kind of try to get to the bottom of a few more pieces of the puzzle that, I mean, this will come full circle for all of us, I think. But yeah, I got hurt. I sustained a major injury about 18 months ago. It was kind of late winter, early spring of 2021. Kind of had like intermittent pain that was periodically like super, super severe. It ultimately ended up being bilateral stress reactions at both pubic rami, so where your adductors insert in your pelvis. And then additionally to that, on the left side of my pubic symphysis, and your pubic symphysis again is that bit of cartilage in the front of your pelvis, kind of where your pelvis comes together. And on like the, on the front aspect of it, I had a stress fracture just to the left-hand side of my pubic symphysis. So kind of major, major big bone stress injuries in a, in a big bone and big bone stress injuries are,

you know, something that we worry about. They're big red flags. They're hard to heal. They have a lot of soft tissue and tendon components that oftentimes create bigger, bigger problems and bigger hurdles down the road. And that's kind of in the phase I'm in now. But it's, it was one of those things where initially, you know, getting, getting the diagnosis and just like having a diagnosis made me feel really, really good because I knew what was wrong. And I knew that we had to have a plan to fix it. But there's no timeline with a lot of these injuries. I used to say, oh man, I'd take a bone break over a, over a hamstring tendinopathy any day. But I've, I totally take that back now after the last 18 months of my life. Um, that even bone breaks can be really, really complicated and getting back to the sport you love can be really, really complicated.

And I definitely made many, uh, I mean, I did a lot of really good things and I also did a lot of really bad things along the way that has kind of, once again, led me full circle back to seeing UW sports med, um, in about a week's time. Yeah. And if I remember correctly, when you had that diagnosis, I think it was a bit of a shock to you because it sounded like it was painful, but it wasn't like what you would expect a stress fracture to feel like. And I I've heard that before of like, well, if, if it was a stress fracture, I wouldn't be able to run. I wouldn't be able to walk. I would be in so much pain. So was that the case that it kind of caught you off guard? I think I remember you saying that. Yeah, it was super weird. And I've, I've heard similar things with other people with like sacral or, or pelvic pelvis related stress fractures, even some femoral stress fractures. Although I think those end up getting pretty painful too. Um, but for mine, yeah, I was able to run a lot of times people, you know, it's, there's a, you know, diagnosis process of like, well, maybe it's a sports hernia even, uh, kind of in that same, same general region. So you got to have to rule a bunch of stuff out with imaging and testing. Um, but yeah, I, I mean, the week I got an MRI, I think I ran, you know, 60 miles with, you know, several TAM summits during the week type of thing. Like running itself wasn't that painful, but the rest of the time I, I had a, I called it a hitch in my giddy up, like taking my dog for a walk was hard, like getting my left leg to move properly,

um, walking around my house or walking from the car back, back into our house was very difficult. And so I think it's like, it was not a, Oh my goodness, my bone is broken. I can no longer run. It was a thing where it's like something's off and I don't know what it is. And I have to listen to that instinct. And I'm glad I did listen to that instinct, but it wasn't like a, Oh, you know, I tip fibbed. I can't run anymore type of type of scenario. Yeah. And I think that is a good example of why it is important to listen to those signs, because if you can run, it's like, you know, that's, that's great. But if then everything else is painful, that is a sign your body is trying to tell you something. There's probably something going on and being your own advocate and figuring out, you know, what, what that is. A lot of times that requires you pain out of pocket sometimes for an MRI, or you can think of your doctor, like I need, you know, cause they want to do an x-ray first and usually you have to do that, but it's like, that's not going to show anything. So really pushing for that. So you, so you know what's going on, um, because yeah, it could be something, something severe and thank goodness, right.

That you, you did listen to that because a stress fracture is one thing, but a full on fracture, you know, if you would have kept running, that's another, that's another thing. And especially in that area that can require like, you know, surgery, uh, putting in like a steel rod or metal rod to hold things together. So I think it's really good to hear you say that, you know, you were able to run, you did TAM summits and you had a stress fracture and thank goodness that you got it checked out when you did. So what are some things that you did? Well, let's start with the good. What, what were some things that you did good? Yeah. The things I did well, um, were like, like putting my team together right away, right? Like I advocated for myself. I thought something was wrong. I have PTs. I trust, I have positions. I trust, I I'm fortunate that I have a really good understanding of the medical system and I'm, I'm highly medical medically literate and maybe you aren't and that's okay.

But if you have that, that PT friend in your running group, maybe that's your person who's medically literate for you, who can help you advocate. So I think putting your team together right away is really, really important. And so I, I did, you know, I was living in the Bay area at the time, was able to reach out to, you know, Dr. Emily Krause right away. Who's, you know, very, very good when it comes to handling, uh, bone stress injuries in particular and working with, with female athletes in particular. And so was able to, you know, have her go over my MRI read and really sit down with me and try to start to formulate a plan. Um, I saw our really good friend, Claire Bernard Miller, um, for PT recognizing that I probably had some pelvic floor dysfunction and needed to start to, to get that, you know, moving, get like, start to get like treatment under, like started more than anything, I think was the big thing there. And then also sometimes you're not going to find the right practitioner right away. I actually had a really hard, my body responds really well to, um, to like manual therapy, to manual tissue, tissue therapy. And it took me a long time to find providers in the Bay area that I really liked that I, that I clicked with who could help, you know, treat what I had going on specifically. And so it's kind of like throwing darts against the board a little bit to, to find those people. But I, you know, I, I put up the money and the funding, which I know is a privilege to do in order to track down those people and have those people in my corner steering the ship because I'm a person that while I'm a coach, I still have a coach because

I need to get, I need to offload that mental work to someone else. I need someone else to say, this is the plan. This is how we're going to execute it. And while I'm still there listening to my gut and being an active participant, I get to lean in and just trust my team. And I think that that, that worked really well. And I was really, really patient and that patient piece and knowing that I might have to step back periodically was another huge piece of that puzzle. I mean, I started a run walk process. I think the injury was end of February. We confirmed with MRI in March, early March. I took six weeks off completely from running, started like a very gradual run walk program. We re-imaged and we probably re-imaged a little too soon just because there's a delay in how bone healing shows up on MRIs. We re-imaged probably a little bit too soon. Didn't see what we wanted to see. And so actually backed off and became even more conservative. So this time last year, like in, like at UTMB even in August of last year, so about a month ago, or I guess 13 months ago, technically speaking, I was going for three to four mile runs and I couldn't do more than two, two running days in a row. So I had like, I had gone through a run walk program in, in like April, May, had to back way off in July and was like getting back into a run walk program again in August. So being like having your team in place, being incredibly patient is really, really important.

And then like, I, you know, this kind of leads into my mistake too. Like I cross trained reasonably. I don't think the cross training was an issue, but like moving beyond that, my, my big kind of slip up there is that it's, you can't just put a bandaid on it. You can't just like be like, well, I did the work once. I should be good now. And I'm not very good at doing the work, like the little things, like strength and stretching and making sure I'm completely taking care of myself. And so for six months, I did a really good job, got to run Madeira this spring. And then post Madeira, we found out we were moving. We moved, we bought a house. I traveled a ton for work. Training was kind of wishy-washy to begin with, but the, all those other pieces that I had put into place in the Bay area when life was stable fell to the wayside. I wasn't getting, I wasn't getting like manual tissue work. I wasn't seeing a PT. I wasn't doing the accessory work. I wasn't doing strength work. I definitely wasn't doing PT exercises. Like none of those little things were happening. And I essentially stopped taking care of myself, which is why we are full circle to where we are today, where I am like, I'm actually not running right now because I am having symptoms that I ran through 18 months ago that ultimately ended up with a stress fracture. And so we are concerned that I have like an early, another early bone stress injury in that same area, essentially that it hasn't healed properly. And that I have like an early stress reaction and we're treating it as such until I see sports med. But it was a real wake-up call of like

not taking care of myself, trying to raise TDS after six months and not taking care of myself and having a mist up there, having a bobble and ending up in this place where it's like, oh, I'm, I'm recognizing immediately that these were symptoms that I ran through before because running feels okay, but it's after running and doing some other like non-weight bearing things later in the day that becomes a big issue. So it's like, while I made a big mistake and I messed up a lot in the last six months, I feel really proud of myself for like recognizing this symptom early on. And like immediately, like I saw my PT on Wednesday, like made the decision Tuesday, saw my PT Wednesday, stopped running, scheduled an appointment with, you know, a really good, you know, the Emily Krause of the UW medical system essentially. So I feel like I'm, I'm back on the path, but it's been a really, it's been a really like hard wake-up call to see that I can do the right things, but it's really easy to do the wrong things.

Yeah. I think there's a lot of good we can take out of what you just described in the fact that you took a pause. You could have just powered through it again, right? Of like, oh, I'm just, you know, I can run. I'm just going to keep going. And then you'd be set back even further. So I think that's a huge, like you learn from your past. You saw your body was giving you maybe those not so subtle signs of like, hey, like things are not going well. And you listened. So I think that's incredibly like you, that's a mature response. It's hard to do. And especially Corinne, I saw you at UTMB and I know that was a big, you know, going through TDS and not finishing because your body wasn't in the place where it was able to do that. That's super hard to do in a big race where you have maybe some self-induced pressure, maybe some external pressure, but it's exciting.

And the last thing you want to do is travel all the way over and then not finish. And you were able to listen to your body there. And I think that is really something to be proud of. And using your past experience to really listen and understand so that you don't end up in the same boat. And I think another good point is that stress is stress. So training stress, we can really conceptualize how that impacts our body, but other life stress, sometimes we don't understand that moving, a new job, not being in your routine, not having a PT, maybe not having the same nutrition. Those things all impact us the same way physical stress would. So you may not be running as much. Your training might be cut in half, but when you have all those other stressors, they start to accumulate and they can really put place your body in a, in a vulnerable place for injury. And so I think that's another good point for athletes to consider just because on paper, you're not training that much that would put you at risk for something or your body is feeling okay. All those other things are starting to add up and they really impact you in the same way. Yeah. A hundred percent.

So I think it's, it's really good to hear that you, you are taking care of yourself. And I've heard you talk, I think on your podcast, um, trail society about prioritizing yourself for a bit because you were really good about saying yes to everything like this podcast that I asked you to be on. I appreciate you here. Uh, but you can't do everything. And knowing that if you want to have, if you, you know, have some goals, you need to give yourself the time to train and recover and also just not have every minute of your day plan. So I think I'm glad that you're hopefully doing some of those things and really wish you the best with your sports med appointment. Um, I think, yeah, you've caught things a lot earlier than the last time. So this is a good reminder to, to do the little things too, because when things don't hurt, it's like, well, I could do PT or I could not, I am guilty of this. I'm guilty of not stretching, not doing PT exercises, body work, et cetera, when things are feeling good. And then when they start to flare up, I'm like, Oh yeah, get back on that program. Whereas if you just stay with those things, usually they pay off. Yeah. A hundred, a hundred percent. And I do think that it's like a mature response or like, I feel like I have, I mean the, an, an older version of me that, you know, 10 years ago would not be this, this mature about it. But I mean, tears were totally shed.

I definitely cried during dinner on Wednesday night, like talking through kind of what that would actually look like and what that would actually mean. And, and kind of, you know, recognizing I, I told my husband, like, I don't care that I'm not going to race again this fall. Like that, that was kind of the hope post TDS, like, Oh, this will just be a little thing. I'll race again this fall. It's not a big deal. And I was like, I don't care that I don't race against this fall, but it's fall. It's large season. Like all I want to do is get into the mountains. And so I think the big thing on my end is recognizing that like, I just, I still have to reframe that even like, okay, maybe I can't run in the mountains, but when, if I'm cleared to walk in the mountains, I can walk in the mountains. Like I, and, and, and also keep that within, like not trying to push it to the absolute limit, not be cleared. Like, Oh, you're cleared to hike and then go hike 20 miles. Like, Oh, you're cleared to hike and like go on a reasonable hike. Oh, you're cleared to do strength. Okay. Well, I'm not going to go live in the gym seven days a week. Like trying to find that balance is, is really, really hard. And I'm fortunate enough maybe that I'm busy, that I'm really, really busy. And I'm like, I finally bought paint samples and you can't see on this wall, but I'm like staring at paint samples across, across the kitchen from me. And that's because it's like, Oh, I've got other things that I can do with my time that are really satisfying that make me really happy. But you know, you're allowed to be sad about it and you're allowed to be upset. I think that's the big, important thing. Like, yes, you can make smart decisions for yourself, but you're still allowed to like grieve or mourn or feel like you're a ship adrift a little bit. And then once again, lean into your support system, lean into your coach, lean into your PT, lean into your friends, lean into your, your family, right. And have them be those, those stability objects for you right now

while you try to like slowly course correct and right the ship. Yeah, a hundred percent. And I think when you don't allow yourself to be sad, you kind of just suppress it and you don't really process it. So I think it's okay to be sad and to grieve something that you've lost, but give yourself a deadline or give yourself like the time to feel it and then start healing and start moving on or progressing forward. And I think that that's an important part of getting through an injury is acknowledging how, how hard it is or how, how sad it makes you feel and actually crying those tears. And it's okay to have a day or two where you're just like, you know, upset or frustrated or moody, or maybe you don't get out of bed, but don't let that be just your new normal feel those feelings.

And then, you know, I think sometimes when you cry it out, you feel a little bit better and then you can start progressing and think about the things you can do. Like you just said, you know, going for a hike or simply being outside. I, we can talk about this in a moment of just how to, how to just embrace a slower pace of life as a runner. But I think that's something that we don't always think about. It's not just running outside that can give us those endorphins, not quite the same, but we can still find the positive. Yeah. A hundred percent agree. So let's move on to Sarah, change it up a little bit. I want to hear about your injury because yours was quite different and it actually required a significant time off from running many years. And so just tell us a little bit about your injury and situation.

This was in the early two thousands. I got into marathon running. I really found an identity through running. I had loved running when I was younger, but really just found my thing. And unfortunately I decided that I coupled that with some body image issues and did a lot of kind of restrictive eating. Not what you would consider like disordered eating. Like there was no diagnosis, but I definitely was cutting calories and really trying to cut corners there. So anyways, but my training was ramping up and up and up and up. And at the time of my injury, the diagnosis was female athlete triad, but we now know it's more of red ass because I did never lost my menstrual cycle and my, I'm sorry.

Wow. I did lose my menstrual cycle for a year. I never was under a low body fat. So to look at me, you would be like, Oh, she's not that lean. Like I still had, you know, I was still very healthy looking, but I hadn't menstruated for a year. And I thought that was awesome at the time because I didn't have to deal with it as a young woman. Um, so I thought that was cool. Uh, so I was on a run and I stepped on a piece of sidewalk that a tree root had gone underneath. And when I stepped down, it collapsed and it hyperextended my leg, which then crushed my medial tibia plateau head down a half inch. And I had a complete break of that. Yeah. So I had to be taken to the hospital, but I was, I had the wherewithal to stop my watch because we didn't want to get any, you know, extra time on the watch there. I mean, it was just this compulsive behavior. And, um, I had surgery.

I was in the hospital for almost a week, had complete reconstruction on the knee, uh, screws, bone paste. And when the surgeon came out of surgery, he told my parents she'll never run again. And she'll always walk with a limp. And I didn't run for eight years, eight years. So, yeah. So that's a kind of like a, I know it was. So, um, but I think that was one of the, at the time it was a lot of darkness and sadness. I was on bedpan bed rest for months in my parents' living room. I had to be immobilized because I had such a bad bruise of my, from my femur that they thought I would need a knee replacement. They didn't think the bone would heal. So I was in a brace from my hip to my ankle in a bed for quite a long time. And then I did CPM cat, uh, you know, the passive motion machines and all of that. Um, and I wasn't fully weight bearing for about six months. I couldn't walk without, I went from wheelchair to walker to cane to walking. Um, so that process, I wasn't even thinking about running because I couldn't even walk. Um, but then once I started to see progress, it was like, well, when am I going to run again? When can I run again? And the doctor finally was like, well, no, this, that's not going to happen. You've mangled your knee so bad. So I took that and decided, well, what can I do? And so, and I got a healthy relationship with my body because I realized what I had done to it. Um, I mean that, that freak accident could have caused the injury itself, but I know that I put my body in such a

depleted state that it wasn't strong enough to handle that. It wasn't as durable. It certainly didn't help things. Um, so I started strength training and I cycled more and I hiked and I did the things that I, I could do so that when I was able to return to running eight years later, which is a whole story, um, I feel like I'm a much more durable athlete and I have a better perspective. So now if something's hurting, I don't push it. I don't run through the pain. Um, prior to my knee fracture, similar to Corinne, I had a stress fracture of my, my pelvic rammus, um, on the left side. So incidentally, my knee was on the left side, the way I, you know, that, that just happened. But so that saying is your body, listen to your body when it whispers or it will be forced to scream. And looking back in hindsight, my body was giving me lots of whispers. It was giving me, you know, not having a menstrual cycle for a year, having a couple of stress fractures, you know, that I took the time off, but as soon as I could, I was right back at it, you know, and I made up for lost time because I am young and I am invincible and I can, I can bounce back when in fact, if I had done what I needed to do to get my body healthy and had a different mindset and not push things, I don't know if I would have dealt with this injury, but I did. And so it forced me to completely rethink how my relationship with running basically.

Yeah. And that's, I think a very similar, many, many runners have a similar story of maybe a disordered pattern of eating or just not fueling their body properly and thinking they can get away with it. And then something, something has to get it. You can't sustain that. It's just a matter of time. And, um, I'm going to talk about nutrition in a little bit, but it's most always a macronutrient deficiency and not a micronutrient. So we always think like, what supplements do I need? I need calcium. I'm, you know, my bones are not strong. I need more calcium. It's like, no, actually you probably just need more energy and you probably need to heal your relationship with food. And that is a tough process. I know you said you were able to do that. And I think it's, it would be remiss to not, to not point out how hard that is. Um, especially in our society right now, when that's kind of, you know, at the forefront of a lot of what we see is this glamorization of disorder eating to varying degrees. So some is more just, I don't want to call it benign because it's not, but it's more just, um, like focusing on health and performance, which can be a form of disordered eating all the way across the spectrum to a true eating disorder where there are restrictions and binging and purging and, um, just a really unhealthy, uh, physiological state. And so, uh, I don't want you to have to go through too much of that, but what did that process look like for you?

Um, just briefly of like, how did, how did you work through that? The nutrition, like getting more comfortable food or just the whole aspect of things? Yeah. The nutrition or just how did you, how did you become, have a better relationship with your body? Absolutely. Um, I did work with a dietician, so that was important because I needed, I needed somebody to say, you know, I needed to see that, that the facts of like, you're not getting enough and having those conversations and, and being able to discuss with food. So I did work with a dietician, which I think was really important for me. And I think it's very important, you know, um, honestly, mine was more of that. Well, if 1800 calories is good, 15 must be better because I can lose a little of this extra weight. I had been told from an early age, if you look, if you had looked at me, I looked healthy, but I never looked skinny and people would sometimes say, wow, you're carrying a little extra. I once had a doctor when I was 10 years old, tell my mom, I was at the top of my weight chart and I could probably, I should probably lose a little at 10. So I know, and I was in the room. And so as a female, you know, we can go deep into like all of that when you're young and in middle school and high school, and just a couple of those little digs here and there where you start to think, well, I'll, I'll be better if I'm leaner. I'll perform better if I'm leaner. And I think I had a very unhealthy relationship with my body. And then when I rediscovered marathon running or discovered

marathon running, cause I had loved running, it was an, it for me, and I'm fully transparent about this. It was a way of, oh, I can train a lot. And then I can lose weight because I'll be exercising so much in the name of training for a marathon. It won't look like I'm obsessive. It won't look like I'm unhealthy. I'm, I have a goal. So if I have a goal, nobody can call it a compulsion. Like it's twisted thinking, but in the time it was, oh, more, more should be better. And yeah, and I didn't work. So, but the nice thing, I guess the, the thing that I walked out of that from is, um, realizing what I had done to my body. I, you know, I also through all of this discovered that osteopenia at the age of 23, I had the bones of a 70 year old, my DEXA scan came back and it was pretty rubbish. And that's a little too young to have bones that bad. So I had to make some big changes because that was, so it was a, it was a kind of a come to your maker moment. And when, then when running was taken away from me and when I say taken away air quotes, you know, my behaviors caused my body to be in a position where it was not healthy to run anymore and it broke. Um, I was like, this is not how I want to be. I'm 23 years old. Like, this is not how I want to be when I'm 30, 40, 50, 60. I want to be able to move and be healthy and, and appreciate my body for what it can do. So it really

made me revisit my relationship with my body and go, wow, I kind of screwed you over. And and I need to eat. You know, for me, I was restricting a lot of fat because in the late, mid to late nineties, that was what you did. I don't know if any listeners out there remember like the snack well's treats. Yeah. So I restricted a lot of, for me, it was protein and, and fats because I decided to restrict what I was eating by following a certain type of diet. And I wasn't doing it for the right reasons. I was vegan and I wasn't doing it for, you know, people that do it for animal ethic reasons. I won't argue that, but I know I was doing it initially because it was a way to control what I could and could not eat under the veil of a title. So, um, yeah, there's a lot to unpack with my early twenties, but yeah. Yeah. Well, it sounds like you in some ways hit rock bottom and you had a choice and you made the choice to try to get healthier so that you could return to some sort of locomotion, whether that be running again or even hiking again, or just being active. You know, if you don't have a healthy body, you can't be, you can't move. Yeah. And movement is an integral part of being a human. And so I think, you know, hopefully it doesn't always take to hit rock bottom to see these things. But in your case, it was just your body had been giving you those signs

and you just kind of kept going through it. And it was finally like done, you know, and you listened. And one thing that I'm taking away from both of you that I think is really great is you've both said, now when things hurt, I recognize that and I cross train or I take a break or I don't just power through it, which is a very mature response and not something that always is the case, even after going through injuries. I think that's really admirable to hear you both say that. I just was talking with my friend, Claire Bernard Miller, who we just mentioned is a PT. She was on the podcast last week. She is a great example, I think, that I like to use. She runs and she's had a lot of injuries.

So when something hurts, she just takes a week off. And I'm just like, wow, Claire, that's so awesome. Like we were going to run last week and she said her hip or hamstring or something was hurting and I'm just going to take a week off. But she has learned from having these injuries that when something is bothering her, if you rest early on, a lot of times you can avoid these conversations that we're having right now about injuries. So I like that. It sounds like both of you are trying to listen to that a little bit more and use that knowledge to help you in moving forward, moving through the present. Yeah. And I would say personally for me, when I had my injury, there was no, you know, sometimes people get injured and they want to do everything they can to be running again. So everything is in with that single-minded focus of like, I need to run again. I need to run again. I need to run again. I was told I would not. So everything I did from that point over is how can I just be healthy again? How can I, my body be whole again? How can I heal from this? Not to run because I was told don't, that's not something that you will, you should be doing or would be doing at the time. But so it wasn't this rush to like cram my healing, which I think was really important for me because had I been told, yeah, yeah, yeah, you can be running in six months or a year or even, you know, whatever, if they'd given me a timeline, I probably would have tried to force that. And I would have tried to, you know, you see a lot of people doing that where they don't take the time off. I gave my body

the time it needed because there was no expectation. And back to like what you just said about like Corinne and I, and I know personally, if my knee hurts or anything hurts, I'm the same as that PT. I take at least three or four days off up to a week or more. I just won't. I'll hop on the bike. I'll go for a hike. I'll rest. I'll up my calories a bit. I don't, I don't run through pain. I just refuse to do it because I know that if you do that, you can put yourself in the position where you're not taking a week off. You're now taking three, four, five, six months off potentially or longer. And I'd rather give up a week than give up a lot longer if I can catch things early and figure out what's going on. I think that's a helpful thing for any athlete or as coaches for us to do is to zoom out. And when you, when you zoom out and say, okay, it's, it's really just a few weeks, maybe a week, maybe a few days of rest right now. And if you look at your goals over the year, that's not that much time away. Whereas if you, you play that, that game and you, you risk it and you keep training, it could be months off. And so I think zooming out is a really helpful thing to do. And like in the grand scheme of things, it's not that many days off. Um, it feels different when it's like you're choosing to do it, but it's such a good thing to do. It's usually, usually a positive reinforcement when you do it and you see the benefit of like, okay,

I actually feel better now. And then you can resume, resume training. So question for you ladies, cause I'm sure you see this too. Like when we have our athletes that are having issues and we are recommending like, you know, let's rest a couple of days. And it always comes back of, I don't want to lose fitness. I don't want to, you know, and having those conversations, it's so important to be like, you're not going to lose fitness in a couple of days. Um, you know what I mean? It's so important to impress on people. I know we all get in that point where I can't take a day or two off. I'm going to lose fitness. And it just doesn't happen like that. And so I wish more people understood how detraining actually works and how taking a couple of days off can actually really potentially save more of your season than people realize. Right. We know major detraining doesn't happen for four to six weeks. And so looking back at like, you know, a few days to a week, you are absolutely not going to lose fitness. And I think we have good science to back that up. So sharing some of that with our athletes is helpful when they can actually see those numbers or they can just know those numbers and we can, you know, provide a study if they want to look at something just to see that, but then actually examining what is the anxiety of taking a few days off? Why are you anxious about this? Because I think that's, it's an uncomfortable process, but I think it's a really great exercise to go through of what are you afraid of will happen if you take a few days off? I do this to myself because I struggle sometimes with like, right now I'm dealing with a hamstring, a sore hamstring. And it's like, I don't want to

take a day off because running or exercise or getting outside has been like my mind needs it because I've got so much going on in my life. But there's a number of reasons why it can be a fearful thing. And I think examining that with an athlete or with yourself of just what do you think is going to happen or what are you afraid of can really help you get over that. And it's not an easy thing. A lot of times it can come from like an energy balance. That's a really common one. A fear of, you know, not exercising for a few days is going to cause you to gain weight, which is completely untrue. Your body is not a checkbook. I can talk you through that. Anyone who has questions, email me. I will give you my long spiel on that. Or is it something like you are truly afraid of losing fitness? And if that's the case, we can talk that through. And there's few injuries where you can't do anything. So what can you do? Yeah. And I would say like we have opportunities to practice this. I love the show. First of all, I love the show and the science thing. Like that's, that's a great way to be like, look, I wrote this article. Here you go. But I think it's, it's, we have, we have all been given opportunities to practice this outside of injuries.

Maybe not all of us, but the pandemic was a really good opportunity to practice that and learn that in part because racing was taken away. Racing was taken off your calendar. So you did examine why you run, you know, right? Like, like, why do you do this activity? Why do you move your body? So I think that, that made a lot of people evaluate kind of what they were doing in their day-to-day and what they were quote unquote training for, needing that why to be redetermined for them. And then the other thing, like I live in the, I live in the Western part of the U S you, you both are familiar with wildfire smoke. We routinely this time of year get shut down from exercise due to unhealthy air qualities. And I watch people run in heinous air conditions, like really, really horrible ones, or they go home to the Midwest for Christmas and they brag about running in a negative 20 degrees.

And it's like, they're okay. This is not, this is not about your health anymore. Because if, if you were running for your health, you wouldn't be running in these conditions. Therefore we need to examine why you run. And so I think we have opportunities to practice that outside of an injury that all of a sudden makes you have to make a change, makes you have to stop running or, or change to a cross training activity or take a day off. So I think that those are things that we can lean into as coaches and, and present athletes with opportunities to practice, maybe practice those things. Maybe it's like a family vacation. I think most of our athletes probably take family vacations, right? And some of those are, I've got some athletes where it's like just them and their partner and they don't have kids and it's a runcation. Great. I'm not talking about those people. I'm talking about the people who have to go to Carbondale to ski with their kids. I mean, have to, it's probably pretty great, but they're trying to figure out how they can fit their training in, or they're going to like a crazy cool beach vacation, you know, but it's in an all-inclusive resort. And yeah, I guess there's a treadmill, but like, do they really want to run on the treadmill, but it's not really safe to run outside? You know, what are they going to do type of thing? And it's like, okay, this is an opportunity to practice. What does moving my body mean to me? What does exercise mean to me? So I think that akin to, you know, my parents giving me a, you know, a pet when I was little in the hopes that like the pet would pass away before anyone else significant in my life passed away so that I could like practice grieving and mourning and understand loss. I think we can do that with our athletes in the sense of like, there are many opportunities in our life, in our day-to-day life, in our,

you know, in our yearly planning where it's like, we can have athletes practice this before they get hurt and then are forced into a corner where they have to learn really quickly. Yeah. 100%. I really love that. And I think it's an important point. And like you said, the beach vacation or like any vacation, like fitting in your training, like that's just like kind of defeats the purpose of being there in my opinion. It's usually short. I mean, maybe some people are fortunate enough to be on week-long, multiple week-long vacations, but usually it's not a significant amount of time. And if you look back at like the mental energy it takes to try to wake up at 4am, to get on the treadmill, to run in this beautiful tropical area and just suffer on the treadmill, I'm painting the terrible picture. It might not be that bad, but you don't need to do that.

You can actually enjoy that slower pace of life. You can be, let's say, quote unquote, lazy. You can enjoy relaxing for a week and you're not going to come out of that any worse for wear. In fact, you might actually heal and have a desire to get back and train and have things be even better when you get back. So I love to try to teach that to athletes or to at least plant that seed of like, you know, if you're going skiing all day, you don't have to get up and run for two hours before you go and are active, even if it's slower than what you usually do. So I think that compulsion to exercise is where we get into trouble a lot of the time. And this could be a good, a good time for me to talk. I'll just go through my injury briefly because we kind of already, we talked a lot about it.

You said the word compulsion. You said the word compulsion and you're like, it's my injury. It's my time. So let me just tell you, so I've had, and Sarah and I've talked about this a bit, but my injury has been my Achilles and I've had surgeries on both sides and I've done some healing a lot better than others. And I'll just kind of briefly go through it. Both of them required surgery, full on Hagelin's deformity where they cut the tendon, shaved the bone off, reattached the tendon. And I've gone through the minimal surgery. It didn't work. I went on for the full surgery at the Stedman clinic. If anyone wants to talk Hagelin's, I can, again, talk your ear off about that and would fully recommend to go for the big surgery because usually the minimally invasive one is fantastic for recovery, but it doesn't actually solve the problem for most people.

So my first time I had the surgery, I actually, well, the first time I had the major surgery, which requires like six weeks in a boot, you know, like six, really six months until you're running again, three months until you can start to run, but it's not fun running. So it's, it's a big recovery in the grand scheme of things, not that big, but when you get it done, it's like, Oh boy, I'm going to like mark my calendar for six months from now. So the first surgery I wanted to move because I like to move. That's how I have my greatest ideas. It's how I clear my head. And to me, I love running. It doesn't have to be running. I'm a multi-sport athlete. And so I will do pretty much any sport when I couldn't walk or really do anything with my legs. There was a time where I went to the gym and I would row and I would, I couldn't use my legs it. So I just use my arms or I would do the ski ergometer and it kind of wasn't that fun.

It felt good after, cause I would be sweaty and I would have the endorphins, but the mental energy it took for me to go and do that was so much because it's not really that fun. If you've ever done the ski ergometer, cross-country skiers do it, but they do sprints, right? It's hard. You finish and you feel like you want to puke. I would do like 30 minute sessions on there and I'd have to trick myself through it. And when I, like I would have a conversation with myself, you know, every so often of like, Stephanie, why are you doing this? And to be honest, that wasn't a good answer. It wasn't like I'm trying to maintain fitness. That was probably my excuse, but it was really a compulsion to move. And there was nothing I was gaining from that besides, I mean, I wasn't gaining anything.

I was losing a lot though. I was losing my mind. I was making myself tired for no reason. Whereas I could have focused that energy on healing or just, you know, doing something else. And turns out, I actually ended up getting a staph infection and it's TBD whether, not TBD, it's uncertain whether it was from a sweat getting into the wound or because I went to an Island and went in the beach and in the water there and got a staph infection. But I had to have a surgery again on that foot to clean it out. So sometimes our best intentions of trying to move backfire. On my second side, I didn't do any of that. I also had a two month old, so that was part of it. But I just kind of didn't do anything. And you know what? My recovery was maybe faster. It definitely wasn't any slower.

My return to run was the same. My fitness was the same, but I had more mental energy that I hadn't burned through. And so I think I have an athlete that we joke about suffer points. And I think I burned all my suffer points rowing and doing the ski ergometer for no reason. And then when I got to actually being able to run, I was just mentally tired. So Sarah and I have talked a bit about the compulsion exercise and we see athletes sometimes who are injured, who are just doing ridiculous cross-training. And I'm not trying to say don't cross-train. I think it's great if it's something that's enjoyable, but when it's just, you know, like in, I'm using myself as an example, when it's just rowing for, you know, with just using your arms, there's nothing that I was gaining from that. So I think that's something that I really love to point out or, or at least try to tell athletes, you don't have to do this. It's okay to sit. It's okay to be uncomfortable with that. And maybe it's a good thing. Yeah. It's okay to completely, to completely decondition, completely decondition.

And that is okay. It's not, it's not going to end, end your career and it might just save it, I think is the big thing there. Like I think, and this is kind of tangential a little bit, and I've talked about this and other places too, but you know, I think the difference between Sarah's injury and my injury is that mine is like this weird biomechanical issue as opposed to a bony, a bony injury at a big bone, which, which is oftentimes macronutrient involved. And so when I see athletes with these big bone stress, stress injuries and they, and they, there is a bone density component, there is a, an amenorrheic in women component. There is a red, a red S component, whatever it might be, you know, that's also a metabolic injury. Like it's a physical injury because you broke a bone or you, you know, you have a horrible tendinopathy because you like don't ingest enough protein or whatever it is. Like you're just chronically under fueled, but it's, it's, it's, it's a metabolic injury as well. And I think it's easy to forget about that. And when you have a metabolic injury, cross training doesn't help because you're continuing to put yourself in this deficit because you're continuing to dig the hole deeper and deeper and deeper. Instead of focus on healing, you're focusing on like how you can get around the system in a lot of ways. It's, it's, it's, it's looking for shortcuts, right? In that sense. And so that is my biggest fear with the cross the, the overzealous cross training in and around injuries is that even if you think you're metabolically sound and you eat well and you fuel well and your body is happy, you still have a major

injury. And so, you know, cross train with a degree of caution, you know, even if it's uncertain what the, you know, the perfect ideology of your injury is just because, you know, like you got to heal the whole system and the, the, your, your body might need a little bit extra, extra kind of sit down power right now as opposed to sweat it out on the arm bike or the ski or I've definitely done some ski or workouts in my, in my time, but you know, what like there's, there's a, there's a degree of insanity that goes along with it. So do things that make you happy. Yeah. Moving your body to a degree is still good, but like I always, I always, you know, advocate for a little bit of caution of the overzealous cross training just because it's there. You're right. There is at, at a certain point, there is no more means to an end. And I find too, that that's such a great point. Yeah. And I find too that like, I don't know if you guys have these conversations too, but if you're, if your body is deficient in something, you're, you're injured, just like you said, there's a metabolic syndrome, there's something going on and you're then swinging the pendulum and overdoing on your cross training, your body, you're using resources, your body needs to heal. And even though you're no longer running, so you feel good about it because I'm not running. So I, I'm not doing the thing that injured me, air quotes, you are still usurping resources that your body needs to try to heal. And you're not doing it any favors by compulsively over-training with the cross training.

So I have a, I have a question for Steph kind of based on that, right? And this idea that I think that the next big hole, the next big pit hole that I see athletes fall into, I fall into this myself at times is that, well, I'm not training, so I don't need to eat or I don't need to eat as much. I'm not hungry, whatever, whatever it might be. And like, that's, that's not entirely true. As Sarah just pointed out, right? Like you need, your body needs resources in order to heal. And if you're, if you're starving yourself of that, robbing yourself of that, you're only going to set yourself back. And I'm wondering if there is kind of a nutritional approach to, to how people can think about that time of injury where, where they're not, they're not training. Maybe they're, maybe they're on complete rest, you know, besides being a normal human. And that is kind of, I think it puts people in a bit of a pickle. Yeah, it's tough. And you're, what you just shared is what a lot of people perceive an injury of like, I don't need to eat. And I like to, to first of all, tell them that just because you're not training doesn't mean your energy expenditure goes down to zero. In fact, it's not that much lower than what it is when you're training, you're missing that time where you're, you're out, you know, running or cycling or whatever, but those calories or that energy, I like to use the word energy instead of calories. That energy is not, when you see your watch and it says, I burned 500 calories in this workout. It's like, okay, but if you would have started your watch

and sat on the couch for that hour and then stopped your watch, you still would have used about, you know, let's say 150 or 200, depending on the person and you know, how long it was. So it's not like you're going to zero and you absolutely need food and nutrients to one, sustain life. Your body needs that. So you can keep living and breathing and thinking and that sort of thing. But then two, to heal, you need extra nutrients to heal. And it's slightly different situation, but in like a hospital situation, a clinical patient who's like a burn victim, they need almost like an increase of 300 to 400 calories per day above what they normally need just to heal the skin. So if you think about an injury, you know, it's a little bit different, but you do need that extra energy. It requires energy to heal. You need the substrate available so that you can build up your body, whether it's your muscle cells or it's your bones or tendons and ligaments. They all need that substrate and that energy so they can heal.

So I like to first start with an athlete from a nutrition standpoint of like, okay, so let's make sure we get the basics done. And that means three meals a day. You need to eat. You can't just skip meals and think that it's going to benefit you or that you're going to stay in energy balance. When you reduce your intake, your metabolism will respond to that. It'll slow down. It will try to preserve everything and shut down anything that's not necessary. And so that backfires because then you have a sluggish metabolism and you don't feel as good. You're eating less. And sometimes you can actually feel like you're, I don't want to say putting on weight, but you're not able to process and your body composition is changing. And that's exactly what's happening. So if you maintain good eating habits, if you give your body what it needs and have three meals a day, good protein in there, good carbohydrate and fat, then you can keep your metabolism going and also provide the energy that you need to heal. The one thing I will say that you can reduce is anything extra. So that might mean alcohol or it might mean, I don't want to say cut out desserts because I think there's a time and a place for them, but just those extra snacks or extra things that you don't necessarily need that aren't part of meals. When you stop running, you kind of can reduce your energy intake naturally by just avoiding those pre and post eating occasions. So when you're training a lot, you usually have something,

depending on the time of day during your run or after your run. And if you just aren't running and you don't have those eating occasions, it kind of works out. So I just think you don't want to overthink it. You want to eat well and just keep your body, keep your metabolism going, give yourself enough energy so that you can heal. Easier said than done. Absolutely. Most all injuries that have to do with something, and I shouldn't say all injuries, but a lot of the time it's an energy intake. So it's a macronutrient deficiency rather than, like I said earlier, the micronutrient. So it's not like, oh, I have these issues going on and I need supplements. I need my calcium supplement and my iron supplement and vitamin B and D. And sometimes you do need those, but they shouldn't come in lieu of the macronutrients. You need to eat those things first and then use supplements if there's a true deficiency. Sometimes for whatever reason, your body isn't absorbing something or it's not getting it or metabolizing it correctly.

That's not the primary case for most of these. Usually it goes back to you're not eating enough. And when you can eat enough, you get most of those nutrients you need. I did a nutrition talk last night and that was one question I got was, what supplements do you take? And none. I take none. I took folic acid when I was pregnant. But I think if you eat well, you can get most everything you need, which is a little bit of a tangent. But it makes total sense. Yeah. And it's good to hear, right? I think sometimes we need permission to fuel our bodies well because there's so much misinformation out there and it sometimes feels like you're a salmon swimming upstream against the norm of what everything you see on Instagram is telling you.

Diet culture is real. Bro science is real. And none of it is true. And so I am giving you permission to fuel your body well because it makes you feel better. It makes you heal faster and it keeps you in balance. Good stuff. Good stuff. Write it down. Yes. Write it down. I wanted to just ask Corinne, ask you a little bit about just training and a return to run after a major injury. And I know it's kind of general because every athlete is different and every injury is different. But how would you approach that as a coach? If you had an athlete who had, say, some injury that required prolonged time off, let's say more than six, like six weeks or more. And then they've done the work. They've been eating well. They did their PT exercises. Now they're ready to run. How do you get them ready again?

Because a lot of times I think as athletes, we pick a race, right? Like I'm in a race in like six months after. And I'm just curious, what's that conversation? Like what conversation would you have with that athlete? And how do you get them back to feeling like an athlete and training again? Yeah. So I literally just had this conversation with my team managers. This is ahead of me like being like, I think this might be a stress reaction again. And it was, you know, why would we put a race on the calendar if you don't feel like you're ready to train? Like if you're not training right now, if you're just kind of like going through the motions, trying to figure out what's going on, like why would we put a race? Why would we put pressure on your calendar when you're not really ready to train for a race this fall type of thing? And I kind of like that. I mean, it was like I got out of the conversation. I was like, yes, I'm on the same page. I'm this idea of, and I noticed that as soon as I took my stuff off the calendar when I was hurt in 2021, like that, that made it feel better. I kept bumping things down the road when I had the injury in March. I was like, okay, well, like maybe UTMB. And I was like, okay, maybe not UTMB, but maybe, maybe I am tough. Like that's two, that gives me two more weeks. And I was like, okay, maybe it's not I am tough. Maybe it's this other thing. And I kept bumping it out the road. Like, okay, what can I race?

Um, and as soon as I took, I am tough off the calendar, I was like, okay, like I, I felt so much better. Like it just allowed me to train without the pressure of being like, okay, well, am I ready to do, I need to be able to do a two hour long run so that I can do a three hour long run so that I can do a four hour long run. And like, you're, you're doing the math. You're longing, you're logging into training peaks and training peaks is telling you that this big race that you're excited about is only 13 weeks away or 14 weeks away. And that continues to build and build and build. Even if you don't think of it as pressure, it's still there. It's still in the periphery. So I kind of like that idea of like, Hey, like, let's not, let's not rush to put anything on the calendar or at least not like put it on the forefront of our minds. Like I'm a person that loves to have a race in the calendar because it helps me when it's like rainy outside or whatever it might be to like, you know, do, do what I'm supposed to do, do the little thing, show up, train, et cetera. Um, but I think in the time of major injury where you've been out for six weeks or eight weeks, et cetera, and you're really just building back. I think that putting a race on the calendar too soon, um, sets you up for a lot of pressure and comparison of what you think you should be doing in, in that phase that you're built up for that race. And, you know, there's one of two ways you could do that, right? You could in theory with an athlete, put a race on the calendar, particularly if you both have the same goal in mind, like this is a race in the calendar.

It's a C level race. It's a D level race. It's like, we're going to go do the event, but we're, there's no performance goals associated with it besides getting to the start line and getting to the finish line and not feeling discomfort or pain afterwards type of thing. Like that, that is the goal. Like that was my Madeira. Madeira was on the calendar because it was to get to a start line and get to a finish line. And that was a ways down the training process to even get to that point. But I think that is an appropriate way to add a race to the calendar. Um, this, I really lean into people's PTs when it comes to run, walk, return to run programs. Um, I'm not a big fan of the ones that take a lot of time, but have a very minimal number of minutes running like the run one minute, walk nine minutes type of thing. I'd much rather you run a minute, walk two minutes, run a minute, walk two minutes, because when athletes are ready to get back to that phase, then all of a sudden it's possible that we can start to build out their cross training a little bit more at that point in which, you know, if you're, if you're, if it takes you an hour to run, you know, six, six minutes that all of a sudden you don't have time maybe to go to the gym or you don't have time to, to you, you were going to do a bike workout or you were going to, you were going to do something else that day. And all of a sudden, if you're, if you're returned to, to run program takes an hour or 90 minutes to accomplish every day, you're doing a lot of walking, which isn't a bad thing, but I feel like we could be more, more practical with that time. So I kind of lean into the, the more condensed. I like a long run walk program, like many weeks in length, but I like the blocks

to be shorter. And, and ideally those athletes are effective cross trainers and that we can utilize that as part of their plan to build, to build endurance primarily to build endurance off their feet or to add intensity off their feet. That's a big one where it's like, I can add intensity on the bike while we just continue, you know, and they do their two intensities in sessions on the bike a week, but every, the rest of the days they're doing their run walk program type of thing. So I think that there are ways to, to be really smart and effective and helpful during that phase. And I think that when you're getting to the point of run walking, ideally this athlete's already in the place to where they, their relationship with movement, their relationship with cross training is not in the place where we're still like frenetic about it.

Kind of the, like, I have to do this or my day can't go on type of thing. So I'm, I'm speaking very optimistically here in that, in that scope that we're being able to, we're using these other tools methodically without it becoming all consuming. And the athlete is returning to a, to a good place there. But that is my kind of general, the general things I've noticed with athletes over, you know, with many different types of injuries, but I've worked with a lot of athletes with bone stress injuries since I've, since I've been injured actually. And that's been a really interesting kind of piece of the puzzle to, to navigate with them is figuring out, it doesn't look the same for any of them is the thing. Like I've worked with lots of athletes with osteitis pubis, which I've liked experience now with, with pelvic stress fractures with, with lower leg injuries. And it's like, it looks different for every single person.

And I think that's the big note here. I actually wrote down a quote that I read recently and it was just about training in general, but it was often the best. They're often great in spite of what they do rather than because of what they do. And I think that that speaks to training in general, but that also speaks to that recovery period that people that are really good who get back to sport right away or whatever it is. Often it's not because of what they did. It's in spite of what they did. And so you really have to be hyper individual and, and still avoid comparison, even in that part of the process. Yeah. Which is not always easy to do. I like that you brought up the point of the run walk and, you know, you cross training, if you do it in a way, like, like you said, nine minutes walking, one minute running, you can spend hours doing recovery, rehab, cross training. And most people don't have that time. And then the other problem with that is when you're used to say suddenly cross training for three hours a day and you go back to now, okay, now you can run 30 minutes and you can run 30 minutes straight. It almost feels like a setback where it's actually a step forward, but it doesn't always feel like that. So being aware of like, don't cross train like a crazy person or, you know, don't cross train many hours a day because then it's going to feel like a step back when you actually get healthy running again. So I think that's a really good point. Yeah. And I think getting out of the, I think a lot of runners treat, treat cycling. Like it's, it's not a, it's not a one and it's not

probably a perfect one-to-one, right? Like an hour bike is different probably than an hour run for various reasons, but it's like, I think people get stuck in this, like, well, I've got a bike twice as long as I run for it to be effective. And that that's like, not, that doesn't hold true. Many of us rely on things like, like trainers or in San Francisco, my roommates owned a Peloton. So that was great. Like I had something and it's like, actually, no, like there's no coasting. It's, it's, it's pretty darn close to one-to-one. Like a, you can be on the bike for a very short period of time inside and have a really effective dose of training. So I think it's, you know, the, the hours can stack up for people and you just have to be, you got to get out of your head a little bit and not, and once again, not worry about what other people are doing or what you've heard or what you've read, like rely on your support system, listen to your gut. And I think those, like those things can help steer the ship. Yes. Yes. And cycling and swimming are training too, even though they are non-load bearing. I had a conversation with actually a friend, um, a couple of days ago that who said I, I didn't run or I didn't train for two days and come to find out this person had swam both days and did a stationary bike ride. I'm like, well, that's not really rest. No, is it? But I think it's like when we're used to running and it's like, Oh, it's running or it doesn't count. And actually that's not true. And like you said, a spin workout can be incredibly hard. And sometimes even, you know, if you're doing like a, a Peloton or Zwift workout, it might even be shorter than an easy run and you can just be wiped out. So reframing your mind around that. Yeah. And I think people don't look at a lot of

activity, like it's activity. Um, my husband's been working in the ICU and the previous ICU who's working at is like a 20 to 30 minute bike ride, like hard bike ride. Um, he can probably do it in 20 minutes cause he can pedal really fast, but it's probably, you know, for most people, it's probably like a 30 or 45 minute bike ride. Um, but like that was his only form of exercise during that month of ICU work because it was like their long, long days. And I think initially he was like, well, I'm not moving my body at all. And he's like, actually, no, I like, I get this thing that allows me to decompress in the morning. And this thing that allows me to decompress in the evening or because on nights, you know, the opposite way around. And I think that it's, it's recognizing that like a lot of things in our life that we do not consider training in quotes is actually like really valuable movement in our lives. Like I, I walk my dog a lot. We go play fetch in the park.

Like that's not, that's not nothing. And I think people get stuck in this idea of, oh, I'm doing nothing. My whoop, my aura ring, my Fitbit tells me that I am not doing enough. It's telling me to move. It's telling me to do these things. And it's like, people need to be a little bit more forgiving, I think of, of what they consider movement and activity. Yeah. And sometimes put the technology away and just enjoy being out with Petey. Yeah. Yeah. She's sleeping on the couch. She doesn't mind the extra napping. She's having a great time. That's a, that's a great example. Watch your dog. When your dog is tired, it will sleep. When it's hungry, it will eat. When it's thirsty, it will drink. They, they're really intuitive beings. So I think that's sometimes a good, good role model. Yeah. A hundred percent agree.

I'll just talk about, I guess, from a nutrition standpoint, I kind of have already explained my thoughts, but I just think it's mostly macronutrient deficiency. And the key thing when you're injured or when you're returning to run is to just eat. That's what I'm normally saying. I sound like a broken record of like eat. If you think you're eating enough, you might even need a little bit more. Make sure that you're getting good protein and protein doesn't have to be animal sources. There are plenty of great plant-based proteins. You can be a vegan and be healthy. You just have to be a little bit more. You have to plan it a little bit more just to make sure that you are getting everything you need. And it's a great opportunity if you have a little more time to spend some time cooking and preparing food. Oftentimes when we're busy, that's something that just goes by the wayside. I know for me it does. I get takeout, I get really convenient things, or I just get on a rut of having the same meals over and over again. And I think one way that you can heal your relationship with food is to be more connected to it. So preparing food is a really great thing. It doesn't have to be this fancy recipe that takes hours. It can be something quick, like making a pizza. You can buy the dough pre-made and then maybe you create the toppings.

And I think that just, I guess the preparation and going through the motions can help you just be a little bit more at ease with eating and to think about it rather than just eat and blaze through it as you're watching TV or answering emails as I sometimes do, but actually sit down and have a meal. And that extra time can be really beneficial for you to examine just some of your nutrition habits or work with a registered dietitian or someone who can really help you kind of go back to the basics. Because again, we don't want to just put a bandaid over the issue. Like Corinne said, you know, going and actually figuring out why did these things happen in the first place, I think is a great from a nutrition standpoint as well. So just making sure that you feel your body well, even though you're not training to the same extent. Yeah. And I would say I love the extra time.

Like I made a like a time intensive vegan lasagna last night and it was so good, but it was so nice to like have the time to actually like roast the butternut squash and then like assemble the lasagna and then bake the lasagna. And it was like, I don't know, it was just, it was nice to have, I don't know, I leaned into having that time as opposed to being frustrated that, you know, that I wasn't doing, that I didn't get to go for a run yesterday, for example. Right. Right. And I think we're, we're making it sound at least to me, like somewhat of an easy process for me. It was not an easy process, but I think if you sit with it, like the first few days are the toughest, just sit with those feelings of like, you know, uncomfortable of not being able to move and it gets better. And then you can enjoy things like we're saying, like making a vegan lasagna or just sitting outside, having a cup of coffee, get some fresh air, spend some time with your dog or your kids or yourself. And I think when you can work through those first few days, maybe first week of not having the movement that you desire, you learn to appreciate something else, a slower pace of life, more time, something different.

It could be physical, it could be non-physical. And I think that's really healthy because we all get injured. We all age, things change, our lives become busier at times and less busy at other times. And you don't always have the same ability to get out the door and run as you maybe do currently. So it's a good opportunity to practice these things before something is taken away from you and you don't know, you don't have the tools to really deal with it. So I appreciate both of you being vulnerable and sharing your injuries and things that you wish you would have done differently or things that you did do well. Because I think this is really helpful for everyone to hear and to examine their routines. And are there things that you should listen to right now? Are there things that are telling you to slow down? Are there little things you can do right now, like stretching and strength and PT and eating well to help prevent injuries from cropping up? Because I think we can all benefit from examining how we're going about our day-to-day routine so that we are able to be healthy. Yeah, I could not agree more. And I think the only thing I would add is that injuries are psychological as well. I think they're isolating.

I think they can put you in a really bad spot. So we did make it sound pretty easy. But there are people that are highly skilled, particularly in that psychological aspect, that emotional aspect of it. And so I think there's no shame, no harm, no foul. And not only reaching out to your PT and to your medical community and to your coach, but potentially even seeking out someone who's a licensed counselor or a therapist or a psychiatrist, someone who's just another person in your corner to help you walk through the emotional roller coaster that an injury can be as well. Yeah, that's a great point. And those tools or those people are even more accessible now with all of the virtual options. So I think reach out to people and lean on your friends, lean on your family. They're going to be there for you. And don't be afraid to get the help that you need. And I can say for myself, and I'm sure you too as well, that we can always help provide those resources or steer you in the right direction to help you find the right, I guess, place to start looking. Because oftentimes you have to be an advocate for yourself. And finding that the right avenue to go down can be a little tricky sometimes.

Well, thank you both so much. And I really appreciate getting the chance to talk to you today amongst your busy schedules. And I hope for all of us that we all heal up and that we continue to use our past experiences to shape how we deal with our future selves. So thank you again so much. Yeah, thanks for having us on. All right, there you have it. Hopefully we shared some wisdom from our personal experiences with injuries and coaching athletes working through injuries. I hope you really enjoyed our conversation. I definitely did. It went through a lot of topics that I think are really important for us to consider as athletes.

And of course, as always, I learned a lot talking with these two fantastic women. They together share so much knowledge that we can all benefit from. And I think one of the themes that I take away from this conversation is to really be a listener to your body, to not ignore those subtle signs, whether they be physical, emotional, psychological, because when you're able to slow down and pause, that's your body's way of telling you that you need to change something or else it's going to force you to. So hopefully this gives you some insight into tapping into your own intuition and you're able to use some of this information and maybe at the expense of where we went wrong to have a healthy, happy, long running career and just happy, healthy life in general. So thanks again to both Sarah and Corinne for taking the time to talk with me today. And you can find all of us on Instagram. I think Sarah is drtyrunner and Corinne, I should look it up, but I think it's Corinne Malcolm. And both are CTS coaches. You can find them on the CTS website. And please, as we said in the podcast, reach out to us if you have any questions or are

struggling with an injury and we can help you find the resources or at least point you in the right direction of someone who might be able to help you because it is an isolating time and can be a confusing time. So reach out to your network. We're here for you. We've got you and have a great rest of your day, evening, morning, run, lounge, whatever it be. And thanks again for tuning in.