RETURN TO RUNNING AFTER AN INJURY
BY JANET HAMILTON, MA, RCEP, CSCS
It's a fact, most runners will sustain an injury that takes them away from their running at some point. For some it's a matter of an interruption of a few days, for others it may take several months before they're allowed to resume training. Once you're cleared to resume training - the next steps you take are crucial to your success.
Base building - If you've not been doing a walking program during your time off running then that's where you should start this process. Gradually increase your walk distance over a period of weeks until you're able to walk 10-15 miles a week with no symptoms. During this time it's important to not stress about pace, or the fact that you're not breathing hard and "getting your cardio" training. The goal for this first phase isn't really related to the cardiorespiratory system... it's related to the musculoskeletal system (the part you injured!) The goal here is to slowly introduce tissue load in such a way that the tissue has time to adapt to it. Keep in mind that this takes time. Some people find it helps to think of this phase as "dynamic strength training". Walking has the best carryover of strength of any form of cross training, so don't discount it's value!
Make the transition - when you're comfortably (symptom free) walking 10-15 miles per week, you're probably safe to begin a transitional program. The ratio of running to walking will vary with the injury severity and the length of time you had been training before you got injured. If you've been training for years and were only off a few weeks, you may be able to do a more aggressive ratio of 50% running and 50% walking in this transitional phase. HOWEVER - if you were new to running when you got injured (running less than a year) and/or you were off for a longer period of time (more than a month) then you'd be wise to take a more conservative approach. It never hurts to start gradually and see how your body responds! Try doing a walk warm up, followed by a pattern of running for 30-60 seconds and walking for 3 minutes. This is very conservative, but it gives you a chance to test your tissue strength with a low risk of re-injury. If you jump in more aggressively than that, you run the risk of overshooting and exceeding your tissue's strength and re-injuring yourself. The set backs are frustrating... so don't go there! Take your time and be smart about this phase.
Progress the transition - as the days slip by you'll sense that your body is ready for a progression. Don't make the mistake of going from the 1 minute run, 3 minute walk routine straight into a full-on running program though or you'll run the risk of setting yourself back to the sidelines. Make sure you're successful for at least a couple of runs at each level before you progress. Slowly increase the run duration and decrease the walk duration, making sure that you don't progress unless you're symptom free for at least two workouts.
Other pieces of the puzzle - depending on your injury, there are several factors that need to be addressed. These may include flexibility issues, strength issues, biomechanical issues and training errors. As you're working your way back into running don't lose sight of these factors. Make sure you're stretching any muscles that are tight, that you're continuing to work on the weak areas (usually the core is involved), that you've covered your bases with using the proper shoes and that you don't get ahead of your tissue strength when it comes to pace. Keep all your run segments at easy pace until you're solidly back into running for several weeks. Only then will you be safe to play around with a few segments of faster paces.
Strength and flexibility - Although the studies are inconclusive on whether or not stretching reduces the risk for injury, it's wise to include some gentle stretching exercises in your routine to maintain your flexibility. Key areas include hamstrings, calves, hip flexors, and quadriceps. Stretch when warm for best results, and stretch consistently! Strength exercises should be performed 2-3 times a week and should focus on core areas like the lower back, the abs, the lateral hips, hamstrings and quadriceps. Heavy weights aren't needed - focus instead on functional weight bearing exercises like squats, multi-directional lunges, and balance/reach exercises.
Footwear - making sure you're in the right shoe for your particular gait pattern is a key element in injury prevention. Stop by your neighborhood technical running shoe store and have them watch you run in several pairs of shoes to help you determine which one gives you the right amount of support.
Training errors - listen to your body. Train at the right pace -- run at "easy effort" or use a heart rate monitor to insure you're keeping your enthusiasm in check. Avoid the mistake of doing too many hilly workouts, or adding mileage too quickly. Keep a training log to remind you of what your recent mileage and terrain were like.
Take it one step at a time and train smart. Listen to your body and do your homework - and one day in the not too distant future you'll be back to doing what you love... running strong and injury-free!
To your success on race day! - Coach Janet Hamilton, MA, RCEP, CSCS