Two of the many of questions I get about my running is “Do you get hurt often?” and “How do I go back to running after an injury?”. It seems like many people associate running with getting injured and I do have an idea why. Running itself is a sport that can easily lead to injury under certain circumstances. Some reasons why you can get hurt when running are lack of fitness, wrong kind of shoes, bad running style/form, and running too fast. There are quite a few more ways how you can hurt yourself when running, but the ones I mentioned I partially experienced myself. The one thing I have to mention up front is that I have been very fortunate when it comes to running related injuries – except for a broken foot I have been spared from major injuries and I want to keep it that way.
How I returned from a broken foot injury
In 2010 I broke my foot, but not while out running. I was actually standing next to my Mountain Bike when a strong wind gust made the bike tip over and the handle bar of the bicycle ended up hitting the top of my foot breaking a bone. First I was out from running for about 8 weeks and then tried to make a comeback. However, bone spur coming from the fracture healing process had covered a nerve in my foot and so running hurt a lot. It required surgery to remove the excessive bone spur and I had to endure another couple of weeks recovering from the surgery and then had to go through physical therapy before being able to go back to running. So, I was out of (running) commission for almost 6 months and it felt hard to go back running. I was not a happy camper.
So, how did I go back to running after this injury? The steps below might not represent a scientific approach and they might be too aggressive for someone with less training age or someone who is prone to get injured more easily. It is however the approach that worked for me and ultimately allowed me to enjoy running again as much as before this happened. First I will describe my recovery the way I did it and then further down I will provide you with some more details about the different exercises.
My first few runs after this injury were on a treadmill. I was concerned about the surgery part and was hoping that no nerve damage had occurred. Before the surgery I could not run for more than 20 minutes until the pain related sensation made me stop. So, I was very happy when I reached the 20 minute marker and did not experience the pain. I felt weak, but had no pain. I still have (up to this day) a small sensation type of feeling in my foot and lower leg which bothers me sometimes, but overall I have learned to ignore it and so it does not affect my running or day to day walking. It is actually more an issue when I walk, not when I run. I kept the runs on the treadmill short and stopped the first five runs after ~30 minutes each. On those days I added some 20 minutes of cross-training exercises (mainly strength training) that were recommended to me from the physical therapy sessions. I needed to rebuild muscle strength as well as have the legs get used to running again and just did not want to over-do it. The following week I stayed on the treadmill again, but increased the run time to about 35-40 minutes followed by cross-training. In the 3rd week I started running outside again – still followed by cross-training – but ran by feel and not based on time.
If you believe in something called “muscle memory” then you are not alone because I do so, too. Over the next few weeks my ability to run up to 6 or 7 miles came back fairly quickly and I believe that some of the quick recovery progress in regards to distance and pace was based on muscle memory. I think it definitely helped me to cover the longer distances more quickly compared to having to work my way up into the unknown. I would say that within 6 or 7 weeks I was almost back to my normal running again, but probably had some work to do on rebuilding muscle and leg strength. My overall pace slowly adjusted back to where it was before. That is one thing with running – you can either increase distance or speed, but usually not both at the same time. My goal was to go distance first and then to work on the time and overall I think that plan worked out great.
Exercises I did to return to Running
As mentioned I started running on a treadmill first when coming back from the broken foot injury. A treadmill offers more “cushioning” and shock absorption compared to running on asphalt or concrete. I wanted to make sure my legs (muscles and joints) had a chance to come back on “softer ground” and get pounded hard immediately. All runs were run at an even pace – no sprinting, no tempo runs. I started at 5.5 mph for the warm-up and then adjusted the speed to 6.5 mph. I ran for a total of 30 minutes and added 5 minute cool-down.
I did several different cross-training exercises to strengthen my legs. While the left leg was in better shape than the right leg (right foot injury) I decided to not do leg specific exercises just for the right leg. Here are the exercises I did:
1. Rapid Squats for 30 seconds. Then 15 seconds of rest. Another set of rapid squats for 30 seconds. Several repetitions. Did this for about 3-4 minutes.
2. Walking Lounges with weights. 60 second sets, 30 seconds rest, several repetitions.
3. High Knees. 45 second sets, then 15 seconds of rest, several repetitions.
4. Leg extensions (machine workout). I don’t remember the weight setting I chose, so pick something that feels hard to do and allows you to do repetitions. I did sets of 10, then followed by 15 seconds of rest, and additional repetitions.
5. Calf Raises. Pick some weights for both hands and do calf raises. 45 second sets, 15 seconds of rest, several repetitions.
6. In-place sprinting. 45 second sets, followed by 15 seconds of rest, several repetitions.
7. Vertical jumping / Block jumps with squat side-step. You jump up high, go into a side-step squat to the right and jump again, side-step squat to the left and jump again. 45 second sets, followed by 30 seconds of rest, several repetitions.
8. Leg Press (Machine workout). I don’t remember the weight setting I chose, so pick something that feels hard to do and allows you to do repetitions. I did sets of 10, then followed by 15 seconds of rest, and additional repetitions.
I did not do all exercises every day, but rotated through several each day. I was definitely sore the next day, but continued on as I wanted to get through this. Not all of these exercises might work for you simply depending on your injury.
Recovery from other running related injuries
As mentioned before there are many ways how you can get hurt while running and depending on what the injury is, there are many different ways for healing and recovery. One of the most important pieces of advice is something we runners do not want to hear:
Yes, the dreaded “stop running” advice is often the easiest cure for running related injuries and we runners do not like to hear it. How long you should not be running depends on the injury. A couple of times I had muscle pain – especially after a hard and super-fast run. It felt like some muscle strain injury or so, but the good news was that it mainly hurt when out running. I went onto an elliptical and worked out that way. When you work out on an ellipictal you use your legs and arms in a different way and in my case that was all that is needed. I stayed on the elliptical for the next 3-4 workouts and then my leg muscle felt fine again.
And then of course there are other running related injuries. Think hurt joints, plantar fasciitis, stress fractures and iliotibial band (IT Band) syndrome. Some of these injuries might require medical attention while others can be recovered from using rest. In this case you also have to separate the actual healing process and then recovery process. If you are out from running for several weeks you need to start up again with a reduced training program. If you are out of commission for four weeks, you probably need about four weeks to build up your strength again. Depending on the injury type you should also consider injury specific exercises. If your IT band is weak, special exercises to strengthen your IT band are needed to avoid a recurring injury. Many runners do not like to hear it, but cross-training is very important – it not only helps to avoid injuries, but cross-training also helps to make you a better runner.