“RUNNING INJURY SUUUUUCKS!”
Scream it out loud with me!!
OK, now that we have that off our chest…
How should I get back to running after I’ve been injured? Just start running again right? Not so fast.
Clearly this will depend on the severity and length of time you’ve been on the shelf so to speak. For example, let’s say said runner had a moderate injury to the calf and wasn’t able to run for three weeks.
First off, what happens when we get injured to make returning to running so tricky?
Well, when injury to our soft tissues or bone occurs, there is a healing/rebuilding process that happens at the microscopic/cellular level The reason rest is important is to allow that healing and rebuilding to take place. Skipping this and running THROUGH an injury is the main reason they will linger (months, even years). In addition, the affected tissue is stiff and weak and can’t accept the load of running (running is about 3x body weight when we land).
Let’s assume in this case the runner was compliant 😉 He/She took the appropriate rest and did the appropriate rehab. The affected tissue (ligament, bone, tendon, muscle, etc) can start accepting load but it needs to be gradual and progressive. A big mistake runners often make is jumping right back into prior mileage and BAM! injury returns, running sucks, I quit. The problem with this?:
- The tissue likely isn’t ready from a mechanical standpoint (it’s a bit stiff and a bit weak).
- The “brain-muscle” connections likely aren’t ready (yes running does take some coordination). There was likely a bit of “favoring” or “compensating” of the area.
- Often the cardiovascular system isn’t ready unless you did some cross training during the non-running period.
- Mental barriers. This can’t be ignored, and is probably a blog topic in itself.
I like to have the patient/athlete hit some benchmarks first before starting a return to running program.
- Brisk walking symptom free. If walking hurts, you’re not ready to run.
- If brisk walking feels good, I’ll have them try a few walking sessions of 15-20 min.
- No pain? Great, next step would be some hopping. Up and down, side to side, front to back. Two to three minutes at a time. Pain Free? Ok, let’s take the next step.
- My typical return to running plan would be three min walk with two min run x three sets three days a week. If this feels ok, I’ll start upping the run time, decreasing the walk time.
In summary, returning to running after an injury takes careful attention and a plan. If you are stuck with a nagging injury and can’t seem to get back at it, we are here to help.
Charlie Boeyink MPT, OCS, CWC
Physical Therapist, USAT Level 1 coach