Patient progression is key to staying healthy.
Making an intelligent comeback to running after taking time off due to injury requires a gradual approach that some runners might find frustrating, but ask yourself this: Would you rather make slow, pain-free progress toward building a healthy running base, or jump back into running and possibly experience a setback that leads to prolonged pain or re-injury?
Your re-entry to running plan should be formed strategically from the following five factors:
- 1. The severity of your injury—a stress fracture or injury that required surgery differs vastly from tendonitis.
- 2. How long you were sidelined from running.
- 3. Your fitness level prior to getting injured.
- 4. How many years of experience you have as a runner.
- 5. Whether you could cross-train during your layoff.
According to DeeAnn Dougherty, a Portland-based physical therapist and RRCA and USATF-certified distance running coach, the worst thing a runner can do post-injury is doing too much too soon—particularly, increasing distance and speed simultaneously. “It’s about being really conservative, always opting for less than more, and avoiding pain. It helps to have a coach or medical professional help with the return to run in order to set parameters.”
Dougherty suggests that runners be able to walk for 30 minutes pain-free before returning to running post-injury. Depending, of course, on the aforementioned five factors, Dougherty’s rules of thumb can be applied: For two weeks off, start back with 50 percent of previous weekly mileage; for four weeks, start back at 30 percent; for six to eight weeks or longer, start with a walk/jog. “After a 10-minute walk to warm up, jog for 100 meters then walk 100m for four laps on a track—jog the straights and walk the curves—followed by a 10-minute walk. Add one lap each time—a max of every other day—for up to eight laps, then gradually increase the running and decrease the walking until you’re running two miles straight.”
In this case, all running is easy and Dougherty recommends straying from hills and any speed work until you’re back to running 75-80 percent of your mileage prior to the injury. San Marcos, Calif.-based Jenn Gill, an RRCA-certified coach, recommends that runners build their base to a consistent 20 miles per week before incorporating any speed elements. “If you can’t run the miles, you can’t run them fast,” she says. “You can probably throw in some strides if you’ve been running pain-free for four weeks, depending on how experienced you are.”
If you feel pain while running during your comeback, stop running. Go back to walking until all pain subsides.
Discovering the root of what caused the injury should also be a priority, as this knowledge can prevent re-injury. “Is it a strength, biomechanics or flexibility issue,” Gill says, “was it a training error, or is it your shoes?”
If you’re mobile during your layoff from running, cross-training on the bike or elliptical, combined with functional strength training, foam rolling and stretching will do wonders for your sanity and fitness level. During your down time, get into a routine that includes a dynamic warm-up, 10-15 minutes of core work and functional strength exercises such as squats, lunges, clams, planks and superman (see sidebar), followed by some yoga poses—the bridge and pigeon pose are great for runners. Building muscular as well as tendon, joint and ligament strength will only help your running form and economy when you resume running. Just make sure to keep up the strength and stretching when you start running again.
“If there’s nothing else you do strength-wise, you have to work your core because it’s your center and that’s where all of your power comes from,” Gill says. “If it’s not strong, when you get tired, your running form will change because your core will collapse.”
Three Key Core Exercises for Runners On The Mend
Lie on your side with your head resting on your arm that’s extended on the ground. Bend your knees at a 90-degree angle and stack your hips on top of each other. Keeping your feet together, lift your top leg up and down, like a clamshell opening. Repeat for 10-15 reps and switch sides. Work up to three sets.
Lie on your stomach with legs straight and arms extended over your head. Lift arms and legs up simultaneously, about ½-inch off the ground. Hold the position for 10-30 seconds, then lower and repeat 5-10 times.
Following the same form as above, bend your legs and push them toward the sky when you lift.