How many of us have suffered a running injury, rested, diligently done our rehab and embarked on a progressive return to running plan, only to land painfully back at square-one?
I’d suggest that an alarming percentage of readers will be all too familiar with this frustrating pattern of recurring injury.
The question is, what can we do differently when it comes to the all important return to running stage of rehab?
When it comes to running injuries, any physio will tell you that there is a well recognised list of common running injuries – all overuse injuries sustained over time through biomechanical overload of a particular tissue of the body.
Put simply, if your body is moving and loading in a certain dysfunctional way that predisposes a particular tissue (muscle, tendon, bone, etc…) to being ‘picked on’, and you then add increased training load – something has to give – and injury usually occurs!
There are of course other less common running injuries – some due more to bad luck or bad planning than others (e.g. ankle sprain), but the common list is almost exclusively populated by overuse injuries.
Many different possible factors can contribute to these overuse injuries, and hopefully your individual treatment and rehab plan will have sufficiently addressed these, enough to enable your tentative and progressive return to running.
But once your physio gives you the ‘green light’ to recommence run training – don’t make the one big mistake I see made by runners almost every week…
The Biggest Mistake – Rehab Running Load
Once your physio gives you a return to running plan (here’s the FREE plan I usually provide) you may notice that the running volume begins very low.
In the case of my program linked above, I like to use a run:walk approach to begin with. Logically this would make sense – there is a part of your body that had recently objected to the loading of running, so we now need to progressively load it again in your ‘rehab running’ (as I term it) phase. It hopefully seems logical that increasing training load / stress factors such as running volume or frequency by too much, too soon, might set your injury back.
But what about the other training load / stress factor, running intensity?
Running Intensity – Don’t Push Your Luck!
It seems to me that while most runners appreciate that run volume (milage) and frequency (how often you run) will determine training load, the other important factor training intensity (how fast/hard you run) gets overlooked.
Years ago, as a new graduate It took me a long time to realise why some of the keen runners who were clinically ready to return gradually to running would break down again very early in their return to running. I eventually realised how naive I was being!
I hadn’t overtly specified what intensity these low volume ‘rehab running’ sessions were to be completed at.
This was my big mistake! Some athletes will be anxious about returning to running and thus naturally run easy during these sessions. However, many others will use the rehab running sessions as an opportunity to release frustration at not having been able to run for weeks on end, and push themselves harder than is appropriate for their stage of rehab.
Certain types of athlete (not all) will see the following type of early stage ‘rehab running’ session…
10 x [1min run : 1min walk]
…as an opportunity to run reasonably quickly for 1min and get their breath back for 1min, ten times. Essentially a short interval session.
Remember – Speed, pace, and running intensity – in this situation all one in the same thing – is another important factor determining biomechcnical stress and strain on the body.
I quickly learned that, runners who are returning from injury need to learn to run easy – truly easy – to give their body the best shot possible at a successful return to running! With every athlete I now stipulate specifically that I want them to run at a conversational, aerobic, easy pace for the first 12 weeks, the rehab running phase after significant injury.
No matter how good it feels we don’t touch any speed work for that first three months. The factors we increase are initially frequency and volume, with intensity being the progression once the first 12 weeks is successfully completed.
Progressively Increase Volume -> Gently Increase Frequency -> Add Speed (after 12wks)Last updated on March 2nd, 2021.
Hi James, what warm up would you advice when returning to running? I’d usually do 10 mins easy pace followed by some dynamic stretching, but given the fact that my first few ‘runs’ will be a combo of walking and running I presume I shouldn’t do that initial warm up run. Should I just do the dynamic stretching then the run? Or just do the run as they are only easy pace to start with anyway and just stretch afterwards? Cheers, Jack. PS injury was a bulging disk (not running related but obviously has kept me out for a while).
Hi James, this programme was suggested to me last year. I suffered with bilateral Achilles tendonopathy for around 2 years following doing ‘too much. too soon’. I have followed your programme which I found very useful & can now plod 5-7km. Can you advise what to do next to improve my running? I’ve started changing surfaces, adding in inclines but now seem to have pain on my iliac crest. Any suggestions gratefully received. Many thanks, fiona
For me other problem – starting running after arthritis which affected my leg bones. Probably I prefer to walk.
Regarding your iliac crest pain – it is … hard to overcome. I read (here: https://iytmed.com/iliac-crest-pain/ ) that a number of causes involved to the pain. I think you need to visit a doctor.