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 RUNNING RECOVERY Schedule

Norman Abnormal decided to start running more. He signed up for a marathon with just one week of training. After completion he put in four 100 miles weeks before his next race, which was a 100 miler. He rested a few days and kept running. Soon after, he decided to run across America, alone, pulling a cart with supplies so he did not need to to buy food along the way. 


If this type of craziness does not strike your attention other will. However, this is an era where we read about stories like this regularly. Perhaps not as exaggerated, but sooner or later runners will get injured and be forced to run less, slow down, or stop entirely to recover. 


Luckily, many experienced runners have learned to keep excessive tissue strain from running in check. They will minimize the chances of injury by remaining below their threshold of tolerance or break down point from accumulated stresses placed on muscles, bones, and tendons. A carefully designed running schedule involving mileage, duration, and/or speed will avoid overuse injuries.


Overtraining, though, is but one of many causes of injury and if you are forced to run less due to pain how do you determine optimal speed and time on your feet without doing further damage? Once healing takes place how do you find the right training volume, frequency, and intensity that keep ground reaction forces below threshold of weakened and painful tissue?

Example


Your particular injury may allow you to run at a certain speed and distance sub threshold of pain. In other words, by running with minimal impact (your easy smooth run) you may be able to continue your training and allow the site of pain to heal as long as it does not hurt. 


Here is how it works. You will start your first trial week with your first long trial run. Go out and run at no more than a 10 minute mile pace or 6 miles per hour. Run as far as you can pain free, so 0/10 pain at the site where you typically have pain.


Note your distance. Remember, if you feel pain during and after your run (even after 24 hours) you have gone too far. You will need to rest a few days and start again. 


Note how far you have gone that first trial run. Rest 2 or 3 days then run again ½ the distance as your first trial run. This is your second trial run. Again note the distance. It is only valid if you feel no pain during and for 24 hours after your second run. 


Those two distances will now be your basis for what you know you can safely run without pain. On your second week you will add a third run (with at least 1 day of rest between each run). This third run will be the same mileage as your second run. 


You will do this again for your third week. For example those first 3 weeks will look like this: 


Week 1: 

first trial run 5 miles, no pain

rest 2-3 days

second trial run 2 ½ miles, no pain


Week 2: 

first run 5 miles

second run 2 ½ miles

third run 2 ½ miles


Week 3: same as week 2


Week 4: same as week 2 or 10-25% less mileage if you feel you need to run less to recover from the past 3 weeks.

example: first run 4 miles, second run 2 miles, third run 2 miles


Remember each run is 10 minute mile pace. Each run should be completely pain free. If you start having pain repeat the process of test runs such as in week 5.


Week 5: second trial week. Go as far as you can. Maintain a 10 minute mile pace. Run pain free during and no pain afterward. Note your distance. Rest 2-3 days. Second run: ½ the distance as your first run. 


Week 6: Run the same distance as week 5 for each your runs. Add a third run later that week, again ½ your distance as your Week 5 first trial run. 


Week 7: three runs, same as week 6. 


Week 8: same as week 6 or 10-25% less each run if you need to recover from aches or slight pains. 


Week 9: new trial runs. Repeat the process. 


If you can do this for 2 months pain free. Then you will have a good chance to start your speed training again. 

To prevent injury always consider speed, distance, and sufficient rest days when increasing weekly mileage volume. 

                          Mileage Recovery SCHEDULE


Assess your pain by running 1/2 of your average weekly mileage 2-3 days apart. Keep dividing your mileage every 2-3 days for one week until you can run virtually pain free. 


Continue running for 2-3 weeks at the distances you determined on week one. Allow a recovery week if necessary prior to doing another test week of increased mileage. Keep you pace relatively slow to allow for longer runs, but stay below threshold of pain. 


Example: you determined you can run 5 miles, 4 miles, 3 miles in one week with < 1/10 pain. Run these distances for 2-3 weeks. Rest 1-2 days between your runs. Continue with your regular cross training schedule. Test run again after 2-3 weeks. Repeat for another 2-3 weeks at your new mileage. If pain is > 1/10 then go back to your prior running schedule. 

                      Time Recovery schedule


Do 2 or 3 pain free test runs on week one. Allow at least 1-2 days between each run. If pain during your run is greater than one on a scale of 1-10 then you have gone too far. Note the length of time you can run with minimal to no pain at the site of injury. By keeping your pace low focus on extending the time on your feet. 


Whether you do 3 test runs of, for example, 10 min, 20 min, 30 min on a given week or 3 min, 5 min, 7 minutes, each run should be below threshold of pain. Keep running for 2-3 weeks prior to doing other test runs at week three or four to determine your new level of tolerance. 

                     Speed Recovery SCHEDULE


Another calculator with a third variable for recovery is speed. This allows you to assess how fast you can run while recovering from injury. This schedule focuses on increasing your speed at a predetermined distance or duration to thereby assess your speed threshold.


For example, if you run 2 miles and have pain then reduce your speed just enough to be able to run free of pain. Rest for one to two days and run the same distance but at a faster speed. If the pain is > 1/10 slow down until you can complete the distance. Keep running for 2-3 weeks at the chosen speed. Reassess your running speed on week 4 at the same distance. Keep training at the new speed. 

Time, Mileage, and Speed Schedules 


Time, mileage, and speed based running schedules will help you get back on your feet. Some injuries may simply just take some minor tweaking to keep running. 


I once evaluated someone for hip pain who, following too many hill repeats, responded well to such a program. With no prior history of pain of this nature, and no past trauma we determined that speed reduction and stride correction enabled her to resume running. However, continuing her regular training schedule was too risky.


Instead, we determined that trial runs enabled her to run 3 x per week below threshold of pain. In addition, she avoided hills, changed her stride, and found the optimal distance for recovery. Ligamentous tissue in her hip could easily tolerate the distances she chose to run the first week. She continued to run these distances for 3 weeks before doing new trial runs at week five. This culminated in an event she ran pain free exactly six weeks after starting the program.


Another person, diagnosed with plantar fasciitis, had stopped running for months due to pain. Refusing a cortisone injection he focused instead on altering running mechanics. My advice was to start running immediately. Following the necessary changes in running mechanics his plantar fascia could now withstand the reduced pressures on impact. However, we had no idea how much running would still allow his plantar fascia to continue to heal. 


Running for time alleviated the pressure of having to complete a certain predetermined mileage. By following a time recovery schedule he could determine the duration of his first and second runs spaced 2-3 days apart and stay below his threshold of pain. His training could now start at the volume similar to what he found during his trial runs. After week three he scheduled a recovery week and then felt ready to increase the time on his feet. He once again did two trial runs. Within a few weeks of training he was up to three one hour runs after months of being side lined. 


Besides understanding the rationale of keeping running intensity below threshold of tissue tolerance. He had also learned to run without putting excess strain to his plantar fascia by having altered his running form. He could now dramatically increase his training volume the first 2-3 weeks because the impact at initial contact had lessened significantly and having altered foot strike he changed the line of stress to the thick band of ligaments running the length of his foot. 

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You will do this again for your third week. For example those first 3 weeks will look like this: 
Week 1: 
first trial run 5 miles, no pain
rest 2-3 days
second trial run 2 ½ miles, no pain
Week 2: 
first run 5 miles
second run 2 ½ miles
third run 2 ½ miles
Week 3: same as week 


Week 4: same as week 2 or 10-25% less mileage if you feel you need to run less to recover from the past 3 weeks.
example: first run 4 miles, second run 2 miles, third run 2 miles
Remember each run is 10 minute mile pace. Each run should be completely pain free. If you start having pain repeat the process of test runs such as in week 5.
Week 5: second trial week. Go as far as you can. Maintain a 10 minute mile pace. Run pain free during and no pain afterward. Note your distance. Rest 2-3 days. Second run: ½ the distance as your first run. 
Week 6: Run the same distance as week 5 for each your runs. Add a third run later that week, again ½ your distance as your Week 5 first trial run. 
Week 7: three runs, same as week 6. 
Week 8: same as week 6 or 10-25% less each run if you need to recover from aches or slight pains. 
Week 9: new trial runs. Repeat the process. 
If you can do this for 2 months pain free. Then you will have a good chance to start your speed training again. 

THE CONNECTIVE TISSUE CULPRIT


In his book "The Lore of Running", Tim Noakes M.D., mentions that intrinsic injuries never involve the joints. Extrinsic injuries are the result of an external force acting on the body such as in contact sports (soccer, martial arts, etc). These types of injuries do not apply to this discussion if the injury causes tissue damage such as a fracture, cartilage tear, or ligament and tendon rupture.


Intrinsic injuries, typically seen in runners, are mostly the result of the connective tissue surrounding the joint i.e. muscular, tendinous, and ligamentous tissue working beyond their capacity or tolerance. 


Pain goes away as soon as stresses diminish when you stop or run slower. Following a period of rest, Dr. Noakes states, "all running injuries will recur only when the athlete again reaches that weekly training distance equivalent to the breakdown point". 


While proper diagnosis and determination of the cause of injury by a health care professional specializing in running related injuries is a good idea, a running recovery schedule can get you back on your feet sooner and safer. 


Following a period of rest, to help heal damaged tissue, non-impact cross training and running-specific strengthening exercise are advised to offer a break from running as well. By raising the threshold of tolerance to the stresses placed on the tissues surrounding the joints training can once again resume. However, how do you know when it is safe to start running again?