Returning to running after an injury is an inevitable process that nearly every runner will face throughout their careers. On the one hand, the anticipation and excitement to hit the trails again can feel higher than ever before – the mental stoke is there. While on the other hand, the dreaded fear of the previous injury coming back to haunt you, your body letting you down, or invoking a sense of self-doubt. Like with any normal training plan toward your big goal race or run, progression in running post-injury is never a directly and perfect linear line of progress: Sometimes, it means a few steps back again to step further forward ahead. So most importantly: Be kind to yourself; you’re not a failure, and remember patience in returning to your running process.
Here are some key takeaways to consider in your plan to progress with your running, with the caveat that I’d highly recommend deferring to either your physical therapist and/or running coach if you have one or, if possible, to work with a coach going forward:
- Remember that not all is lost from previous training. In fact, if you’ve been consistent enough with your rehab and strengthening programs during injury recovery, you might actually be propelling yourself forward and feeling stronger than you were ever before. You may have even picked up new habitual, positive routines and patterns for strength training, mobility, checking your gear, nutrition, sleep, and other aspects that support your growth as an athlete. Depending on the duration of your previous injury, getting back into running may feel awkward and foreign from a biomechanically initially. Still, you may surprise yourself at how fast the muscle memory from the previous running will return, in addition to previous aerobic adaptations as well.
- Try to recognize and take note of what caused the original injury, and don’t repeat it! There was likely an overload of stress that eventually surpassed a threshold that your body was not adapted to, such as too much of an increase in running volume, intensity, or both of those, too fast. Use a 1:4 ratio when evaluating the minimum amount of time to proactively address the injury you dealt with. So if this was only a 1-week injury, then you’ll want to take about 4 weeks to work on it through active rehab, prehab, and a gradual approach back to running. If it was a 6-month injury, it could be as long as two years to proactively address the issue.
- For more severe injuries or bone fractures/stress injuries, utilize walk/run intervals to ease the load and hedge those injury bets. And better yet: do these first activities on soft, flatter surfaces like the track, flat and level trail, or even the treadmill. Start conservatively with both overall shorter total mileage/duration as well as shorter running intervals. The track is a great venue for these activities with the option. Then during and after each of these walks/runs in these early stages, take close note of any soreness or pain and give it a score between 1-10 on the pain scale.
- Start easy, progress gradually. Recognize the small wins. I always tend to err toward building easy, aerobic volume first before introducing any type of faster, intensity running, including strides, pickups, or any harder effort that’s above your Aerobic Threshold (AeT). This initial phase may take 4-8 weeks of easy running first, or even longer for more serious injuries. This may mean running every other day in the earlier periods, then progressing toward your usual threshold of total volume per week before your injury.
- Rehab/Strengthening: Following a plan closely from a physical therapist who understands runners is the optimal path to go! Otherwise, generally begin with slower, controlled movements through the range of motion, less weighted, and with isometrics (static holds, such as a front plank) from the beginning of an injury. Then slowly progress exercises with more weight and more dynamic movements such as a Kettlebell Swing or Elevated Glute Bridges off a bench with added weight.
- Build your team, build your home prehab environment: I like this concept for any athlete but try to surround yourself with a village and community that will bring you up, not down. This includes help from professionals like coaches, physical therapists, massage therapists, acupuncturists, registered dieticians. And this also includes surrounding yourself with other athletes and runners from the community or others with similar goals as you. Then from your own home, create an environment that will better enable you and remind you to stay on top of the all-too-important “little things” that will keep you running pain-free and promote longevity in the sport. Post and tape your strength routines on your wall. Use a paper calendar to checkmark the days you completed your strength, or use your training log.
- Build in a pre-run warm-up routine that includes basic activation of the key muscles or muscles/joints related to your injury, mobility, and things that promote more blood flow to the muscles. Here is a sample routine:
- A simple walk around the house, including toe walks and heel walks
- Resistance band exercises including Crab Walk (lateral), Monster Walk (linear), and Standing Hip March
- Single-Leg Deadlifts with no weight
- Leg Swings: 1. Side-to-Side (lateral), 2. Forward/Backward (linear) with Straight Leg, and 3. Forward/Backward (linear) with Knee Bent
- 1-2 minute light jog or shakeout
- The following is a sample criterion in deciding whether to back off or to keep progressing with your running duration and volume but most importantly, listen closely to your body cues. You know your body best.
|Pain (or soreness) felt during jog/walk warmup that’s persistent → Rest 2 days, drop duration on next attempt.
|Pain felt during jog/walk warmup that goes away over the course of the run → Current threshold, repeat same activity on the next attempt. 2 days rest between if ~2-3 miles is a threshold. 1-day rest between if able to run more than 3 miles.
|Pain felt during jog/walk warmup that goes away but then returns later or toward the end of a run session → Rest 2 days between, drop duration on next attempt.
|Pain felt the day after running → Rest 1 day between, repeat similar duration on next attempt.
|No pain felt during a run or the day after a run → Gradually increase duration threshold on next attempt.
Be patient, start conservative, don’t ditch the strength/prehab work, and build your momentum toward your next breakthrough!
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