Physiofit’s Guide to Returning to Running

After a break from running due to an injury, it can be tricky to know where to start, how much you can tolerate, and is it ok to have any symptoms as you return to running?

Before you think about running, a good place to start is to test your ability to hop on one leg. Running is a series of hops so once you can manage to repeatedly hop pain-free, then you’re good to start with a short run. If not, you may need to continue your rehab a little longer, and our physiotherapists can help guide you through this if you need some expert help.

If it has been a long lay off, you may need to follow a couch to 5km approach with a structured and progressive introduction of walking and running combined. Why not join the Running Bear Virtual Running Club on Facebook to access their different training plans? 

When planning your return, you need to consider how far to run and how hard. The first step is to establish a baseline of how far you can run without aggravating the symptoms. You should expect some aching and discomfort when you first start to run but this should be no more than a 2-3/10 pain (0 is no pain and 10 the worst pain you have known). The discomfort should not last more than an hour after you stop and be no worse the next day. If it doesn’t settle; that first run may have been too hard. Once you have that baseline distance, take off 10% to give you a safe starting point. It is also useful to have a test such as a single hop or heel raise to assess whether the first run made that worse the morning after. Some injuries should always be pain free when we return to activity, so it is always best to discuss this approach with your physio.

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In addition to the distance covered, you need to have a measure of how hard you will be working. Your effort can be measured on a scale of the rate of perceived exertion (RPE) from 1-10 where 1 feels like chilling on a beach and at 10 you are barely able to stand up due to jelly-like legs! In the first few runs, you should look to run at an effort of 3-4, for the baseline distance less 10%. At that point, walk to recover and assess the impact over 24 hours. Once you are back running pain-free at this intensity, you can start to increase the distance. Aim to build back up to run 3 x a week with rest days in between and avoiding back to back days. If the pain increases again, replace a run with some cross-training on a bike, rowing machine, or pool, mirroring the RPE and volume to replicate the demands of your run.

One of the key factors for preventing injury recurrence at this stage is to start a diary to record your running. This can be electronic on Strava or Garmin etc., on your phone or in a notebook. Try to take account of distance, pace, time, RPE, how you felt before, during and after, and any discomfort or pain you felt during or after. Multiply the RPE score by the distance covered to get a more accurate measure of load in any given training session known as Session Rate of Perceived Exertion (sRPE). This measure of load is useful for tracking how much you are doing in a given day, week or month and how your body is responding to it.

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Over the weeks, you can progress your running by increasing your volume by 10% of the previous month’s average load (sRPE added up), before increasing intensity and higher speed runs. Some runners can tolerate greater than 10% increases based on factors such as genetics, fitness levels, strength and stress levels. The more you track your data, the sooner you understand how much your body can tolerate the week on week changes and how to avoid future sudden spikes in workload which may have caused your injury. Do not forget to factor in other activities and the impact of your job on overall load.

Finally, alongside running should be your strength and conditioning programme which should be done 1-2 time a week. Regularly checking the capacity of different muscle groups in your legs can help to assess side to side asymmetries and establish baseline measurements for each muscle group. If an exercise starts to feel harder, you may need to work on it to avoid developing imbalances. If you are not sure how to develop a specific strength plan for you, make sure to ask one of our running specialist physios for help.

Keeping to these simple guidelines will help you achieve your goals and stay injury-free.