Green means go when it comes to traffic signals – but not for injured runners. For runners recovering from a running injury, the all-clear to start running again is not as easy as heading out on your favorite trail.
After months of rehabilitation, being given the green light by a doctor or physical therapist to start running again feels like a prison reprieve. Except that returning to running after an injury is not that easy: There needs to be a slow and steady ramping up stage to decrease the potential of further injury. More importantly, runners need to continue to strengthen and support the core muscles that are the foundation for healthy running bodies.
How to start running again after an injury
If possible, meeting with a running coach to evaluate form and bio mechanics is an ideal way to make sure that a re-entry into running does not inflame the old injury. Knowing that form was an integral part of my hip injury, I invested in a consult with an experienced running coach who evaluated my stride pace, foot strike, posture and strength to suggest a comprehensive plan to build a new running foundation. Regardless of a whether or not you have a coach, there are three basic components to ramping back up after injury: strengthening, building a solid foundation and stretching.
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One of the most important biomechanics gifts runners can give their bodies is to help strengthen and activate the muscles that support us while we run. Margie Shapiro, a professional triathlete and co-owner of Potomac River Running stores and PR Training Programs in Virginia, recommends activating the hip (pelvic girdle) and glute muscles with a series of exercises that ought to be performed as often as possible – as well as after warming up prior to a run.
A strengthening routine will increase overall mobility, which will help the major muscle groups function more efficiently, reducing the potential for injury.
One sequence of strengthening drills is known as the MYRTIL routine, which strengthens the muscles around the hip girdle to support running.
Strengthening drills for runners include:
1. Activate the gluteus max with donkey kicks.
2. Lie on your side for clam exercises.
3. Squeeze outer glute muscles during fire hydrant drills while you're on your hands and knees.
4. Use both directions of a breaststroke kick for egg beaters.
5. Stand, keeping your foot under your knee while letting your foot graze the ground – and then swing behind you for leg swings.
6. Get heels as close to your butt as you can with butt kicks.
7. Backwards running.
Shapiro suggests doing these drills every other day (or more) and incorporating butt kicks and backwards running drills after a warm up on a running day. That will help activate the glute muscles.
[Read: A Beginners' Guide to Running.]
Build a solid running foundation
Regardless of the pace or mileage prior to the running injury, runners need to let go of the mindset of what they should be able to do when they get ready to start running again. As disheartening as it was to know how far I could run prior to my hip injury, I needed to accept that I was starting over, as a newbie runner, preferring persistence and patience over adrenaline so that I could continue running in the long term.
There are many new-to-running programs out there for new runners that suggest a mix of walking and running at predetermined intervals over time. The theme in all of these is an overall progression that increases the rate and time spent running over a period of time.
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A sample four-week “back to running” plan
This is the routine that I followed for the first four weeks of my return to running. Each run session begins with a 15- to 20-minute brisk walk, and is followed by a stretching routine:
Week one: Three run sessions of five intervals. I ran for two minutes and walked for three minutes.
Week two: Three run sessions of five intervals: a 2-minute run followed by a 2.5-minute walk.
Week three: Three run sessions of five intervals: a 2-minute run followed by a 2-minute walk.
Week four: Two run sessions of five intervals: a 2.5-minute run followed by a 2.5-minute walk.
[Read: Your Guide to Exercising Through the Ages.]
In addition to using a foam roller each day (or at least after every run session), a consistent stretching routine will assist in increasing the range of motion. Many sports chiropractors and physical therapists also suggest keeping periodic maintenance appointments for a thorough session, especially during the rebuilding stage to prevent re-injury.
Important stretches for runners recovering from injury:
1. Lunge stretches for the hip flexors.
2. Use a band for a deep iliotibial band stretch.
3. Use a rope to pull each leg outward at a diagonal for an adductor muscle stretch.
4. Use a band to stretch the hamstrings.
5. Stretch the priformis/gluteus medius with the figure-four stretch, crossing one ankle over the opposite knee.
While persistence and patience are key to success while treating a running injury, they are also crucial to starting to run again for long-term running success.
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Elena Sonninois a writer, public speaker, strategist, traveler, runner, cancer survivor and chaser of dreams. Her inspirational wellness, travel and social good stories have been published in the National Wildlife Federation's e-book, Be Out There, at the Huffington Post, TravelingMom.com, HiltonMomVoyage.com, ThisGirlTravels.com and BlogHer. Elena is passionate about fostering self-sufficiency and empowering others on her website, LiveDoGrow.com.