Running Injury Recovery: Top 3 Things Every Runner Should Learn
Whether you run every day, on road or trails, following a structured training plan or just “winging” it and running to feel, injuries are part of the game. I didn’t believe this, and neither do most recreational runners. However, according to research published in 2021, almost half of us incur injuries throughout the year.
A large proportion of running injuries happen to the knees, legs and feet – understandably. And, interestingly, researchers found that those with a previous injury are were almost twice as likely to sustain a running-related injury compared to runners getting injured for the first time. This points to the fact that we runners need to learn how to better cope with injury when it occurs.
What are the most important things runners should learn when recovering from an injury? In addition to avoiding the common mistakes many make when going through rehab, recovering recreational runners need to embrace cross-training as a way to take pressure off the injured area, as well as accept a reduction in running volume.
In this article, I’m going to cover a mix of personal experience and scientific research looking at:
How to avoid "common" mistakes;
Accepting that it's ok to not run as much.
Avoiding the 3 biggest injury mistakes runners make
One of the glaringly obvious – yet often made – mistake when it comes to running injuries is that we tend to believe we’re not injured at all. Or, if you’re like me, you might just think that you’re not a “full-time” or “real” runner so you don’t need to focus on niggles and small pains here and there… that they will just go away. The truth is, an injury is most often caused by repetitive stress rather than by a sudden event like a trip, fall, or sprain. This is why it’s easy to keep going beyond a point at which you simply need to stop running altogether.
Running through pain
Running is one of the sports that has become notorious for overuse injuries. Often, this is because of the propensity of runners for ignoring niggles and carrying on running through pain up to a “point of no return.” There are two instances of this.
Firstly, when committing to a running training plan and working towards a goal race, many runners tend to focus solely on completing their sessions, come what may. Instead of listening to their bodies, stopping during a session if a persistent niggle occurs, or cancelling a day’s training to allow for better recovery, they carry on running through the initial minor inconvenience. Over time, a small niggle could carry on being noticeable during the day, or you could end up waking up with a stiff ankle that hurts when you walk, for example. Unfortunately, this happens all too often with both uninjured runners and those recovering from an injury who are keen to “get back into it.” By the time niggles are addressed, they’ve become a reason to actually forego the training plan altogether and even jeopardise that goal race the plan was put together for.
Secondly, runners could be persisting through pain with the misunderstanding that it might go away as they warm up, or thinking that they can handle a certain level of pain during running rehab. The former is minefield: injuries like Achilles tendinopathy or patellar tendinopathy (known as runner’s knee) do get better as you warm up, then they start feeling worse again a while later. When you keep “upsetting” your tendons repeatedly, the injury will get worse over time.
As for “handling” the pain, this is somewhat true: when you’re starting to run again after an injury, you can gradually return to being active while listening to your body and accepting a slight amount of discomfort as you increase your training load. However, there’s a fine line between knowing when to stop and going too far. More experienced runners could get away with this approach, but it’s not ideal for everybody.
Not finding out the cause of injury
If you’ve gone through the steps above and actually stopped running at the right time, went to see a doctor and a physio and have had your running injury diagnosed, that’s great! However, it’s often not enough.
Treating your injury is important, but another step of the recovery process needs to be understanding what caused it in the first place. Commonly, recreational runners get injured because of either a structural imbalance / bio-mechanical issue, or a rapid volume / pace increase.
The former is easy to address. If you have an overuse injury such as Achilles tendinopathy or shin splints and you can look back at your training log and see that you jumped from a 20-mile week to running 50+ miles, doing too many long back-to-back runs or running exclusively on the road for hours on end, you can begin to address this by making your recovery training plan gradual and varied. Including different terrain and ensuring that you’re progressing by around 10% in volume per week, with a recovery week every 2-3 weeks, is a relatively easy adjustment to avoid future re-injury and to get you back to form.
However, if you’ve been increasing your running volume gradually and are also following a strength and conditioning plan, stretching, cross-training, and “doing all the right things” and you’re still injured, you need to dig deeper before you consider yourself truly recovered. Your running form – the length of your stride, your hip positioning, how your upper body moves when you run – can be the culprit. This isn’t an easy assessment to make, nor is it a quick fix. It is important to discuss it with a physio and possibly a running coach, and will be an essential part of good running rehab.
Not carrying on with physio
During running injury recovery, most of us will have met a physiotherapist and followed some exercise plan designed to address muscular weaknesses or bio-mechanical issues with our running form. This is where the majority of runners then go wrong – once “healed”, the physio is all but forgotten. However, the underlying issues it was addressing have most likely not gone away at all.
Physios the world over will remind you that you need to continue your rehabilitation exercises and work on the weaknesses you identified in the first place. By doing these once a week at a minimum, you’ll maintain whatever recovery progress you’ve made already, build on it, and avoid the original problem cropping up again.
Additionally, the stretches and strength and conditioning work done during physio / running rehab will also help counter negative lifestyle impacts such as sitting for a long time at a work desk and tightening hips, hamstrings and quads. Fixing your posture for “everyday” will also have a beneficial effect on your running.
Why you need to embrace cross-training
Recovering runners risk getting re-injured if they start running again at the same volume and intensity they were used to previously. It’s not just a question of gradually ramping up again. It can also mean embracing cross-training so that you can take the pressure off injured joints or build cardiovascular capacity without risking falling back into old movement patterns.
During injury recovery from conditions such as runner’s knee, do some of your training volume on the bike instead. You’ll still be outside moving and enjoying the benefits of outdoors exercise, while building your leg strength and your cardio. However, the reduced impact on knees and hips means you can be out for longer without the same risk of injury as from running.
Similarly, try aqua jogging for an underwater strength and cardio workout. It’s a good opportunity to focus on running form while moving without stressing any of your leg joints. Additionally, the resistance of the water will make you feel that you’re working hard, which is always a bonus! You can always add a swimming session onto your weekly plan as well, to increase cardio workouts.
Finally, strength and conditioning sessions are not negotiable. This links in with continuing your physio exercises, but it can also extend to doing a yoga or Pilates class to focus on posture and stability, and – of course – to strength workouts in the gym, targeting major muscle groups with squats, lunges, deadlifts and core strength routines. All of these will improve your strength, running form and endurance, making you a stronger and healthier runner.
Accept that it’s ok to not run as much
The final big lesson from running recovery is that running volume – whether you count the time or the miles you’ve clocked – isn’t everything. It’s easy to think that, if you’re training for an ultra-marathon, you need to run consistent 100-mile weeks. Or, if you’re just running for the fun of it, going out every day can be very attractive once you’re injury free.
However, a key part of running injury recovery is also a mental unlock: it’s ok to not run as much as you did before. This is a tough one to accept, but quality over quantity is so important when it comes to preparing for big races or simply when running for fun and fitness. Running pros like Clare Gallagher, who won the UTMB CCC 100-km race after having to drop out of Western States at mile 93 (with only 7 miles to the finish!), are a living proof that you don’t have to run as much to do well. You can read her story here to understand the mental switch.
After all, running less isn’t just that. It means cross-training and prioritising quality sessions that focus on speed and race specifics (you might need to do fewer miles, but hillier, if you’re aiming for a mountain marathon, for example). At the end of the day, you’ll still be active, but with a different purpose and, hopefully, a better end result.
Never having been injured before, the simple idea that I had a running injury and that it needed to be treated and addressed as something serious was hard to accept for me at the end of 2021. However, this also prompted me to do some research into why we fail at recovering properly – and how we can avoid this.
It all boils down to staying clear of some “classic” errors, while accepting that cross-training and a reduction in running volume are key tools for recovery. And, hopefully, including these lessons into all training planning going forward can keep us all (re)injury free for a long time!