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Injured Runners: The Cost of Cross Training

I’ve noticed a common theme in my clinical practice lately, so I decided to get up on my soap box for this blog and talk about it.

For runners, running is our “norm”. We follow a training schedule, run long on the weekends, and make plans to run with friends for social time. We time our meals and decide what to eat based on our workout(s) that day. When we get injured, all of this gets disrupted, among other things.

What I’m seeing frequently is injured runners cross training too much and eating too little while they are trying to heal from an injury.

“I’m not running, so I don’t need to eat as much”

“I don’t want to gain weight, I feel like I’m losing fitness as it is.”

“It’s going to be so hard to get my fitness back, so I need to cross train as much as possible.”

These just scratch the surface of the fears that I see in injured runners. And I get it. I’ve been there, too. Just as recently as 2018-2019, I swam and biked nearly every day as I was trying to overcome a posterior tibialis injury. Not only did my ankle take forever to heal, but I also ended up with a multitude of other problems that not only further delayed my return to running, but also forced me exclusively to the pool because of pain on the bike.

Yes– I was a Physical Therapist at the time. I knew better. But I was also under a lot of stress with my residency program and struggling with my mental health. I was blinded to my own knowledge and common sense, swallowed up by the deep desire to keep some sense of normalcy, which for me is intense exercise and training.

I won’t do it again, though. And I hope you, reading this, won’t either.

Cross training is an essential part of rehab– It increases blood flow to the tissues, releases endorphins and dopamine, and of course helps maintain sanity– but too much can use up precious energy that is needed for the body to heal. Certainly the volume of cross training is going to vary depending on the athlete and the athlete’s goals, but I would rather err on the side of “less is more”. Some detraining during a period of injury is actually favorable. If we compare ourselves to a car, we can think of our heart and lungs as the “engine” and the body as the “chassis”. If we maintain our engine with vigorous cross training, no matter the modality (swimming, cycling, etc), there is still a significant adaptation period when we start loading the body through running again. We don’t want our engine to overpower the chassis and cause a set back.

The other part of this equation is nutrition. I often see athletes restricting food or significantly changing their diet while injured. Sure, you don’t need to fuel like you do when you’re marathon training, but restricting food in times of injury can really affect the recovery process. It is important to remember that there is an energy cost in both the cross training and physiological process of healing. This is especially relevant in the case of bone stress injury, where oftentimes an energy imbalance is a component of the root cause. Eating well is just as, if not more, crucial while recovering as during training.

Working with a sports nutritionist can be key here, because they are trained professionals in assessing your current habits, suggesting new ones, and mapping out a plan to optimize your recovery. I also recommend that all athletes have a sports nutritionist on speed dial, because they can be so helpful in maintaining energy balance and planning out individualized race nutrition.

Okay, I’ll get off my soap box here and give you a hug. Being injured sucks. It’s hard to grapple with all of these things and stay positive. But let’s not prolong it, okay?

Keep going, you got this!

Dr. Kacy Seynders, PT, DPT


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