Veteran ultrarunner Chris Twiggs, a 17-time Hardrock 100 finisher and accomplished running coach, once said to me, “When it comes to falling in trail running, it’s not a matter of if, but when.”
I got to experience that firsthand last weekend at the Mogollon Monster 42-kilometer run, outside of Payson, Arizona. Running the race as a tune-up for the Javelina 100 Mile next month, I started out at a relaxed pace in the middle of the pack. After cresting the first climb, the trail emerged on top of the Mogollon Rim, where we enjoyed smooth singletrack and expansive views out to the valley far below. At around the seven-mile mark, I clipped a small rock with my right toe and went down to the ground hard. Fortunately, the section was not too rocky, and I only suffered minor cuts on both my shoulders and elbows.
After getting back to my feet and starting to run again, I did a quick all-body check to get a sense of what had happened. After a few minutes, I began to notice a sharp pain in my left rib cage area that over time was radiating into my lower back. I shrugged it, off assuming I had bruised my rib by jamming my elbow into my side during the fall. However, an hour or so later, the pain became so severe that I could not run, as the jostling and bouncing hurt too much. I resolved to just hike the last 12 miles to the finish and enjoy a beautiful day in the mountains.
The author at mile seven of the 2024 Mogollon Monster 42k. Photo: Aravaipa Running
After crossing the finish line, I checked in with the medical team to get an assessment. I was given a thorough evaluation, and the medic concluded that there had been no blunt trauma and that my kidneys, heart, and lungs were fine. It was likely an intercostal muscle strain.
The intercostal muscles are the muscles that lie in between the ribs and help to stabilize the upper body. These muscles can become strained through twisting or stretching in a way that they typically do not. In sports, these kinds of strains are common for baseball hitters, tennis players, and track-and-field athletes. As I deconstructed my fall at Mogollon, I concluded that as I was falling to the ground, in an attempt to protect my head and face, I twisted hard to the right. When I hit the ground, my entire left side was forced outward and upward, leading to the muscle strain.
As I sit here five days later, I continue to have pain and tenderness in my left rib cage, but it is improving a bit every day. I cannot yet run, but I can walk without pain, and do most of my regular activities, although sleeping requires a bit of creativity. I am icing and taking some over-the-counter pain medication, and am hopeful that my symptoms will continue to improve in the days to come.
What this particular fall reminds me of is that in running not all of our injuries are specific to running. While runner’s knee, plantar fasciitis, and iliotibial band syndrome (among others) are typical running injuries, at times we can run into circumstances that are not typical and we need to adapt accordingly. Additionally, recovery time from something like an intercostal muscle strain can vary from person to person and can’t be rushed. As with so many things in our sport, coming back from injury requires patience, persistence, and acceptance, which are not always easy.
AJW training above Cunningham Gulch in Colorado before the 2016 Hardrock 100. Photo: iRunFar/Bryon Powell
After over 30 years of long distance running, I have come to accept injury as part of the deal, and falling as part of trail running in particular. And, while this is my first-ever experience with an intercostal muscle strain, I am confident that with time I will heal up and be able to get back out there. With any luck, the next time I fall, and there will certainly be a next time, the injuries will be less painful and the recovery less lengthy.
Bottoms up!
AJW’s Beer of the Week
This week’s beer of the week comes from Grand Canyon Brewery in Williams, Arizona. Kachina Throwback Ale is a delicious wheat ale that is crispy and slightly sweet. In contrast to European style wheat ales that are hazier, Kachina Throwback is clean and clear with a subtle hop character and a touch of fruitiness. Check it out the next time you are in Rim Country.
Call for Comments
Have you suffered any bad falls while trail running? How was your recovery?
