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Rehab Programme For Runners After Injury

Tips for preventing injury/re-injury

  • Many running injuries are caused by being too quick to increase the distance you run. Don’t increase your weekly running distance and time by more than 10% at a time.

  • Increase the intensity of the jog or run (how hard/fast) before you increase the duration (how long).

  • When you increase the frequency of the workouts (how many days you jog or run), decrease the duration.

  • Change your running shoes every 600 Km.

  • Be careful of running downhill too much and try to run on softer surfaces (like grass) rather than hard surfaces (like concrete or tarmac).

  • If you’re struggling to run more than two days a week because of the impact this has on your joints, you may find a cross-trainer helpful instead, to keep your fitness levels up.

  • Make sure you rest between workouts, and eat and drink properly to avoid tiring yourself out. Try to maintain a healthy body weight so that you’re not putting unnecessary strain on your joints.

  • Cool down properly. At the end of each run walk around for three to five minutes to allow your heart rate to decrease. This should be followed by stretching. Stretch your muscles until the point of tension, and then hold the stretch for 30 to 45 seconds. Do at least three stretches per muscle group.

  • If you have a particularly tight spot in your muscles, stretch frequently – not just after a run, but also after your initial warm-up or even at every mile.

return-to-running programme

When beginning a programme to return to running, you should adapt it to meet your needs, taking into consideration your original injury and your health.

You should progress through the programme one phase at a time.

Phase one: walking programme:

You should be able to walk pain-free and at a fast pace (roughly six to eight Km per hour), in a controlled environment (preferably on a treadmill) before moving on to the next phase.

Phase two:

A one-Km run typically consists of 1,500 foot contacts (750 per foot).

This phase involves exercises that have 470 foot contacts per leg (equivalent to two-thirds of the foot contacts during a Km run).

Stretch your calves, quads and hamstrings between the exercises. If you experience pain, or are unable to complete an exercise, stop, stretch and apply ice to the affected area. If you are pain-free the next day, try to restart the routine.

Rest for 90 seconds between sets, and three minutes between the exercises.

Exercises Sets Foot contacts per set Total foot contacts

Two-leg ankle hops: in place 3 30 90

Two-leg ankle hops: forward / 3 30 90


Two-leg ankle hops: side to side 3 30 90

One-leg ankle hops: in place 3 20 60

One-leg ankle hops: forward / 3 20 60


One-leg ankle hops: side to side 3 20 60

One-leg broad hop 4 5 20

Total 22 - 470

Once you’ve successfully completed this phase, you should be ready to attempt running 700-1000 m.

Phase three: walk / jog progression

You can begin this phase (making sure you only run on level ground) if you have successfully completed phases one and two and you have no pain with your normal daily activities.

The exercises

Stage Walk Jog Repeat for

Stage one 5 minutes 1 minute 30 minutes

Stage two 4 minutes 2 minutes 30 minutes

Stage three 3 minutes 3 minutes 30 minutes

Stage four 2 minutes 4 minutes 30 minutes

Stage five Jog every other day with a goal of reaching 30 minutes

Begin with five minutes of walking, gradually increasing the pace. End with five minutes of walking, gradually decreasing the pace to a comfortable walk.

Phase four: timed running schedule

You can begin this phase (making sure you only run on level ground) if you have successfully completed phases one, two and three and you have no pain with your normal daily activities.

Run every other day for eight weeks for the duration outlined in the table below.

Cross-train or rest on your days off.

Estimate a pace between eight to nine minutes per 1.5 Km.

Week Mon Tues Wed Thurs Fri Sat Sun

1 30 - 30 - 30 - 35

2 - 30 - 30 - 35 -

3 35 - 30 - 35 - 35

4 - 35 - 40 - 35 -

5 35 - 40 - 40 - 35

6 - 40 - 40 - 40 -

7 45 - 40 - 40 - 45

8 - 45 - 40 - 45 30

After eight weeks, you can start running multiple days in a row. Increase the duration or intensity of the run on the first day you run or jog after a day of rest; then decrease your activity on the following day.

9 - 45 35 - 45 40 -

10 45 45 - 45 45 30 -

11 45 45 35 - 45 45 40

12 - 45 45 45 - 45 45

What to do if you experience pain:

If you develop swelling in a joint or muscular pain that lasts longer than 72 hours, you have done too much and need to decrease your running activity and increase your rest between workouts.

Try to identify the exact location of your pain. Is it in the same place all the time, or does it ‘move around’ in a general area? If it’s in the same place all the time, be very cautious and try to rest more. If it moves around, continue your return-to-running programme, but do not increase the intensity of your running activity.

Try the following for these different types of pain and discomfort:

Tightness during running:

Stop and stretch the affected area well (at least three to five times for 30 seconds), then resume your activity. If the tightness returns, stop and stretch again. If pain develops or after three stretching sessions the tightness remains, stop and apply an ice pack to the affected area for 10-15 minutes.

Pain during running:

If the pain disappears after 10 minutes, continue with your run or jog. If it develops and then intensifies, stop running/jogging. If the pain persists, decrease your activity level to the previous phase.

Pain after running:

Stretch the affected area well (at least three to five times for 30 seconds), do a long gentle stretch and then apply an ice pack to the affected area. If the pain is just general muscle soreness, continue with your return-to-running programme. If joint pain and/or swelling develop, increase rest between exercise sessions and decrease your activity level to the previous phase.

Pain on waking:

If you wake up in pain, decrease your activity level to the previous phase, even if the pain disappears.

Pain at night:

If you’re experiencing pain at night and it’s keeping you awake, this means you are doing too much. Rest until the pain has gone and then restart your return-to-running programme at the previous phase.

If you experience pain for more than a few days, try to grade it; is the pain getting worse, staying the same or gradually disappearing? Use a pain scale of 0 to 10, in which 0 is normal and 10 is the worst.

If your pain is getting worse, rest and decrease your activity level to the previous phase.

If your pain is staying the same, decrease your activity level to the previous phase and stay at that phase until the pain lessens.

pain is OK if?

  • General muscle soreness.

  • Slight joint discomfort after a workout or the next day that is gone in 24 hours.

  • Slight stiffness at the beginning or a run or walk, that disappears after the first 10 minutes.

pain is not OK if?

  • Pain that is keeping you awake at night.

  • Pain that you experience at the beginning of the run/walk and that worsens as you continue.

  • Pain that changes your stride.

What to do?

  • Ice the affected area for at least 15-20 minutes, several times a day.

  • Don’t apply the ice directly to your skin – wrap a towel or something similar around the ice first.

  • Get plenty of rest and start on the programme at the phase that did not increase your pain.

  • Try to identify what caused your injury. Think about anything different you did in training; whether you rapidly increased your distance or pace, if your shoes need changing or have recently been changed, or if you’ve switched from running on a soft surface to a hard surface.

  • Plan a gradual and sensible return to training.

This programme is based on Steven Cole Programme College of William and Mary. UK

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