What every runner must know about returning to running after injury

Running is a sport in which injuries are commonplace. In fact, the average runner will be forced to take time off from training at least once during a calendar year due to injury. But returning to running after an injury can be tricky. It is important to determine the root cause of the injury, so the source of the problem can be addressed. It is also imperative to have a plan for transitioning back to being more active. A runner without a plan is bound to be a runner with another injury down the road.


Do

Do seek out an expert opinion

Most running injuries have a root cause. As a result, it is vital to seek out an expert, such as a physical therapist, who can help identify why the injury occurred. Knowing the cause of the injury can help with recovery and help prevent a future injury.

Do have a plan and stick to it

The average runner needs to take a number of weeks to build back up to his/her usual running levels after an injury. Use a calendar to map out a slow and sensible return to your usual mileage. Give yourself recovery days between your runs to allow the body time to rest. Starting with 25 percent of what was previously normal is gentle enough to avoid reinjury.

Do start slowly

Overdoing it is the beginning of many overuse injuries. Avoid the pitfall of "too much, too quickly." Slowly returning to running after an injury will allow the body to adapt to the stress of running without being overwhelmed. Start with alternating bouts of jogging and walking. It’s an easy way to slowly introduce the stress of running to the body versus just jumping right back to your usual mileage.

Do mix up your routine

Recognize that doing other sports can help maintain fitness, while giving the injured area time to heal. Biking and swimming are great ways to stress the cardiovascular system without the pounding stress of running. This approach often means that you are fresher for your next run. Cross training, even when not injured, is a smart way to prevent injury.

Do listen to your body

Most common running injuries will give you warning signs. Pain is often a sign of tissue breakdown. Pay close attention to new aches and pains. This will allow you to address causative imbalances early enough to avoid serious injury or setbacks. Seek out a physical therapist when you notice new aches or pains to prevent future issues.


Don't

Do not go by feel alone

Just because you are not feeling pain, does not mean the problem has been resolved. Corrective exercise and a slow increase in running should not stop just because you are not feeling pain. In fact, these aspects of recovery should continue until imbalances have been resolved and the runner has slowly built back to his/her usual routine.

Do not mask symptoms

Using over-the-counter pain medications to mask painful symptoms should be avoided. Instead, focus on corrective exercise to solve causative problems versus masking them with pain meds. Doing this will likely mean the injury will come back as the problem was never addressed.

Do not push through pain

Pain is the body's way of telling us there is something wrong. Trying to run through pain often results in other areas being hurt as we compensate for the original problem.

Do not make sudden changes

Slow and steady wins the race when returning from an injury. Avoid rushing back too quickly, even if you are feeling good. Consider adding increases to your routine in 10 percent increments. This will allow tissue to adapt to new stresses without being strained.

Do not forget about the pool

Pool running is a great way to maintain run fitness. The use of a buoyancy belt allows a runner to move in a running-specific movement in the deep end of a pool and avoid the compression stresses of on-ground running.


Summary
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After an injury, returning to running will be different for each runner. Key components of a successful return to running include a sensible plan to gently increase distances, rest days to allow for recovery, cross training to avoid overuse and a willingness to actively listen to the body for warning signs.


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Robert Gillanders, PT, DPT, OCSSpokesperson for the American Physical Therapy Association

Physical therapist and American Physical Therapy Association member Robert Gillanders, PT, DPT, OCS, practices at Sports + Spinal Physical Therapy in Washington, DC. He is a board-certified orthopedic clinical specialist, a certified ergonomic a...

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