When and how to return to running after a running injury

How do I get there from here?

A common concern expressed by injured runners I see is how to manage their recovery back to running after a lay off. Obviously it is not sensible to go straight back to preinjury levels of running, as fitness levels will have decreased and we want to test the injured tissue to make sure it can tolerate running loads.

A good rule of thumb is to wait until pain levels during normal daily activities are below 3 out of 10 on a 0 to 10 scale, both during and after activity. This suggests that the injured area is able to tolerate normal loads in walking, climbing stairs, etc.

Once this is established we can then go on and apply some stress testing, perhaps trying some forward jumps or single leg hops, followed by a short 5 to 10 minute run on the treadmill if you have one. These are some tests that I would go through with runners when planning their return to running. If you do not have a treadmill you could try running up and down the road or even round the garden. The aim of this is to gain confidence that nothing dreadful is going to happen once you start running. In the event that you get significant pain during these short tests then you know it is a little too soon and you can go back to focusing on the rehab exercises, trying again in a week or so.

Your first run

The next step if the above is ok is to try some longer runs. I usually recommend starting with the Couch to 5K plan or similar. Whilst this might seem condescending to experienced runners, it does give a structure again allowing you to gain confidence and reduce the risk of overdoing it in the early stages. Depending on how that is going I suggest doing this for a week or two, then gradually increasing your running miles, frequency of runs and effort in that order, using a 10% increase as a rough guideline, avoiding changing more than one variable at a time. So initially you might focus on 2 runs a week with a 2-day gap in between to allow recovery, gradually increasing your mileage in those runs at a steady pace, then perhaps adding an extra run, until you are up to your target weekly mileage and frequency of runs, then finally adding in your harder sessions, keeping the ratio about 80/20 easy to hard.

During this period you are hopefully continuing with your strength and conditioning exercises to increase and maintain load capacity in the injured tissue.

Common mistakes

Common mistakes I come across in recovering runners are progressing too far too soon, changing more than one variable at a time making troubleshooting difficult, and giving up too soon on essential strength and conditioning exercises once back to running.

Summary

Returning to running after injury should be done gradually and in a structured way, initially increasing running mileage, then frequency of runs, keeping all runs Zone 1 steady, then finally effort/intensity. All this while continuing with your rehabilitation exercises.

Common mistakes are returning to pre injury levels of running too quickly, changing more than one variable at a time making troubleshooting difficult, and giving up too soon on essential strength and conditioning exercises once back to running.

If you are struggling with managing your recovery from injury and need some structure, get in touch with me so I can help you.