Coming Back From Injury? Get It Right The First Time

Raise your hand if this has happened to you: you get injured, you rest, you rehab, you rebuild your training (gradually) and just when you’re back in top form… you’re hit with the exact same injury all over again. (My guess is quite a few of you would have your hands in the air if it weren’t so weird putting your hand up while reading a blog.) 

So are we destined to a never-ending cycle of run-injury-rehab-run-repeat?

The most common reason for injuries in endurance athletes is biomechanic overload. Sure, there’s always the chance that we’ll twist an ankle, but most of the injuries that sideline us are overuse injuries.

What are overuse injuries? Overuse injuries are the result of the running motion overloading a particular tissue of the body (muscles, connective tissue, bones, etc.). We all have muscle imbalances and weaknesses. As we increase our training, we simply put too much load on our weak links. And our weak links, in turn, give us the finger.

Healing from overuse injuries involves rest, recovery, and rehab. Believe it or not, runners often do a great job in the rehab process. We attack rehab with gusto because we want to start running again. 

Our mistake, however, usually comes immediately after we are given the green light to start training again. 

I’m free! we say to ourselves. I can run again! 

And then we ramp up our training load too soon. And that is a problem.

Training load is the volume, frequency, and intensity of our training. It's a three-pronged equation in which one prong usually gets overlooked. 

One prong is a gradual build-up to our total mileage. It’s an easy concept: don’t jump back in at the mileage you were logging before your injury. Most of us are pretty good at taking care of this prong. 

Another prong is the gradual increase of running frequency. It’s the same concept as the first prong; frequency increases as mileage increases. Not a problem. 

The third prong—and this is the problem prong—is intensity. We tend to forget the intensity prong since we’re rested and fresh. Our lungs are in front of our legs.

What do I mean by “our lungs are in front of our legs?” Cross-training allows us to keep up our cardiovascular fitness even when we’re not running, which means when we finally start running again, our cardiovascular system is much stronger than our muscles and tissues. Many times injury recurrence happens because we overload our muscles, tendons, and ligaments before they’re up to the task.

Along the same lines, we often neglect our rehab strengthening. Rehab strengthening should be considered prehab. We need to strengthen our weak links so they can handle the training loads we plan to maintain once we get the green light.

So how do we bounce back from injury safely and effectively? First, keep the three prongs of training load in mind. No matter how good you feel, build up your training very gradually in terms of volume, frequency, and intensity. As a general rule of thumb, I have my athletes increase only one or two pieces of the training load per week, and intensity is always the last piece to increase.

How gradually should you increase your training? I like the equation of Time Off = Time Back to Normal. Meaning, if you were running 30 miles per week and were off 6 weeks due to injury, you should take at minimum 6 weeks to build back up to 30 miles per week. Frequency should follow a similar timeframe. Intensity should not be increased until normal volume and frequency levels have been reached. And you should not run anything faster than your previous intensity until you’ve maintained at least 3 to 4 weeks at normal mileage and frequency. You should also keep up with your rehab/prehab work 2 to 3 days a week. This will help you bounce back stronger and healthier than before.

Focus on the three prongs of training so you can bounce back without setback, because there's nothing worse than an injured endurance athlete. 

Good Luck and Happy Racing!
Coach Cary

Tim Cary is Head Track & Field and Cross Country for Lindenwood University at Belleville and the former Fleet Feet Assistant Training Manager.  Over his more than two decades of coaching, Tim has coached athletes to three national team championships, five national individual championships, two national records, and numerous All-American and All-State honors.  Click here to subscribe to our blog.