By Raechel Bugner DPT, FAFS
Finish Line Physical Therapy

How Sleep May Affect the Recovery Time of your Knee, Foot, Hip, Ankle or other Running Injury

Have you been struggling with plantar fasciitis or exploring runner’s knee treatments?  If you’ve been sidelined by an running injury and are constantly dealing with nagging pain, look beyond the training and rehab for clues as to why your injury isn’t healing as planned. You may be stretching, working the foam roller, and doing the strengthening exercises recommended by your physical therapist or favorite running magazine, but if you continue to experience nagging pain, it may be time to examine your sleep habits.

Sleep plays a critical role in the body’s ability to repair tissue damage, build energy stores, and stimulate brain function.  However, according to a report released last year by the Center for Disease Control, 1 in 3 adults are not getting the recommended amount of shut-eye.  A two-year study by the National Sleep Foundation recommends that, in order to reap the restorative benefits of sleep, adults aged 18-64 need 7 to 9 hours of slumber.

Studies have demonstrated that healthy individuals who are deprived of sleep (less than 6 hours per night) will present with an increase in white blood cells, specifically neutrophils. Neutrophils are typically the first responders to injury or infection and play a critical role in kicking off the inflammatory process.

While it may seem like a great idea to have your immune system revved up and ready to fight infection, high levels of neutrophils that are present over prolonged periods of time (several days of poor sleep) actually contribute to chronic inflammation, which can then lead to diseases such as diabetes, heart disease, and high blood pressure — none of which are favorable for your health.

What does this mean for runners?   Chronic inflammation may affect your body’s ability to heal that calf or ankle injury.

Following an injury, the inflammatory response is a normal step in tissue repair; its goal is to help remove damaged tissue to allow for healing to occur. This stage of healing should only last for about a week, with peak inflammation occurring within the first 1-2 days after an injury. Lack of sleep prevents this tissue repair and muscle growth from occurring.  

Without sufficient sleep, a running injury may continue to nag you because the inflammatory phase persists longer than normal, preventing the subsequent two stages of healing from occurring.  During the deepest stage of sleep, blood flow to your muscles increases, growth hormone is released (which contributes to muscle growth), protein synthesis occurs, and your energy stores are replenished. These processes occur primarily while sleeping; if you’re not getting enough shut-eye, you’re seriously missing out on key mechanisms necessary for healing an injury.

Sleep should be a focus all of the time, however, not just when injured.  Late nights in the office also affect running performance. In addition to replenishing the body’s energy stores, the deepest phase of sleep also increases the production of glycogen, the stored carbohydrates that are utilized for energy during exercise.  Late nights and early mornings changes the body’s glucose tolerance and carbohydrate metabolism; this alters the supply of energy to the muscles. If energy provisions are depleted and your body is prohibited from creating new stores, the time it takes to reach exhaustion on a run decreases and your performance suffers.

How can you get a restful night’s sleep? Here are a few tips:

#1- Set an Alarm … For Bed!

Count backward from the time you need to wake up and set an alarm in your bedroom to go off approximately 7-9 hours prior to your desired wake time.

#2- Read a Book

Reading may help take your mind off of the stressors that make it difficult to fall asleep.  It may also help to tire out your eyes. Just make sure your book is a hard copy and not downloaded to your iPad; research shows that the bright lights from electronic devices can suppress melatonin (the hormone responsible for making you sleepy).

#3- Your iPhone Needs Some Rest Too!

Charge your phones and devices far away from your bed. This will prevent you from sending after-hours work emails or engaging in a late-night group chat with your friends.

#4- Take Some Time to Meditate

Similar to reading, meditation can help take your mind off of stressors and worrying thoughts that keep you up at night. Try focusing your thoughts on your breathing, the rising and falling of your chest, or a word or phrase.

The next time you’re frustrated by a persistent running injury, remember that your body’s ability to heal is dependent not just on the amount of stretching and strength training you do, but also on the amount of sleep you get.  

Physical Therapist Raechel Bugner joined the Finish Line PT staff in 2014 and is recognized as a Fellow of Applied Functional Science (FAFS) through the internationally acclaimed Gray Institute. A competitive gymnast in high school, Raechel started running in college and has run three marathons and numerous half-marathons.

Raechel Bugner, DPT, FAFS
Finish Line Physical Therapy
Chelsea: 119 West 23rd Street, Suite 304, New York, NY 10011
Midtown East: 212 East 57th Street, New York, NY 10022
(212) 486-8573 | finishlinept.com