Plan: A Return To Running

by Stephen M. Pribut, D.P.M.

If you have paid very close attention to your body, you should be learning to tell the difference between normal healthy discomfort that can even be the pain of exertion from abnormal tendon or bone discomfort or pain which could indicate an injury about to happen. If you are both smart enough and lucky enough to detect an injury our favorite way to fend off injury is called “relative rest”. This means to briefly and dramatically alter your running and exercise plan. Cut back on your running. Return to the basics of necessary stretching, core strengthening and to consider adding in some cross training to make up for some of the distance and time you have given up in running.

After the pain abates, you could consider these general guidelines for returning to your normal mileage.

Analyze, Rest, and Plan Your Return To Running

• First Goal: Rest for enough days that you do not have pain while walking or after walking. This may be 2 to 5 days for a minor injury. It is better to rest early than suffer long.
• Second Goal: Safely return to running in graduated steps. Make certain you don’t repeat the same steps that led you to injury.
• Third Goal: Analyze your schedule to see where you may have gone wrong. Correct your errors for your future training.
  
• Third Goal: Determine your approximate mileage for your return and start moving.
  

Percentage Based Return To Running

First return week: 30 to 50% of your normal mileage
Second return week: 40 to 60% of your normal mileage
Third return week: 80% of your normal mileage
Fourth week: back to your normal mileage and cautiously add in more challenging runs.

Return to Running: After 8+ Week Lay-off

Week 1: 1-2 mile walks on alternating days
Week 2: 2 – 3 mile walks on alternating days, add-in changing speeds.
Week 3: 5 – 10 minute easy jogs every day. Walk breaks every 3 -5 minutes are ok for 1-4 minutes. Walk 2 – 3 miles on alternate days.
Week 4: 12 minute jogs every other day. Walk 2 – 3 miles on alternate days or 30 minutes of elliptical trainer.
Week 5: 12 minute jogs 4 days per week. 3 mile walk on 2 days, cross training or elliptical 30 -40 minutes .
Week 6: 14 minute jogs + 20 minute walks 4 days per week. Cross train or elliptical 2 days.
Week 7: 16-18 minute jogs + 30 minute walks 4 days per week. Cross train or elliptical 2 days.
Week 8: 20 – 25 minute jogs + 30 minute walks 4 days per week. Cross train or elliptical 2 days.

The first 6 weeks of running after an extended lay off are important to strengthening not only your cardiovascular system and muscles, but more importantly your bones. Make sure that you take in adequate calcium (usual recommendation is about 1500 mg per day for an adult) and Vitamin D.

Run Walk FTW

Mixing it up with a run/walk allows for breaks in stress forces applied to your body and allows for an easy transition back to running. You can combine the concept of run walk with any return to running program. Starting with more walking than running, you will gradually reverse that. Follow with some gentle stretching and core exercises at the end of your routine.

• Level 1 5 minutes walk, 1 minute run, repeat  5 times (30 minutes)
• Level 2 Start with 5 minute walk, 2 minute run, 4 minute walk, repeat 2 min run/4 min walk x 5 (35 minutes)
• Level 3 Start with 5 minute walk then follow with 3 minute run, 3 minutes walk x 5 (35 minutes)
• Level 4 Start with 5 minute walk then follow with 4 minute run, 2 minute walk x 5 (35 minutes)
• Level 5 Start with 5 minute walk then follow with 5 minute run, 1 minute walk x 5 (35 minutes)

Exercises: The Core and More

• Calf Stretches (Wall Stretch) – 10 times 10 seconds
• Gentle Hamstring Stretch – 3 times 30 seconds
• Straight Leg Lifts - 4 sets of 10 – working towards 10 sets of 10
• Bridges 10-15 reps
• Single Leg Bridges – 8-12 repetitions
• Planks 15 – 30 seconds
• Optional - Balance Board – 4 minutes for proprioception and balance

Lifetime Tips: Live Long and Exercise!

• As the years go by, you may find more reason to mix in cross training. Consider a sprint triathlon. It isn’t as speedy as it sounds, but it is shorter than the other triathlon distances.
• Cross training while injured helps burn calories and can keep your cardiovascular fitness somewhere above zero. Cross training safely means to do what doesn’t hurt during or after.
• Strength training is a healthy supplement to running. It becomes even more important as the years and the miles add up. Full body training is helpful at all ages.

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About Dr. Pribut: Dr. Pribut is a member of the Advisory Board of Runner's World magazine. He is a past president of the American Academy of Podiatric Sports Medicine (AAPSM). He served as chair of the AAPSM Athletic Shoe Committee for 5 years and has served on the Education Committee, the Research Committee, the Public Relations Committee and the Annual Meeting Committee. He is a co-Editor of the current AAPSM Student's Manual. Dr. Pribut is a past president of the District of Columbia Podiatric Medical Association, serving in that post for 4 years. Dr. Pribut currently is a member of the American Podiatric Medical Association's Clinical Practice Advisory Committee. Dr. Pribut is a Clinical Assistant Professor of Surgery at the George Washington University Medical Center.

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