By Coach Brendon

It's a common situation for runners… they train and they get injured.

Injuries fall into two camps - either overuse or accidental. Things like tree roots, potholes or runner vs car etc are generally called accidental injuries.

Incorrect training often causes overuse injuries such as stress fractures, shin splints, groin pain, and heal pain - pushing too hard, not listening to your body and failing to have a rest are among the obvious causes. Getting a coach and having a proper training plan to follow are key components in avoiding this type of thing. Even with the best intentions injuries occur, especially when athletes head into new territory chasing a PB or running something longer like their first marathon.

In all cases it's important to get good advice and get the initial stage of rehab underway quickly. This initial phase, through to getting back to walking pain-free, requires a lot of patience for the athlete. There is always the inevitable pressure to get back in to training for the upcoming event but if you come back to training too soon, then everything is delayed. Generally speaking I think that the medical profession is very good at this stage of rehab, as it's fairly common to treat people and get them moving again. However, it's not so common to get people back to full sporting function, so it's often from this point on that many things go wrong.

The advice of "Ok go and do some small runs and ease back into things" is generally what is given after pain free walking is achieved. The issue here is that the athlete translates this to "after a few runs do what you were doing before" which clearly is not the intention. The athlete promptly goes out and has a high risk of re-injury and once that happens the risk of further re-injury must be higher still.

This is where a good coach with experience in rehab programs can help, not to mention some sports physios who are great at providing assistance too. A coach working with a sports physio is, in my opinion, often the best situation.

What to do whilst waiting for injury recovery

There are several options to consider when getting back into training. Let's take a closer look at some of these:

Cross Training

Non-weight bearing sports such as cycling are popular and a good way to keep general fitness up whilst waiting for the injury to be ready for running. The down side is that upon returning to running, the athletes cardiovascular system is in great shape but their muscle and/or skeletal systems are not ready for anything serious. So some danger lies in going too hard too soon. So long as this is recognized then I think it's fine.

Soft Surface

I am a great believer in returning to training on softer surfaces. I think the ideal surface is a pine or chip wood trail - if you have these surfaces near you, count your lucky stars! Obviously good grass surfaces such as cricket or rugby fields are ideal; however, watch our for very wet surfaces, as slippery conditions can lead to re injury too.

Water Running

Water running is another great option in the period prior to running or indeed in the phase where you can do some running (but not anywhere near the time you were putting in prior to injury). As with other forms of cross training, it's important to watch the return to 'real' running but I think it has its place.

See our article on Deep Water running here for more info on water running.

Walking with Running

One of my favorite methods of getting back into things is walking with some running, which over time turns into a run with some walking and then finally running.

For example: in the first week of a rehab program you might go for a 30min walk with 3x4min Jogging, week 2 might then be 30min walk with 3x6min Jogging (so mostly running) then week three might be 30min Jog with 2x2min walking and week 4 may be 30min jog no walking.

Example 4 Week Walking / Running Rehab Prog

* All sessions are total minutes.
* All running to be done on flat terrain if possible, especially in the first 4 weeks.
* This is an example program it is not suitable for all runners returning to running but is provided as an example of what can be done.

Additional Things That Help Rehabilitation...

Follow the 10% increase rule

The 10% rule simply means don't increase consecutive sessions by more than 10% while coming back. So if 25min is OK one day then the next run should be 27.5min.

Have a day off after each session

Run one day then wait a day, run the next day. I have found that it's safer to start increasing things a little faster back towards pre training levels once athletes are back to 30min Pain free. Work slowing and methodically toward that point and then think about getting back to pre injury levels.

Use pain as an immediate terminator of a training session

Aim to always be under the 'pain threshold' - if 30min gives you pain but 25min doesn't, then your next run should be 25min. Once you have done this, then go back and test 27.5min, if there is no pain then go back to 30min. It's important in the early rehab phase to never be far from the car or house - once it feels like it's getting sore, stop immediately and walk back.

Ice Post-Run

Have a good stock of ice in your freezer and take the time to ice the injured area after those initial runs. Maybe even consider taking some with you to your training venue. As always, it's better to be safe than sorry.

Anti-inflammatory drugs

Watch the anti-inflammatory drugs if your doctor has given them you. In hot weather, make sure you keep hydrated as some reduce kidney blood flow and dehydration does so further.

Shoes

Ensure you are in the right shoes. Once injured what might have been tolerable for your body may not be any more - Podiatry and good shoe advice might pay.

In addition to the rehab process you need to follow, it's important to keep hydrated and eat well as this helps your recovery and may also stop you putting on unwanted weight.

Final word: It is important to stay positive and focused when coming back from injury - it requires as much attention (if not more so) than your regular training. If in any doubt get some qualified advice on a rehab program, look for someone who has studied sports injuries and physical conditioning at university level. Ideally you should also look for someone with experience in this area who can help you get back on track safely and effectively.

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