Return to Running Guide

Follow these simple recommendations to guide your return to running after injury.

When it comes to injury recovery, there is no “one-size-fits-all” so make sure to modify the recommmednations according to your own individual circumstances. If you are not sure, ask your practitioner.

Some variables to consider…

Age –The older you are typically the longer it will take to recover and the more cautious you should be when you start running again.
Training history – If you are new to running it may take you longer to return from injury compared to someone who has run for many years.
Severity of injury / length of recovery – generally the more severe your injury and the longer your recovery has taken to this point, the slower you should progress with your return to running.
Injury history – The greater the number of previous occurrences the more cautious you should be with your return to running.
General health and fitness – The better your overall health, generally the faster you can progress.

Guidelines

Surface

Pick your running surface wisely – generally softer, flat, and even ground is best tolerated.

Approach

Warm up thoroughly before running. A good warm up will pre-activate key stabilising muscles and increase blood flow minimising re-injury risk.
Start with a walk/ run e.g., run for 100 metres, walk for 100m metres, repeat for desired distance – This will help you to avoid fatigue which is an independent risk factor for re-injury.
Don’t run on consecutive days – this will allow for recovery and give time to assess any reaction to the run.

Volume

Start with 10-20% of your preinjury distance. For example, if you were running distances of 10km, start with 1-2km.

Progression

The “10% rule” is often quoted as the maximum to increase training load to avoid reinjury but as scientist and researcher Tim Gabbett points out this should be, at best, a ‘Guideline’ rather than a ‘rule’.

The problem with the 10% rule is that increases in distance in an athlete who hasn’t done much running over the last month (like someone returning from injury) will be so small that it will considerably delay the return of that athlete to full capacity. For example, if you start your return to running at 1km and only increase your runs by 10% per week it would take almost 2 months to reach 2km!

The opposite problem can arise with higher-level athletes with considerable miles over the last month. In this case 10% may actually be a too great an increase in distance and they may only tolerate much smaller increases in training load from week to week.

We should therefore modify increases in volume depending on where you are the return to running process.

Progression Guide

Weeks 1-2: Start with weekly increases in load of no more than 10%. Start with small increases 10% or less in training load initially to test tolerance.

Weeks 2-4: Increase weekly mileage by up to 20-30%. If running has been well tolerated (see below), try increasing your training distances by larger margins. Do not increase your weekly training loads by more than 30% as this has been shown to increase injury risk in runners.

As you begin to reach your per injury distance start to reduce your weekly training load increases back to 10% or less.

Once you have can comfortably run your preinjury distance you can start to increase intensity.

Response

As long as pain is not increased (>3/10) during or after (directly after or the next day) slowly increase the length of your runs in line with the guidelines.

If you develop pain (greater than 3/10) during or after running don’t run for one week. Continue with your other exercises and management strategies. Retry running in one week for half the distance.

‘Return to running guide’ was written by Steffen Toates. Steffen is a chiropractor at Dynamic Health Chiropractic in Jersey, Channel Islands. For more information about Steffen click here.