Running Injury Comeback
Your injury has finally healed!
You graduated from PT!
It’s finally time to jump back into training!
Unfortunately, the return to running is usually a bumpy road. For a while, running will feel harder than it used to, and the injury may flare up from time to time. Just don’t forget that two steps forward and one step back is still progress.
The most important thing about coming back from an injury is being very specific and clear about the end goal. The end goal should be complete healing. So many runners who are eager to get back out there settle for a level of pain or discomfort that is manageable. This is a huge compromise that will end badly and involve more setbacks when intensity or mileage increases. The goal is never to simply “manage” discomfort, but to fully move past an injury.
Pain-free running is a beautiful thing.
Asking the Right Questions
When I’m coaching runners back to full strength after a little niggle experienced in training or a more serious injury (and they’ve graduated from PT) I always have the same 4 questions:
What is the pain level? scale of 0-10
As a coach, I discourage running for everything at level 3 or higher. If the pain is >3 do not proceed, do not pass Go, do not run.
During the run: did the pain increase, decrease, or stay the same?
If the pain is increasing during the run, stop running.
After the run: was pain or discomfort greater than it was before the run?
If the pain is greater after the run, how long does it take for the pain to return to the pre-run level?
The following day: is the pain greater than it was yesterday?
If yes, do not run. If no, proceed with caution, asking all the same questions again.
These questions must be asked every single day until the answers are all pain = 0. And these questions must be asked after every step forward in training and every new addition of intensity or volume.
Bone vs. Soft Tissue
For serious injuries involving bone fractures or breaks, or injuries requiring surgery, the build up plan is generally flexible in only 1 direction: a longer and slower build up. There’s no “art” that allows a quicker return from a stress fracture or a surgery - we take at least the doctor recommended rest time, and then often more. After the the minimum rest and treatment is completed, return to running can possibly begin. Start with guidance from your doctor and by discussing question #1.
Soft tissue injuries can allow for a little flexibility both ways and return to running can sometimes be sooner than initially expected. Return to running can often begin significantly sooner with professional treatment, whether it be from an athletic therapist, physio therapist or massage therapist. Even self therapy can be a huge help in returning to running as compared to rest alone.
Return from injury is an art and a science. Even if we follow a plan to gradually “build up” to full training, plans like this are very flexible. Ultimately, it doesn’t matter what the plan says if the pain or discomfort isn’t improving.
Rest Alone is not the Answer
Rest allows an injury to settle down and healing to begin, but rest does not correct the problem that caused the injury. For the best changes to prevent an injury from occurring, the return to running and subsequent training must be different than it was when the injury occurred.
Related: Your Running Injury Needs Treatment
Some injuries (like bone and surgery) require rest initially, and some simply require a decrease of intensity and/or mileage. But rest alone is never the answer. A successful return to running requires treatment and preventative strengthening and constant evaluation (either by a medical professional, yourself, or both).
Specific Recommendations for your first run back, how to progress to longer runs & higher mileage, how to bridge the gap between easy runs to workouts & more. Return to Running: Injury Comeback
Nicole Sifuentes is a former professional runner and 2-time Olympian, a Certified Strength and Conditioning Specialist and full-time Running Coach for adults of all ages and abilities. Read more about her services, and schedule your free coaching consultation.