Starting to run again when you have been ill or after an injury is in many ways more "dangerous" than when you start running for the first time.
Novice runners are usually quite careful and tend to follow strict training regimes. The more seasoned runner often risk reinjury through impatience and pushing their mileage too quickly.
I know all the theory and I advise my patients daily about the importance of slowly building up running strength and endurance. When it comes to my own training, I turn into a typical athlete and often get carried away with the running bit and neglect the strength aspect.
As runners we like to run. Period. I interact with lots of runners of varying abilities and ages per week and most of them (including me) do not really like doing much else. The reasons for this range from not having time (it’s so easy to just put your shoes on and run) to just really disliking strength training, cycling or swimming…the list goes on.
This time round, I have decided to chronicle my return to running programme. This will hopefully help me keep myself on track with my strength training, stop me from increasing my mileage by super-human chunks and serve as a guide for other runners to make a safe return to running.
Mistakes we make when we start running again
One of the biggest reasons why people get injured when they start running is that they don't give their joints, ligaments, bones and muscles enough time to adapt to the new load they are placing on them.
Your body is always looking out for you to make sure that you have the best chance of survival. One of the methods it employs is to not waste energy on things that it thinks you don't need. It will for instance only give you enough muscle to complete your daily tasks, since any more would not be used. In the same way as it will only thicken your joint cartilage and bones and tendons to the extent that they can cope with the loads you put through them.
How does the body know how much muscle you need? You tell your body to adapt through carefully loading or straining it. If you work a muscle a bit more than what it is used to, it causes micro-damage which signals to the brain that it is time to rebuild that muscle a bit stronger so that it can cope with the new load. The same goes for joints, ligaments and tendons.
With each step you give the ground reacts to the force you put on it by sending an equal force through your foot and up your leg. This force is then absorbed by the muscles, ligaments and joints in your body and acts as the stimulant to create stronger muscles, ligaments, joints and bones.
To prevent injury, you have to give the body enough rest and nutrition after your training session so that it can recover from the micro-injuries and rebuild the body stronger and also not increase your training load too quickly. You're heading for an injury if you train too frequently and do not allow your body to recover after a session.
As you get fitter, your body can tolerate much higher training loads and require much shorter rest periods to recover. This is the reason why some people can train 7 days a week while others only 3. It is really important that you choose your training regime according to your own level of fitness.
If you lack the basic muscle strength and control in your legs needed for running, you also risk straining other structures e.g. joints and ligaments. A strength training programme is therefore a must if you want to remain injury free.
In summary: To stay injury free strengthen your muscles, increase your mileage slowly and allow enough rest days.
My return to running plan
1. Join the gym and start a strength training programme
I'm more than capable of doing strength training at home, but the simple fact is that I have tried this in the past and always found something else to do instead. I have therefor joined the gym across the street from our clinic and am not allowed to catch the train home if I have not done my workout.
I am happy to report that this has happened and I am now "pumping iron" every Monday and Thursday.
I am going to keep the load low (15RM) and reps high for the first 6 weeks to give my muscles time to adapt to the new load and also suss out how my body copes with the way I have scheduled training. Do I need more rest days and fewer run days at the beginning? Only time will tell.
RM stands for repetition max and just means that I will be using a weight that just allows me to complete 15 repetitions before the muscle is exhausted.
After 6 weeks I will likely shift towards using a 10RM load. I will also start combining exercises e.g. the chest press and plank will be replaced by push-ups etc. You may be wondering why I have included upper body exercises in the programme since you run with your legs. I will spare you the long winded detailed answer at this point and just say that the whole body contributes to your running style and form. If you want to be a strong runner, you need a strong core and upper body.
My ultimate goals for the strength training (end of 2016):
Single leg press 1.5 times my bodyweight (which roughly translates to 105kg…gulp!)
Be able to do 1 pull-up with my full bodyweight (this has been a secret ambition for the last 36 years!)
Mondays and Thursdays (I have simplified my original programme so that it fits into an hour):
Leg press (single leg)
Assisted pull-up
Single leg bridge (foot on high bench)
Overhead press
Various abdominal exercise set
Seated Row
Single leg calf raises
Bench press
2. Do a slow run/walk programme until I am able to run 5km without walking
I don't care how many years of running you have under your belt - if you are coming back from injury or illness you will be well advised to do a few run/walk session to test your body's ability to cope with the load. This has worked well for me, especially since I was still battling with the tail end of my last cold. I never looked at my watch, but instead forced myself to walk as soon as I started feeling out of breath.
It took me about 3 weeks to achieve this goal. It may take you longer to reach this goal depending on your general fitness/condition. I had a fair baseline level of fitness since my bike is my main mode of transport in and about town and I had still completed the odd run 6 weeks earlier.
If you are a total beginner, you may want to consider the NHS’s couch to 5km programme. It is a well thought out programme and my patients do very well on it.
3. Do little bits often and apply the 10% rule
In the past I mostly ran on weekends only. This time round I want to get my body used to running more regularly and get my mileage up without tiring my legs out too much. I have opted to run 4 times a week, with a harder session followed by an easy or slow run.
With the 10% rule I just mean that I will try not to increase my weekly mileage by more than 10%. Research has shown that novice (and thus deconditioned) runners are more likely to sustain an injury if they increase their mileage by a large margin every week. Granted, this may be a bit on the conservative side, but my gym programme will also count towards the total load my legs have to cope with each week.
4. Run a fast 5km (that's around 24min for me) by July (done!) and then a fast 10km (50min) by September
Why this goal? Being able to do a fast 5km with good form, will mean that my legs are strong enough to cope with the training needed to complete a fast 10km and so forth.
And I am definitely not allowed to enter any race if I have not yet run the distance in training. I am renowned for entering long events, not managing to complete full training and then doing the race in any case…still chasing my original planned pace. This rule is very specific to me and my own personality.
One of my patients mentioned that he had used Bupa’s marathon training programme in the past. It turns out that they have some good training programmes for 5km and 10km as well. I have adapted their intermediate 5km plan which consists of a nice mix of strength and endurance sessions. You can follow my progress on Strava.
5. Have an easy week every third week
This will give my body time to recover as well as adapt to the new training load and hopefully stave off injury from overuse.
5km PB DONE!!!
3 July: 24:34 or 4:54/km
Update end June 2016:
15RM Single leg press: 84kg
15 RM Assisted pull-up: 49.5kg (translates to being able to lift 24kg)
Best 5km time: 25:13 or 5:03/km
Update end May 2016:
15RM Single leg press: 84kg
15 RM Assisted pull-up: 49.5kg (translates to being able to lift 24kg)
Best 5km time: 26:40 or 5:20/km
Update end April 2016:
15RM Single leg press: 81kg
15 RM Assisted pull-up: 54kg (translates to being able to lift 20kg)
Best 5km time: 28:16 or 5:40/km
Need more help with your injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan.
About the Author
Maryke Louw is a chartered physiotherapist with more than 15 years' experience and a Masters Degree in Sports Injury Management. You can read more about her here. Follow her on LinkedIn or ResearchGate
