Common Errors to Avoid When Returning to Running After Injury

by Alyssa Wagner, PT, DPT, SFMA-C, Cert. FDN

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As a Physical Therapist, there is no better feeling than getting a patient back to running after they have been rehabbing a running-related injury. But sometimes after initiating a return-to-run program, some soreness or pain can return and begin to interfere with running. If you’re returning to running after an injury, be aware and avoid the following 5 common errors!

1. No Proper Warm-Up

A warm-up is integral to enhance your body’s performance for running, especially when recovering from an injury. A good warm-up should take you 5-10 minutes and should involve some light plyometrics (marching or skipping) and activation exercises (single leg toe taps or single leg running man). These prime all of the major muscle groups, help decrease stiffness in your joints for your run and can decrease your risk for injury or re-injury.

2. Jumping Back Into Your Previous Training Load

It’s important to be realistic with your return to running based on life at the current time. Keep it simple!

  • Conversational pace: 4/10 on exertion scale
  • Walk/run intervals: allows the body to adapt. Especially when coming off an injury, you have to work on tissue capacity in order to properly manage the loads of running. This will also help decreasing avoidance and improving load of the injured area to return to running with confidence.
  • Use a treadmill or track so you are able to stop when you need and variables are controlled (no hills, flat surface). You will also be able to focus on cues (ideally given by your PT after a running analysis).

3. Ignoring “Soreness Rules”

Does the soreness start in your warm-up but go away throughout your run? Or does it go away and then come back? Are you sore after your run and into the next day? You may need to take an extra rest day (or 2) in between your runs or decrease your intensity (distance or time). Purely ignoring your body’s response will not be beneficial in the long run and may slow down your recovery.

Use the stoplight analogy for your level of soreness to safely guide your return to running:

0-3/10 green light – safe to continue your program

4-6/10 yellow light – tread lightly

6-10/10 red light – stop activity

4. Dropping Your Corrective Exercise Program

This is one of the most common errors we see with patients after being given the green light to start running again. However, it’s equally important to continue your corrective exercise program to keep progressively improving load tolerance of the tissue through resistance training. You need to continuously strengthen and load the tissue in order to accommodate the high load of running. Running alone does not strengthen our muscles and finding time to cross train with your corrective exercises is imperative.

5. Poor Sleep and Stress Management

Your body is already working overtime to recover. When the amount of sleep you’re getting is decreased on top of that, it makes recovery even harder. Proper sleep is essential for optimal cognitive, motor and physiological function. Additionally, it’s just as important to plan recovery days into your training schedule. You don’t get faster during your runs – you get faster between runs when you give your body time to recover and reload.

It’s always best to seek the guidance of a trained physical therapist when recovering from an injury and returning to running. Your therapist can create an individualized training program to treat your specific injury and establish a protocol to safely get you back to running. A PT trained in running gait analysis will even look at the mechanics of your running form and find ways to optimize your running efficiency and economy. Reach out to request an appointment!

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