How to safely get back to running / exercise after injury

There are few things as frustrating as thinking that you’ve gotten rid of an injury just for it to flare back up after a few sessions of running or exercise. In this blog post I’ll explain how you can make sure that you make a smooth return to sport without reinjuring yourself.

In this article:

• What happens when you get injured

• What strains that part of your body?

• Use your running / sport as final strength training

Here's the video I did about this.

What happens when you get injured

I’ve written in detail about how injuries heal so I’ll keep this brief. The main thing that you need to understand is that your injured body part’s strength reduces significantly when you injure it. As a result its capacity to cope with the forces from running or other activities drops.

This is why it doesn’t work to just rest an injury until it feels better and then try and jump back in to what you think is an easy run. You have to actually first strengthen that part of your body back up to the point where it can handle the forces from running. An easy run may still “feel” easy because it hardly makes you breathe hard, but the forces that go through your body may be too much if you’ve not done enough strength training.

How much is enough? You can’t just pull a figure out of the air. You have to test it to find out. For example, if you’ve strained your calf muscle, I would want you to be able to do all of the following BEFORE I give you the green light to start running:

• be pain free with walking,

• easily do 3x15 heel raises,

• and hop 10 times pain free.

Every injury has a different set of things that you’ve got to be able to complete before you go back to your sport, because every structure in the body works in a different way when you run or play sports.

What strains that part of your body?

It’s really useful to understand exactly how that part of your body normally works – when does it normally take a lot of strain? Understanding this can actually allow you to get back to running or other sports more quickly as long as you make certain adjustments.

A medial meniscus strain in the knee is a good example of this. Some of my patients have found that they can continue running as long as they avoid uneven ground and stick to flat surfaces. This is because the meniscus mainly takes strain when you twist your knee so, depending on where the tear is, you don’t strain it if you stick to doing activities or running in straight lines.

Use your running / sport as final strength training

OK, so let’s assume that you’ve done all your strength training and passed the tests that shows that you’re ready to get back to running. The forces generated in your muscles, ligaments, tendons and joints when you run are very high. For the Achilles tendon it can be equal to up to 6 times your body weight! That’s why you should view your first few weeks of running as an extension of your strength training programme.

I usually get my runners back doing a run/walk programme for the first 2 or 3 weeks, depending on the injury. Yes, it may be frustrating because you just want to get out there and run, but what’s the use of doing 6 weeks of rehab to go and mess it up and then having to start from scratch? Every run or training session that you do will help your injury grow stronger as long as you make sure that you don’t increase the volume and intensity too quickly.

If it was a significant injury that took 6 weeks or longer to settle down, I would advise that you take about 12 weeks to build back up to your normal training programme. This period of time could be shorter but may also have to be longer – it all depends on your injury and your goals.

Let me know if you have any questions. Need more help with an injury? You can consult me online via video call for an assessment of your injury and a tailored treatment plan.

Best wishes

Maryke

About the Author

Maryke Louw is a chartered physiotherapist with more than 15 years' experience and a Masters Degree in Sports Injury Management. Follow her on LinkedIn, ResearchGate, Facebook, Twitter or Instagram.

References:

1. Cook J, Docking S. “Rehabilitation will increase the ‘capacity’ of your …insert musculoskeletal tissue here….” Defining ‘tissue capacity’: a core concept for clinicians. British Journal of Sports Medicine 2015;49(23):1484-85. doi: 10.1136/bjsports-2015-094849