Returning to Running After an Injury
Written and illustrated by Marie-Catherine Bruno, BScPT, Cped(C).
We have all been injured in the past and wondered how and when we were going to start running again. There is no miracle answer to that, and most people and health professionals go by trial and error, but having worked with many athletes throughout the years I seem to have developed a fairly decent recipe (meaning that people DO get back in shape and DO NOT get injured again). I will share this recipe with you now.
The Number One Rule
Giving your body a chance to get back into it slowly is the number one rule. See yourself like someone who is picking up running for the first time. Begin slowly and increase distance, time and intensity gradually and only as your body feels ready for it. Listen to your body as it usually knows what it can take and what not.
Limiting the Impact
Part of the secret when recovering is to treat your body with respect and make it exercise on pillows. Ground forces transferred to your body are quite significant with just walking and increase significantly when running. Vibrations created by the ground forces may aggravate your condition and slow down the healing process, causing millions of mini-lesions in the injured area (and in the rest of your body, but you normally recover overnight and do not feel the effect the next day). So here are a few suggestions to walk on clouds:
- Treat yourself to a new pair of shoes to ensure you have proper cushioning, which will decrease the stresses transferred to your body from the ground forces. Older shoes bottom out and therefore lose their cushioning and shock absorption properties.
- Choose the softest surface possible to train on in your area. A good rule of thumb is that trails in the forest are the softest, and they get harder in this fashion: wider trails in the open, forest roads, gravel roads (crushed stones), asphalt and last (and worst) cement/concrete (sidewalks usually). Softer surfaces will reduce the forces transferred to your body by absorbing some of the impact.
- Whenever doing hill workouts, use ski poles or walking sticks as you can use them like crutches on the way down and reduce the load on your legs. Hills are an excellent way to get back in shape because the inclination going up reduces the distance between your foot and the ground on every step and therefore limits the impact as you land on the ground. On the way down though, make sure you are walking very slowly because now the inclination has the opposite effect.
Playing with the Variables
There are many ways to progress your training. There are mainly three variables that you can play with in order to improve your running ability: speed, time and incline. Never increase more than one parameter at a time for a given training session. For example: if you have been doing 3-minute hill repeats on a given hill, do not change to a longer and steeper hill; move to the steeper hill if you choose to increase steepness, but then maintain your 3-minute interval (the length of your last training session).
So a good way to get back into running is to play with those variables so that your return is gradual. I suggest you experiment with the following pattern for the first few weeks or until you feel like you are back to your previous regiment. This pattern involves 3 sessions a week, which gives you at least a day to recover in between each session.
- 1. Walk fast for 10 minutes. Then jog for 4’ and walk for 5’. Repeat 3 times. Cool down. As you feel stronger, increase the jogging time and reduce the walking until you can jog the whole session. I recommend that you make changes by 30” increments.
- 2. Walk fast for 10 minutes to a nice and steep hill. Charge up the hill (you can use ski poles or walking sticks to help reduce the stress on the way down) for 2’, then very slowly walk back down (coming down slowly will limit the impact on your body but also increase your quads strength and endurance – a thigh burner!). Repeat 4 times or until your legs feel like Jell-O. Increase the duration of the climb by increments of 30” every week.
- 3. Go to your local gym and work out on the Ellipsoid machine. This machine recreates the walking/running motion, but without the impact (your feet neber leave the platforms). Most of then also allow you to get an upper body workout, which increases your heart rate even more. Working out indoors is extremely boring, so I recommend you only do a 20-30 minute session and then quickly go down to the pool and water run. Begin in the shallower section where you can actually run, but make sure you wear a floating belt so that you can continue in the deeper section and walk-float (you will pretty much look like a seahorse!). This technique allows you to do longer corridors (as opposed to staying in the shallow where you keep turning around) and therefore makes it a bit more interesting. Try to get a good 20-minute session, so that combined with the Ellipsoid machine you will get almost an hour of impact-free running.
Make sure that even if you do not feel like you are getting a real workout, you still do your stretching (before and after). Your muscles have not exercised in a while and will undergo minor damage from the training session, just like in a hard workout when you are in your Olympic shape. Refer to ONA of May 2002 and July 2002 for proper stretching techniques.
Limit the Inflammation
Any type of injury will likely get an inflammatory reaction after your first training sessions. Limit the damage by making sure you use ice or contrast baths on the affected body part (refer to ONA April 2001 for recipes) or if you are still using anti-inflammatory medications, time yourself accordingly with the training sessions.
Listen to your Body
Your body will most likely tell you whether you are doing too much or if it is just right. Pain is your body’s main voice, so listen to it. Pain usually indicates that you are causing some damage. However, chronic injuries sometimes have to go through a phase of breaking down scar tissue which may or may not cause pain, so make sure you discuss this with your health professional and agree on how much pain you should tolerate.
Returning to running after an injury should be a pleasant and motivating experience – if done right. If it is not pleasant, continue riding your bike or keep watching TV until you are actually excited and happy about your running.