Injury: Recovery & The Grand Return. *Plus Bonus 12 Week Running Program

Last week I discussed, in Pushing Through The Pain, the meaning and role of “good” vs “bad” pain and the need to understand what pain is communicating with you. This week I would like to discuss some of the most important items to consider when returning from a training injury: healing, recovery, and the grand return back to running.

Does it hurt?
The first step in your recovery process is healing. It is important to give your body the adequate time it needs before attempting to return to full speed. This is where pain will provide you with the greatest input.

Before you can go out and start running again, It is important that you have pain free range of motion. Do you have a specific pain (can you point to it?) associated with joint movement? Yes? You are still injured! Your body has not fully healed. Now is not the time to begin your previous training program. Pain affects efficient movement, which creates inefficient habits (poor form). Poor form is one of the primary causes of injury and recurring injury, and it is incredibly hard to unroot from your body. If you do not have pain free joint range of motion, it is not worth the risks to push through it. You WILL be creating a cycle of chronic pain and injury for years to come.

Instead, I suggest taking extra time to allow your body to heal. This does not mean sitting on your rump and twiddling your thumbs. It is a very active process. There is much you can do to help facilitate the healing process including deep tissue fascial massage, self massage using a foam roller, lacrosse or soft ball, and corrective exercises. I suggest spending at least an hour each day devoted towards actively engaging in your healing process. Here are 10 steps to Recovery From Your Running Injury And Becoming A Better Runner.

Now That You’re Pain Free
This is a big step. What you do over the next 3-6 months will lay the foundation for how you move for the rest of your life. Now is the ideal time to work on improving how you move on a purely functional level.  Now is the time when you can develop healthy biomechanical habits, learn to move with efficiency, strength, balance, and postural awareness, and take the kinks out of your gait that may be the leading cause of your injury in the first place… i.e. now is the time to work on improving your form.

Every journey begins with a single step. The goal of this is to help you develop good running and movement habits and injury prevention so you can run pain free for the rest of your life. If you’re like me, that means another 40-50 years of running. Keep it in perspective. Three or Six months of training might seem like a long time, but if it means that you’ll significantly reduce the amount of time you are lame with chronic pain and injuries over the rest of your life, is it worth it?

Form, Not Conditioning
You cannot learn a new movement pattern (form), and – at the same time – use that movement pattern to train for endurance, strength, power, or speed (conditioning).

For example, if you are recovering from a running injury and are training to improve your running gait, you cannot use running to improve your conditioning. The two on a fundamental level don’t work together!

Training to improve your form and training to improve conditioning are not compatible trainings. To improve form, you need practice… perfect practice. You are training your neurological system to develop new bio-mechanical habits. To have flawless form, you must repeat the movement pattern flawlessly with every repetition. At this stage of training, form breaks down at the first sign of fatigue. Once fatigued, you will no longer be able to maintain perfect form. Training with imperfect form reinforces the very poor movement patterns that can ultimately lead to injury. Fatigue is a core component to training endurance, strength, power, and speed. You will not achieve significant improvements in your conditioning without training into some levels of fatigue.
What this means is that if you wish to improve your form to reduce the recurrence of injury, then you must limit how much you run until you have fully developed your new and improved running gait. This may take a few months or longer, depending on your age, conditioning level, injury history, and a few other factors.

You may be able to continue to work on conditioning.  However, it will come from activities which do not aggravate your injury (i.e. not running). Options may include: cycling, swimming,  climbing, walking, hiking, rowing, functional training, and metabolic conditioning.

Training Program
There is no training program that can guarantee for you a speedy pain and injury free recovery. Because of what I see in the lives and bodies of my clients doing the work I do, I tend to err on the conservative side. I would rather see them, and you, spend a few months developing a solid postural foundation and basic fundamental movement patterns.  We typically start with something like the ability to perform a functional squat or lunge prior to getting back on the trail. I feel that squats and lunges are a basic progression before running. If you cannot perform a functional deep squat, lunge, or lateral lunge, then running is not advisable.  Not until you can complete those movement patterns pain free. Spending a few months, right now, bomb-proofing your body with healthy and efficient movement patterns will pay off huge dividends in added years or decades to your active, pain and injury free running life.

I highly recommend performing foam roller therapy daily; corrective exercises to strengthen your feet, hips, and shoulders (click the links for exercises with descriptions); functional movement training, and transitioning to more of a barefoot/minimalist lifestyle. I also highly encourage you to find a highly qualified deep tissue fascial therapist with experience treating the specific injury you have and getting regular body work. Here are Five Steps to Choosing a Massage Professional.

Getting You Back To Speed
Be patient! For at least the first few months, I suggest limiting your total running time to no more than 2-3 days per week. With at least one day off between runs. For the first 12 weeks of getting back into running, I am a big fan of interval training. Running intervals builds recovery into your workout. This helps prevent fatigue and form collapse. Right now, running for 5-10 minutes straight is just too much. Your body is not conditioned for it. Within a minute or two, you will fatigue and your form will suffer.

Focus on form, not speed. Intervals are not about high intensity, unless you are specifically doing sprint intervals… which you should not be doing right now! Keep a nice quick cadence, around 180 steps per minute; and a quiet footfall.

Listen to your body
As I said in last week’s post,

“Pain is not good or bad. Pain is a vital piece of a complex communications system that tells you something is going on within your body. Pain is there for a reason, and it should be listened to, respected, and understood. Listening to, and participating in this conversation is incredibly important. If you listen to the ideas of “pushing through the pain” or “no pain, no gain,” you are  consciously disconnecting or ignoring the body’s natural warning signals.”

This period of time is ideal for reconnecting and listening to the communication of your body. Don’t push it. When something hurts, or doesn’t feel “right,” STOP! Your workout is over. Take a couple of days off.

 

An Example of a 12 Week Injury Recovery Running Program

All workouts begin with a dynamic warm up. A good dynamic warm up is the most important phase of any workout. It prepares the body for your workout by increasing heart rate, body temperature, and joint mobility; while significantly preventing injury.  The dynamic warm up should last between 10-20 minutes and will feel like a workout in and of itself. I highly recommend doing the majority of these workouts completely barefoot.

Here are some great examples of dynamic warmup exercises by my buddy Doug Balzarini of DBStrength.com out in San Diego, Ca.

Note:
It takes about eight weeks for your muscles to adapt to a new conditioning program. It takes years for your fascia to adapt. By incorporating self massage using a foam roller, deep tissue massage therapy, flexibility training, corrective exercises and functional movement into your training program, you can significantly speed up this process, while decreasing the amount of time dealing with chronic pain and injury.

Week 1
Day 1: Dynamic warm up: Run 1 minute: Walk 1 minute: Repeat 5 times.
Day 2: Dynamic warm up: 30-60 minutes functional exercise
Day 3: Dynamic warm up: Run 1 minute: Walk 1 minute: Repeat 5 times.
Day 4: Rest
Day 5: Dynamic warm up: Run 1 minute: Walk 1 minute: Repeat 6 times.
Day 6: Dynamic warm up: 30-60 minutes functional exercise
Day 7: Rest

Week 2
Day 1: Dynamic warm up:Run 90 seconds: Walk 1 minute: Repeat 4 times: 30 minutes functional exercise
Day 2: Dynamic warm up: 30-60 minute functional exercise
Day 3: Dynamic warm up: Run 90 seconds: Walk 1 minute: Repeat 5 times
Day 4: Rest
Day 5: Dynamic warm up: Run 90 seconds: Walk 1 minute: Repeat 5 times.
Day 6: Dynamic warm up: 30-60 minute functional exercise
Day 7: Rest

Week 3
Day 1: Dynamic warm up: Run 2 minutes: Walk 1 minute: Repeat 4 times: 30 minutes functional exercise
Day 2: Dynamic warm up: 30-60 minute functional exercise
Day 3: Dynamic warm up: Run 2 minutes: Walk 1 minute: Repeat 5 times
Day 4: Rest
Day 5: Dynamic warm up: Run 2 minutes: Walk 1 minute: Repeat 6 times.
Day 6: Dynamic warm up: 30-60 minute functional exercise
Day 7: Rest

Week 4
Day 1: Dynamic warm up: Run 2.5 minutes: Walk 1 minute: Repeat 4 times: 30 minutes functional exercise
Day 2: Dynamic warm up: 30-60 minute functional exercise
Day 3: Dynamic warm up: Run 2.5 minutes, Walk 1 minute: Repeat 5 times
Day 4: Rest
Day 5: Dynamic warm up: Run 2.5 minutes: Walk 1 minute: Repeat 6 times.
Day 6: Dynamic warm up: 30-60 minute functional exercise
Day 7: Rest

Week 5
Day 1: Dynamic warm up: Run 3 minutes: Walk 1 minute: Repeat 4 times: 30 minutes functional exercise
Day 2: Dynamic warm up: 30-60 minute functional exercise
Day 3: Dynamic warm up: Run 3 minutes: Walk 1 minute: Repeat 5 times
Day 4: Rest
Day 5: Dynamic warm up: Run 3 minutes: Walk 1 minute: Repeat 6 times.
Day 6: Dynamic warm up: 30-60 minute functional exercise
Day 7: Rest

Week 6
Day 1: Dynamic warm up: Run 3.5 minutes: Walk 1 minute: Repeat 5 times: 30 minutes functional exercise
Day 2: Dynamic warm up: 30-60 minute functional exercise
Day 3: Dynamic warm up: Run 3.5 minutes: Walk 1 minute: Repeat 6 times
Day 4: Rest
Day 5: Dynamic warm up: Run 3.5 minutes: Walk 1 minute: Repeat 7 times.
Day 6: Dynamic warm up: 30-60 minute functional exercise
Day 7: Rest

Week 7
Day 1: Dynamic warm up: Run 4 minutes: Walk 1 minute: Repeat 5 times: 30 minutes functional exercise
Day 2: Dynamic warm up: 30-60 minute functional exercise
Day 3: Dynamic warm up: Run 4 minutes: Walk 1 minute: Repeat 6 times
Day 4: Rest
Day 5: Dynamic warm up: Run 4 minutes: Walk 1 minute: Repeat 7 times.
Day 6: Dynamic warm up: 30-60 minute functional exercise
Day 7: Rest

Week 8
Day 1: Dynamic warm up: Run 4.5 minutes: Walk 1 minute: Repeat 5 times: 30 minutes functional exercise
Day 2: Dynamic warm up: 30-60 minute functional exercise
Day 3: Dynamic warm up: Run 4.5 minutes: Walk 1 minute: Repeat 6 times
Day 4: Rest
Day 5: Dynamic warm up: Run 4.5 minutes: Walk 1 minute: Repeat 7 times.
Day 6: Dynamic warm up: 30-60 minute functional exercise
Day 7: Rest

Week 9
Day 1: Dynamic warm up: Run 5 minutes: Walk 1 minute: Repeat 5 times: 30 minutes functional exercise
Day 2: Dynamic warm up: 30-60 minute functional exercise
Day 3: Dynamic warm up: Run 5 minutes: Walk 1 minute: Repeat 6 times
Day 4: Rest
Day 5: Dynamic warm up: Run 5 minutes: Walk 1 minute: Repeat 7 times.
Day 6: Dynamic warm up: 30-60 minute functional exercise
Day 7: Rest

Week 10
Day 1: Dynamic warm up: Run 5.5 minutes: Walk 1 minute: Repeat 5 times: 30 minutes functional exercise
Day 2: Dynamic warm up: 30-60 minute functional exercise
Day 3: Dynamic warm up: Run 5.5 minutes: Walk 1 minute: Repeat 6 times
Day 4: Rest
Day 5: Dynamic warm up: Run 5.5 minutes: Walk 1 minute: Repeat 7 times.
Day 6: Dynamic warm up: 30-60 minute functional exercise
Day 7: Rest

Week 11
Day 1: Dynamic warm up: Run 6 minutes: Walk 1 minute: Repeat 5 times: 30 minutes functional exercise
Day 2: Dynamic warm up: 30-60 minute functional exercise
Day 3: Dynamic warm up: Run 6 minutes: Walk 1 minute: Repeat 6 times
Day 4: Rest
Day 5: Dynamic warm up: Run 6 minutes: Walk 1 minute: Repeat 7 times.
Day 6: Dynamic warm up: 30-60 minute functional exercise
Day 7: Rest

Week 12
Day 1: Dynamic warm up: Run 6.5 minutes: Walk 1 minute: Repeat 5 times: 30 minutes functional exercise
Day 2: Dynamic warm up: 30-60 minute functional exercise
Day 3: Dynamic warm up: Run 6.5 minutes: Walk 1 minute: Repeat 6 times
Day 4: Rest
Day 5: Dynamic warm up: Run 6.5 minutes: Walk 1 minute: Repeat 7 times.
Day 6: Dynamic warm up: 30-60 minute functional exercise
Day 7: Rest

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