I have recently been fortunate enough to have participated in the Marathon Des Sables (MdS), a 250km 6 day ultramarathon in the Sahara desert. This has been a dream of mine for a while, I’m delighted to say I completed it at the end of April 2023.
Any multi-day event requires a huge amount of resources and focus to even get to the start line. The MdS as it is known, usually has a completion rate of 95% with the greatest amount of “drop-outs” before even travelling to Morocco. Typically 20% of those who sign up don’t make it out there. This is often due to a change in circumstances or more typically due to injury. Balancing the training load for any event is a fine line between over-training and being able to tolerate the distance required to not only complete the event, but in my case enjoy it too.
I focused my training on being able to complete the distances required as well as being able to go again each day for 6 days. For me, this included 5 days of 30km each day, a 85km long day and a 3 day event covering 85 miles sleeping in a sports hall overnight. As well as consistently completing a minimum of 50km each week over time and incorporating cross training to consider strength and general health. I wasn’t able to do any training camps in hot climates but did have some sessions in a heat chamber (Loughborough University) as well as a bit running in sand whenever I could, with family and friends visits to Croyde!
Its important to gradually build up with any fitness, the body likes consistency and a balance. I aimed for a maximum of a 10% increase on distance each week and was careful to include rest days. Either complete rest or walking / swimming / yoga. Another component I considered with my training was the other factors in my life. This is something that’s hard to control, being busy at work, sleep hygiene, other occasions, eating and drinking, or fuel and hydration. There’s a lot to balance, as well as keeping everything in context, not wanting to miss out on family special occasions or socialising / spending time with friends.
My typical week involved a couple of 10km runs during the week then a longer run / two at the weekend. Also a session of two with weights and some yoga. Nearer the event I also started increasing my tolerance carrying a weighted backpack, as a self-sufficient race, you carry everything for the week. This includes food (which weights approx.. 3.5kg at the start of the event) and mandatory kit. The pack weights a minimum of 6.5kg at the start and combined with the 1.5kg of water at each check point typically weights a minimum of 8kg on day 1. The route is all on tracks / sand / and surprisingly a minimum of 500m elevation each day so it was also good to get to the peaks to get some hills in and on varying terrain.
A few months before the event I was enjoying a solo trip on the Edale circuit, and was just coming off Kinder Scout when I went over on my ankle. I felt an immediate sharp pain which made me stop. After a few moments I checked I could weight bear and hobbled to a sheltered spot to catch my breath. As it didn’t swell immediately and I could put my weight through it I managed to walk back to the car with poles. When I took my trainer off there was a localised swelling around the outside of the ankle, pretty consistent with a lateral ankle sprain. The next morning the ankle had ballooned and I struggled to walk. I therefore followed the principles of PEACE and LOVE conscious I was 10 weeks away from the start line and had hoped to build the mileage.
What’s changed in the management of soft tissue injuries?
We used to use the acronym RICE or PRICE/R or POLICE which advocated the use of ICE and anti-inflammatories. However this has been updated in the last few years to shift the focus on early mobilisation once the initial phase has passed and the avoidance of anti-inflammatories and ice, which may delay healing.
Along with having to change my training expectations I also had to re-consider a training plan to maintain fitness and maximise conditions to optimise healing. I was assessed to determine what the injury was and get a rehabilitation timescale / plan to manage my expectations.
The first 10 days of a grade 1 strain pretty much focused around reducing the swelling and regaining range of movement and strength / proprioception in the area. I combined some open water swims and bike riding along with strength training to keep myself in a good place. Its really important if you pick up an injury to consider what you can do as opposed to just what you can’t.
I was fortunate enough to make a good recovery over a couple of weeks following a regime of active rest and elevation initially, followed by regular exercises to regain range, strength and reaction in the ankle. I also used the static bike and rower to keep a cardio-vascular challenge and worked on general strength with weights, Yoga and Pilates.
It’s important if you do pick up an injury, whether it from falling over or something starts to hurt or niggle that you get it assessed properly so you know the best way to manage it. Sometimes we need to protect an area from all movements, at other times its important to keep loading the area so knowing what will facilitate the best healing times is essential. Depending on the structure or part of the structure can make a big difference to how to rehabilitate the area. A muscle responds differently to a ligament or tendon for example. Its also important to consider what else needs to be considered in reducing the risk of re-injury such as strength in other areas of the body.
If you’re planning something special then get in touch, if you want to work with us to make sure you’re robust enough for the challenge, or add something into your training schedule such as Yoga or Pilates. Or if you do pick up an injury then get it assessed so you can set realistic goals. We will work with you with the aim of optimising your recovery so you can achieve and enjoy your goal.
For further info on the management of acute soft tissue injuries;
Special thanks to Finn who assessed my various injuries (hamstring and knee rehab blog to follow!) Mariangela for the awesome Yoga instruction and the whole Pilates team for keeping me strong and flexible. And of course the rest of the team for working hard in my absence and cheering me along the way.
