Let us assume you had an injury such as a stress fracture that forced you to shut down any form of running for 4-6 weeks, and now you have been cleared to return to running. What do you do? Where do you start? Do you resume running where you left off? The answer is ABSOLUTELY NOT!
There are specific things to take into consideration when returning back to running. Firstly, it is important that during the time of the injury there was some form of cross training that was occuring in order to maintain key cardiovascular fitness without the high impact of running, such as swimming, or cycling. Another key training element during that time is performing some level of supervised strength training provided by your physical therapist or strength coach, where specific key muscles were being targeted to assure great strength and stability for your return to running. Lastly, assuring flexibility was being addressed and maintained as well.
So, you did all the prep work, and now you are ready to begin the running. Running will be structured to be gradually progressed over a period of time. We want to gradually introduce the weight bearing stresses of running and allow the tissue and bone to adapt to the stresses.
Therefore, there are 4 major categories we adhere to, in order to allow for this adaptation.
- Introducing walking stresses. This would include gradual progression of walking duration ranging from 10-60 minute walks for a set frequency/week.
- Introducing run/walk intervals. This would include some sort of brisk walking as a warm up, followed by a run to walk ratio for a set duration. For example, it can be walk for 3 min, run for 1 min, repeat the cycle to add up to 20-40 minutes. Followed by a walk cool down.
- Progressing the run time. The focus here is building the running time, so it can now look like a brisk walk as a warm up, followed by 2 min walk, 2 min run, and repeated for a set number of cycles to add up to 20-40 minutes. Followed by a walk cool down. If progressing well, then the walk duration decreases as the run time increases so it would then be 1 min walk, followed by 3 min run, etc.
- Continuous running. This is now where 20-30 minute continuous running occurs, with gradual progression for weeks to come. The frequency is set based on how your body is reacting, but can vary anywhere from 2-4x/wk.
This is just a general example, it is important you discuss with your support team (physical therapist, coach, MD) your specific symptoms so that a program is put in place to assure your optimal return to running.
Some key things to keep in mind are:
- At least 2 consistent weeks of certain phases should be adhered to prior to jumping to the next phase.
- You should not increase your mileage/duration by >10% per week.
- Look for signs of intolerance. Pain should not exceed > 5/10, and it should not linger towards the next day.
In conclusion, listen to your body, and respect its healing time, everyone is different, and if you are unsure as to where to begin, do not hesitate to reach out to a physical therapist who can help tailor a program to get you back on track for years to come.
Happy training!
Authored by:
Dr. Anakaren Lopez, PT, DPT, OCS, CSCS, PCES
Doctor of Physical Therapy
Orthopedic Certified Specialist
Certified Strength and Conditioning Specialist
Certified in Trigger Point Dry Needling
Postpartum Corrective Exercise Specialist