Know when to Hold and when to Fold

Kenny Rogers' song “Know When to Fold ‘Em,” has nothing to do with endurance sports training, however, when it comes to training and racing, it’s important for athletes to know when to hold and when to fold.

Recently, one of our athletes was in a training block preparing for an event that was only about three weeks away.  Her knee began bothering her.  As athletes, we hate when our training is interrupted by injury.  We are constantly talking with each other about this or that ache or pain and deciding whether to push through or halt training.  It’s hard for us to halt our training, but we’ve learned the hard way, that if precautions aren’t taken at the onset of pain, what may have been a sideline from training for a few days, becomes weeks or months of recovery.

I (Paula) am the poster child for why pain should not be ignored.  In 2013, I did my first intense marathon training cycle with a time goal in mind.  I had a few marathons under my belt.  The goal of each of these marathons was to complete them without walking.  My previous training had included zero speedwork.  It was all about time on my feet and building aerobic fitness.  However, this time, I was ready to add speedwork and began reading everything I could get my hands on about preparing my mind to press through an entire 26.2 miles at goal pace, knowing it would get hard somewhere between mile 16 and 20.

What I read emphasized – "no pain no gain!", "You have to be mentally tough!", "No guts, no glory!"  Filling my mind with all this advice of pressing through the pain, I literally did just that!  I learned to place all pain – both mentally and physically in the background and keep that main goal – which for me was to qualify for Boston – at the forefront of my thinking and training.  During this training cycle, my back and my knee, all on the left side hurt.  I mean, really hurt.  I went to an orthopedic doctor, who took x-rays and just said that at my age it is normal to experience pain as a runner.  He prescribed a cream which I religiously applied to my knee. 

My training was definitely paying off!  Midway through the training cycle, I raced a 5K personal best by nearly 4 minutes!  I wasn’t sure I could race that day, as my knee had really been hurting.  But, I rubbed on the prescribed cream, kept telling myself – hey, you’ve been to the doctor; you’re cleared to run – and I had a great race.

I continued to train and ignore the back and knee pain.  I kept training hard and reading all the things about being mentally focused and strong.  In November of 2013, at the Indy Monumental Marathon, my femur snapped in two pieces and my race was over.  I was pretty sure my running career was over.

Thankfully, a skilled surgeon put me back together, and after months of rehab I was able to begin walking normally and eventually running again.  In December of 2016, I was released and given the ok to begin marathon distance training again.  This was definitely an answer to prayer, as initially the thinking was that I’d be lucky to run 10Ks in the future.

I learned so much through this process, and it has definitely caused me to be super careful with the athletes we coach. 

So back to our athlete who was three weeks from a race and her knee began hurting.  We backed her training way back.  All the fitness in the world is not worth it if you aren’t healthy at the starting line.  Did this athlete lose fitness over those three weeks?  Most likely!  But, through rest, visiting a PT, implementing some stretches and exercises, and being patient, this athlete was able to compete with no knee pain.

Had she only looked at the short term and wanted to PR this race, she could have created a knee injury that would cause her problems for years.  Instead, she realized that while she only has two knees, there are hundreds of races to choose from in her future.

As coaches, it’s hard for us to gauge when to tell our athletes they need to back off or take a complete break from training.  We know they each have big goals, and the last thing they want is an extended lapse in training.  However, we always err on the side of caution.  How do you know when "when to hold and when to fold.”

When it comes to physical pain, there are a few guidelines to ask yourself:

1. Am I hurting equally on both sides?  For example, after a tough workout, an athlete’s quads may be sore.  While athletes do need to give themselves plenty of recovery time between hard workouts, if both quads, or both calves are equally sore, it’s probably an expected outcome of the muscles breaking down in order to build back stronger.  It's important to  give your muscles time to recover and strengthen, but this likely isn’t a red flag to halt training altogether.
2. Does the endurance activity intensify the pain?  Or is the pain worse after you swim, bike, or run?  In my training block leading up to Ironman Louisville, I began experiencing pain in my right ankle that was exacerbated by running.  Neither biking nor swimming made it worse, so Dean - my husband/coach - was able to continue prescribing swim and bike sessions, and I also did a fair amount of pool running.  Focusing on what I was able to do, rather than stressing over what I couldn’t do, enabled me to continue to build fitness while letting my ankle recover.  Also, I began physical therapy and was eventually able to add running to my training sessions.
3. The bottom line is this – if the body is experiencing pain, that’s its way of telling you something needs to change.  God created an amazing body that, if properly cared for, does an amazing job healing itself – sometimes with the help of doctors and physical therapists.  1 Corinthians 6:19 reminds us that our bodies are God’s temple.  We need to take good care if His temple!
4. We also need to listen to our bodies if we are ill.  We have athletes who insist on continuing to train through an illness.  Our general rule is that it’s better to rest the body when it’s fighting an illness.  Training when sick typically prolongs the illness.  It’s much better to rest and recover. 
5. When in doubt – fold!  IF you aren’t sure if the upcoming training session will make an injury worse, just wait.  It’s far better to miss a few days of training, rather than risk making a bad situation worse.

We recently had an athlete whose toe was bothering him.  Although we suspect the injury was derived from jump roping the athlete had added, running definitely aggravated it.  He wisely rested from running and halted jumping rope altogether.  After a few days, he was back at it.

Recovery is not always as quick as the two athletes we’ve just mentioned.  We have an athlete who trained and was healthy all through 2018 and 2019.  However, in early 2020 her hip and pelvis began to hurt.  It has taken her a year to be able to run with much intensity.  She was patient.  She swam.  She biked.  She is very committed and consistent with her strength training and stretches.  She has focused on what she can do.  I know at times it has been frustrating for her, but as coaches, we are so proud of resilience.  And might I add that her swimming is amazing!

What about all the books and literature I read about being tough and pressing through.  There is a time for this!  But that time does not pertain to physical injury.  We’ve talked a lot about when to fold.  And with most of our athletes, it’s hard for them to fold.  However, there are times to hold and press through.  There are both physical and mental aspects to this.  To get better, there are barriers and boundaries that sometimes have to be moved.

Sometimes in a tough training session -maybe a 400 meter swim time trial, a big gear or long steep hill bike workout, or threshold run, your mind starts trying to convince you to slow down.  Maybe your breathing is harder than your used to and you convince yourself that if you don’t back off on the swim effort you are going to drown.  Or maybe at mile 4 of a marathon you decide it’s not your day.  9 times out of 10, when you are struggling mentally and convince yourself to slow down or quit, you regret it later.  There is both mental and physical grit required to improve.  Sometimes you just need to press through those mental challenges and believe in yourself.

Dean and I have both experienced tough patches in our endurance races.  We could have decided to throw in the towel.  Instead, we remained focused, pressed through the barrier and met our goals.  My best advise is to avoid making deals with yourself and push through the mental barriers and physical fatigue.  The accomplishment is in knowing that you left it all out there!

Distinguishing when to quit and live to race another day – due to risk of injury, and when to press on through the struggle, to mental anguish or physical fatigue is especially hard for newer athletes.  And it’s definitely something I struggled to figure out over the years.  I can’t tell you how many people tell me, “Well, I can’t run; it hurts my knees.”  When we drill down into what their attempts to begin running looks like, it’s almost ALWAYS the case of too far or too fast, or BOTH too soon.  As a beginner, you have to be SMART.  You have to start slowly and with short distances.  Then – slowly increase mileage over a long build block.  For me it was several years of all slow running until I finally built a solid base.  Once that aerobic base is established and the skeletal and muscular systems have had time to adapt to the load, then and only then is an athlete ready to start building speed and adding intensity.

This winter, I have been messaging back and forth with an athlete from Tennessee.  She has been running less than a year, completed a half marathon, and was registered for a marathon.  She was injured, sidelined, and frustrated.  Fortunately, her marathon was postponed.  She has taken several months to recover and is now slowly building a base.  With her new approach, I’m excited to watch her success as she develops her fitness.  Had the marathon not been postponed, I’m not sure she would have given her injury the rest it needed.  But, thankfully she did!

As coaches we often talk to our athletes about the importance of patience and consistency.  If an athlete is constantly injured, he cannot be consistent.

If you don’t have a coach, it’s a good idea to at least have an endurance athlete accountability friend who will shoot straight with you and give you good advice.  Most endurance athletes are type A, and it’s hard for us to miss a workout.  This often leads to poor decision making.  A coach or endurance friend can help you make better decisions.

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