runners injury rehabilitation

Running injuries are common. Unfortunately, the more serious a runner you are and the more training you do, then the greater chance you have of suffering an injury. Most competitive athletes will probably have a least one period of training interrupted due to injury each year.

When an athlete suffers an injury he will rest, receive treatment and then, once the injury has healed, will begin to run once again. Most therapists, coaches and athletes are aware of the importance of building up the mileage gradually post-injury. For example, a common approach would be to start with a 10-minute run at a steady pace to test how the injury has healed. If there is no reaction to this, then after a day’s rest the athlete can try for 15 minutes. Assuming all is well, the athlete can then slowly increase up to 30-minute training runs once again. This approach to post- injury training follows the common-sense principle of gradual progression.

But hear this

It is important to remember that the progression of training post- injury must also include a speed component as well as a mileage component. A common mistake that I have seen athletes make is to recover from an injury, begin training once again, slowly and sensibly building up the mileage at steady training pace. But once they are running at their target weekly mileage, based on the assumption that all is well, they will do a track session at a much faster pace, only for the injury to recur.

Athletes and coaches must remember that training pace for steady runs is significantly slower than the pace during track sessions and most distance races up to 10k. The ground reaction forces and speed of muscle contractions increase significantly at faster paces, placing greater stress on the muscles and tendons. Therefore, a gradual progression back from injury must also include steadily increasing doses of fast-paced running. This is especially important after soft-tissue injuries, such as hamstring strains and Achilles tendinitis. This may seem obvious to trained therapists, familiar with rehabilitation progressions, but it’s a practical detail, which is often ignored to an athlete’s disadvantage.

For example

The following is a good example of an approach to post-injury running that includes both increases in mileage and fast running. Assume the athlete is a 5k and 10k distance runner and that the training goes without problems.

Week one:

10 minute run.
15 minute run.
15 minute run.
20 minute run.

All runs at a steady pace.

Week two:

20 minute run. Steady pace, including four 30 second bursts of faster running.
25 minute run. Steady pace.
20 minute run. Steady pace, including six 30 second bursts of faster running.
30 minute run. Steady pace.
25 minute hilly run. Steady pace, pushing hard up hills.

Week three:

During this week the athlete can perform five to six 30 minute runs at a steady training pace, as normal. Plus two mini interval sessions, eg 2 x 800m, 3 minutes’ rest, at 3k pace.

A good runner would normally perform 5 or 6 reps at this pace in a tough session, but for the first time back after injury, it’s best to hold back until you are sure that athlete can cope with the increased stress of running faster. This approach is especially prudent in the athlete who performs the session on a track.

Week four:

The athlete can resume full training.

Notes

If the training progression causes problems, rest a little, receive some more treatment and go back to the previous week’s level of training.

Athletes who run middle-distance events also need to think about sprinting progressions. After a week of easy running, perform a couple of 100m strides a few times a week, before reintroducing fast track sessions at 400m or 800m pace.

Raphael Brandon