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How to Come Back from the Dead (…Best Return to Running After Injury)

How to Best Return to Running After An Injury

Ok let’s admit it – you’re addicted…. to running! Or at least you were, before you got sidetracked. 

And it’s unfortunately not that uncommon to get injured while running. So let’s talk about how to get back to it, because a study showed that up to 90% of those training for a marathon have gotten injured! Now, how to avoid those injuries is another blog post, but it can happen to any of us.

Because sometimes as well, life happens. Despite running up to 128 miles per week in marathon and ultra training, I remained uninjured for 6-7 years. Then, after going through extreme stress, I was so tired I simply tripped over my slipper. It took 1 second – but 4 1/2 months later, I’m going through the same come back process. And I’m here to tell you exactly what to do. 

Returning to running after an injury can be tough. At least when you’re sick, you don’t “feel like” running. An injury is juuuuust enough that you mentally want to go run, but due to the doctor’s orders or simply the pain, the injury just says no.

But, once you have the doctor’s OK to start, here’s how to kick start your re-start, the right way.

1. Be realistic about coming back

The time it will take to get back to normal will depend on many factors. How long you were off from running, how bad the injury was, and yes, how long you had been running before you were injured.

First, if you were off from running for 4-6 months, you’re going to take longer to get back on track than someone who was off for 4-6 days. The drops in fitness after about two weeks are steeper than the drops before that point.

Second, how bad was the injury? If you had a superficial blister break and it took a few days to heal, that is going to take less of a toll on your body and running than a severe ankle sprain, in which case you will also need to monitor how it is responding to your renewed training routine.

Third, how long had you been running before you were injured? Someone who has been running for many years, will re-adapt to training faster than someone who had been running for a month before being injured. 

The longer you run, the more you build up what’s known as the aerobic base. That will take longer to dissipate. And, the person who had been running for a longer time will have built up “muscle memory” that may allow them to re-adapt faster as well.

If you were off for less than a week and have been running for years, you can try going back to where you were before you were injured. 

However the longer you have been off running, and the shorter time you had been running before, means the shorter the time with which you can start. It’s better to be conservative than do too much, for example even five minutes isn’t an unrealistic goal for many. 

2. Start with walking

I know this is almost a cliché – you need to walk before you can run. But, walking is biomechanically similar to running, and starting here can also help you to re-gain the mental “habit” of running regularly.

Running is an exaggerated form of walking, which adds impact to each step, so will be harder to come back without transitioning from just walking. Depending on how long you were off, the muscular and skeletal system can be deconditioned, which can cause re-injury or even a new injury in many runners re-starting their routine. This is another reason to take it easy as you come back.

A good target to set is to make sure you can walk 30-60 minutes before starting to run, especially if you plan to take on something larger, like training for a race. Try to do this for a week or at least a few days to make sure this step is comfortable for you.

Start off on flat, even surfaces to avoid unexpected twisting or rotating. A treadmill is fine for this as well. Treadmills can have a softer surface than walking on the road and are flat without hidden holes or uneven surfaces.

A track with a rubberized surfaced can also help with this. The other advantage of a treadmill or a track is that if something starts to hurt or you get tired, you can stop without being too far out.

Once this activity goes well, you can move to roads and trails. Hiking and fast hiking on trails can help you get adjusted to uneven surfaces and re-strengthen your legs, core and balance skills as a result.

Mentally, you will probably want to start running. This is a good thing. You want to be both physically and mentally READY to go when you begin. 

3. Transition to run-walk

Yes, I know it can be tempting to just go out and start running. Especially at the exact pace and distance you were doing before. But the number one thing NOT to do is to OVERdo things when getting back into it.

Start off with run walking in intervals of 30 seconds to 1 minute running to 1-2 minutes walking. Do this every other day, as sometimes the injury can feel OK that day, but then flare up the next day. 

Build this up in segments that you feel you can handle, for example adding five minutes of this run-walk pattern each time, until you are run-walking 20-30 minutes without issues.

Then, fill in the blocks of time with more running, such as 2 minutes of running to 1-2 minutes of walking, increasing your run intervals gradually until you are running consistently for 30 minutes every other day.

If that goes ok, then you can add in more days of running gradually, such as adding in a day a week of running and seeing how your body responds to back-to-back running days.

Once you have reached your desired number of days of running, then add more volume to the daily runs.

Don’t be afraid to pull back if you feel any excess soreness or pain beyond normal muscle soreness from getting back into it.

4. Crosstrain for cardio

You may not feel as if you are “getting a workout”, because the intensity of the aerobic component may not be that high or long, especially if you had formerly been a marathon or ultra-runner.

Still, you don’t want to push it until your bones and muscles have adapted to the activity and you know that the injury is strong enough to withstand running.

So, if there is a cross-training activity that doesn’t irritate the injury and has been approved by your doctor, you can work this in with your running.

For example, if you are run-walking for 15 minutes, you can do another 15-30+ minutes on the elliptical, bike, or by running in a pool. This holds especially true if you have been able to cross train while you had the injury.

5. Start to include strength and flexibility work

While running you may have felt like a gazelle with your legs flying in the wind. Well, depending on your time off, your leg muscles may have lost some of their god-like powers and weakened during the layoff. 

Sometimes, if one of your legs was injured, we can adjust our stride slightly to avoid pain, which can cause muscular imbalances that could be exaggerated when you come back to running. 

And, especially if you work a desk job with a lot of sitting, your muscles could have gotten tight. We also tend to move less when injured in general. 

So, start with a full body strength routine and work from there. It does not have to be in a gym. A basic workout of 3 sets of 15 reps of squats, lunges, push-up, and core work can help get you started. 

Flexibility can also be basic to begin. You can attend a yoga class at the gym or online. It can even be setting reminders to get up and stretch at various periods during the day to loosen up.

6. Cut yourself a break

If it’s been a while since you’ve been able to run, you’ll most likely “feel slow” and that your pace is off from where it was. However, within that pace is a lot of overall fitness adaptations. Some are slow to develop but come back over time, such as your aerobic system.

Some are faster to come back such as your neuromuscular system, the part of running in which your nerves and muscles learn to coordinate and help to produce leg turnover leading to speed.

Stick with it with patience and consistency and you’ll notice a difference soon.

7. Add in hillier courses

If running on flats feels ok, you can try running on hillier surfaces. Hills add a training stress, so make sure you bring them back gradually, and again don’t overdo it. 

Try a hillier course, and if you respond ok, then try adding them in for 1-2 days a week at first. If this bothers your injury or feels like it is too much, don’t be afraid to pull back.

8. Watch your nutrition and sleep

As your runs get longer and the difficulty increases, make sure you are fueling yourself enough to continue healing your injury as well as to account for the additional running. Stoking the engine can take practice and getting back in the habit, so make sure you are making adjustments here, too.

And, you may notice you may need increased amounts of sleep as you continue to get better and renew your running. What “should be” an easy run still is causing multiple systems in your body to adjust and rebuild.  

9. Add in easy, flexible speed work

Rather than going to the track and pushing yourself to do intervals, add in informal intervals, also known as fartlek runs, in which you run fast for a time that feels comfortable to you and then slow down again. Keep these runs feeling easy so you can see how your body responds.

Then, add in strides. These are 20-30 second of quick leg turnovers, almost like sprints, to help you get back leg speed and work on your running form.

Start with 1-2 sets on a soft surface such as grass. As that becomes comfortable, you can add in more sets as time goes on.

10. “When can I start training for a race again?”

You may be raring to race and wanting to get back in the game. For a marathon or longer, typically you should be ready to start training if you can run for an hour pain-free. For a shorter race, you want to be able to run for at least the duration of the race with speedwork integrated into your routine before attempting to jump back in. 

Take it easy coming back and you’ll return to running sooner than you think. Let your body and mind guide you as to if your rate of coming back is too fast, or is the right pace for you.

 

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