It can be tricky to safely return to running after injury as it is easy to re-injure yourself again. Every injury is different and every recovery process is very personal, so my best suggestion would be: Find a sports injury specialist (such as a physiotherapist) nearby for an assessment of your injury. Get the professional advice on a rehabilitation programme that will get you back to running after injury.
The right diagnosis first!
An accurate diagnosis from an “injury specialist” is the best starting point towards recovery anyway. This to prevent you from being mislead by similar symptoms of a different injury.
To give you an example: I was surfing online to find information on my heel pains and pretty quickly I found an injury with the exact same symptoms: it was called heel spur. Later on, when I finally went to a podiatrist, I was diagnosed with plantar fasciitis. Two related, but different injuries!
Initial stage of treatment
In most cases the first treatments involve reducing pain and promoting healing such as ice pack cooling and relative rest. After the pain and the swelling are reduced, a more progressive reconditioning may begin: step by step! Exercises to target specific muscle groups, tendons, or joints will be prescribed. This will mostly not include running yet! It will first focus on mobility, flexibility, co-ordination and balance and it will target several areas in the body, not just the injured body part.
When progress is being made the physiotherapist can give the best advice on how to re-establish strength and prescribe a rehabilitation programme that is suited for your specific injury.
My injuries (plantar fasciitis combined with a heel bone fracture) took more than one year to re-establish strength. I did all kinds of exercises with towels, balls, rubber bands….they were awfully boring. And my patience was challenged every day. I was advised not to start running until I could hop on my injured foot for about 10 minutes, without pain. Unfortunately I was not that disciplined. Every time I thought everything felt much better, I decided try a short, slow, mini jogging session. How bad this was! It wiped out all the progress I made the weeks before and only increased the pains and my injury went from bad too worse!
It took me several “try & errors” until I finally learned my lesson: Listen to the medical specialists! They are not trying to make your life more miserable, they are really trying to help you get back to running, so do as they say.
Rehabilitation: getting back to running after injury
Just re-establishing strength by doing specific exercises might not be enough to treat your injury. Your physiotherapist might add other treatments as well, such as massaging, shock wave therapy, dry needling, etc. There are even some home remedies. In this post I will only describe the exercises during the rehabilitation.
When my foot was finally healed enough and strong enough for rehab, I started a three weeks Run&Walk; Rehabilitation programme. My first session was only 10 minutes long. Honestly: I felt a bit silly. I wasn’t even sweating so although I was happy I finally could get back to the “running” it felt as if I had done “no run at all”. As I had learned from my mistakes in the past, this time I did not try to speed up the process. I followed step by step, day by day instructions. And this time I stuck to the programme! I didn’t walk or run any longer than scheduled and I did take the day rest the day after.
The hardest part of rehabilitation is being disciplined and patience. I often thought I could do more, but like I said, I tried “doing extras” before and all those times I FAILED! This time I simply did not want to delay my recovery any longer.
The following sessions, I was allowed to increase the total time of my Run&Walk; sessions by 2 minutes. During the three weeks I stayed really alert on how my injured foot felt. I had promised myself to stop and finish the session, should I feel any discomfort during the runs. And sometimes when I felt my foot afterwards, I allowed myself an extra resting day. Luckily I never experienced any increase in pain so after the three weeks of this Run&Walk; rehab I felt strong enough to safely return to some longer runs. I gradually built up distance and speed . I’m actually still working towards my previous half-marathon fitness level. I feel confident to run a half-marathon again!
Run & Walk rehab programme after my plantar fasciitis injury
- Day 1: 5 sets: 1min Run + 1min Walk (10 min)
- Day 2: Rest
- Day 3: 6 sets: 1min Run + 1min Walk (12 min)
- Day 4: Rest
- Day 5: 7 sets: 1 min Run + 1min Walk (14 min)
- Day 6: Rest
- Day 7: 8 sets: 1 min Run + 1min Walk (16 min)
- Day 8: Rest
- Day 9: 9 sets: 1 min Run + 1min Walk (18 min)
- Day 10: Rest
- Day 11: 10 sets: 1 min Run + 1min Walk (20min)
- Day 12: Rest
- Day 13: 7 sets: 2 min Run + 1min Walk (20min)
- Day 14: Rest
- Day 15: 5 sets: 3 min Run + 1min Walk (20min)
- Day 16: Rest
- Day 17: 4 sets: 4 min Run + 1min Walk (20 min)
- Day 18: Rest
- Day 19: 2 sets: 10 min run + 1 min Walk (21 min)
- Day 20: Rest
- Day 21 : 20min Run
Now you can now slowly increase the total running time, but don’t get over-excited. Do not to increase your total weekly volume by more than 10%.
The walking in between the runs is very important as your body may need up to several months to regain full strength. The walking minutes between the running sets allow the muscle tissue and ligaments to recover. This helps the injured area to strengthen without reaching its breaking point.
Increase training intensity
After this Run & Walk rehab period of three weeks you may slowly increase your training intensity Choose carefully which elements you want to increase per running session: distance, duration or speed. But keep the total increase of your training intensity to a maximum of 10% per week. Keep listening carefully to your body and especially your (previously) injured body parts. If you need longer recovery, then do so! Take more resting days in between the run & walk days. Or stretch out the programme over a longer period. Just don’t rush it!!
Flexibility, strengthening and core stability training
After you’ve finally recovered from your injury, it is very tempting to fully get back into running. I know the feeling! You feel released again: no more pain, back into the fresh air and run! But be aware! You do not wish re-injure yourself again, right? Therefor it’s really recommendable to add flexibility, core stability and strengthening sessions to your weekly schedule. Strengthen all muscles in your lower body (calves, ankles, feet, upper legs, bum, hips) and core and keep them flexible too. Specific runners yoga can be useful. Always do a proper warm up before and cool down after each run. This will all be helpful to prevent another injury.
If you are injured right now: I wish you all the best. Celebrate every mini achievement of your recovery and stay disciplined not to push the mileage too soon! You will get back to your previous running level again! Just hang in there.
I hope this post was useful. On my site www.morefun2run.com you’ll find more articles on running related topics. If you have any questions, feel free to send me an e-mail (firstname.lastname@example.org) or leave a comment below. I will get back to you as soon as possible.