The Return to Running

Tips and Advise to do it Properly 

As the weather becomes nicer, a scenic long run might seem more enticing! For runners who have been sidelined due to an injury, whether minor or major, returning to running can be a frustrating and nerve-wracking process. So, what do you do when you begin to feel better and get the green light to return to running from the medical team? Here are a few guidelines, tips and things to consider to help you resume your normal training and racing after an injury.

1. Develop a return to running plan with your physical therapist and/or physician.
   1. Discuss proper warm-up (brisk walk for 10 minutes) and dynamic stretches to be performed prior to running
   2. Even though you may not feel side effects (except for blisters and sore muscles), overtime running can lead to injuries because these structures have not adapted and can thus induce stress onto your body! Therefore, it is important to gradually progress back into running to allow for your bones, tendons, muscles and cardiovascular system to adapt to the stresses of running again.
   3. Incorporate 3 running days with cross-training days in between the running days. Cross training can include biking, using the elliptical trainer or cross-country ski machines, or water running. It is also important to include exercises to strengthen your core, glutes, hamstrings, and back.
   4. Start with a run/walk progression program such as this program:

      Week	Day 1	Day 2	Day 3
      1	Walk 2 min, run 30 seconds - 1 min; repeat 3x	Walk 2 min, run 1 min; repeat 3x	Walk 2 min, run 1.5 - 2 min; repeat 3x
      2	Walk 1 min, run 2 min; repeat 3-5x	Walk 1 min, run 3 min; repeat 3-5x	Walk 1 min, run 4 min, repeat 2-5x
      3	Walk 1 min, run 5 min repeat 2-3x	Walk 1 min, run 8 min; repeat 2-3x	Walk 1 min, run 10 min; repeat 2-3x
      4	Run 30 min	Run 30 min	Run 30 min

      • If you have pain with progressing repeat last day until pain free progression

       

   5. Begin running on less impactful surfaces (track, treadmill or level trail) and avoid hills, especially downhill, to reduce stress onto the joints.
   6. The 1^st run should be used to familiarize your body to the running motion again. Initially, you may feel uncoordinated or “new” to running, but that should improve as you continue to run. It would be helpful if your physical therapist can be present to observe and evaluate your running mechanics in order to assist in correcting any abnormal or compensatory mechanisms. Mild soft tissue stress and discomfort can occur as your muscles begin to get used to the impact and running motion. However, if you begin to feel pain at the site of your injury, you should consult your doctor and/or physical therapist. You do not want to cause further injury or cause a major set back in your recovery by running through the pain.
   7. Once you have completed the walk/run progression program, you can begin to increase running duration before progressing speed. Do not progress duration and speed at the same time!!

       

2. Here are a few other tips to keep in mind:
   1. Shoewear – do not attempt to return to running in a new pair of shoes. Use the shoes you are used to running in so that you avoid skin breakdown and blisters and you are not introducing a new structure from the shoe that can place stress in the foot or leg
   2. Remember to perform trigger point rolling to the lower extremities to reduce soft tissue tightness, improve flexibility and assist in recovery from running

       

3. Lastly, listen to your body! “No pain, no gain” does not apply! If you begin to feel pain, do not progress with distance or speed. Re-evaluate what can be causing the discomfort and if the pain persists, seek consult from your physical therapist and/or physician.