Planning Your Running Comeback After an Illness or Injury

** This is a post I pre-wrote before my surgery!  I am over the worst of the recovery, but still am not feeling great.  I'm following doctors order to rest so I can come back to work (my first priority!) as quickly as possible!!**

The comeback.  I think it’s something every “athlete” thinks about the entire time they are sick or injured.  Even if you are just a weekend crusader or a hobby runner like me, it can be hard to be forced to take a break from doing what you love.  I miss running.

I was on a training high, running faster than I ever had before and ready to crush my previous 10K PR when I got hit with health problems AGAIN.  I keep having to start over.  And I know coming back after surgery this time is only going to make this harder.

So I thought a little advice from an awesome local trainer could help us all out.  I’m sure we will all be in the position, at some point, for a comeback.

Meet Timothy Thew…

                  Hi Tim!

Timothy has been a personal trainer since 1996 focusing on rehab recovery, health and fitness maintenance and sports specific performance training for many years. He is certified by ACSM Health Fitness Specialist and also as a USA Triathlon Coach.

COOL!

Tim is the owner of Carolina Gold Fitness and works with clients at Lelia Patterson Center and at Fletcher Park.  You should seriously call him if you need a trainer!!

http://www.carolinagoldfitness.com/

        Super nice image huh?  Thanks Tim!

So basically he knows his stuff! Tim was kind enough answer some questions I had about my comeback and offer some advice to everyone on returning to running or fitness after an injury or illness.

Julie:  Coming back to running or fitness after an illness or injury can be tough.  What are some good things to keep in mind to help the process?

Tim: Before returning to activity, you should have pain-free full range of motion. The injured bone, muscle or joint should have full range of movement and flexibility with no discomfort.

The most important and most overlooked aspect of recovery training is realizing that you will not be able to perform at the level that you were prior to injury/illness.  Most clients/athletes will return to training with the mindset of full throttle training. The solution for this is to ease back into your training with the idea that (depending on how long you have been out of training) you will progress at a faster rate.

Also, if you have had surgery, it is important to keep that injury in mind as you program your training schedule. You should program for rehabilitation of the repaired area before re-engaging into full sport-specific training.

Best advice for the first weeks back after extended absence is to use common sense with your training and set reasonable rehabilitation goals. This will take the pressure off and reduce frustration which always keeps training fun and rewarding.

Finally, while some swelling, stiffness and discomfort is to be expected, I tell all of my rehab athletes that if they feel sharp pain with a significant movement or exercise they are to back off of the resistance/intensity, if this does not correct the issue then they will need to re-evaluate their injury.

Julie: How long does it take for you to lose significant fitness?

Tim: You will notice decreases in performance and muscular strength in about 5 days. I say about because everyone adapts and detrains at different rates.

At 2 weeks you will notice the following changes :

• VO2 Max (the volume of oxygen your body consumes and Uses at 100% work effort) decreases 5-7%

• Lactate threshold: decreases
• Blood Volume: decreases
• Flexibility: decreases
• Heart rate increases 5-10%
• Blood Pressure increases 5-10%
• Stroke volume decreases 6-12%
• Muscle glycogen stores decrease by 20-30%

… with another 5-10% decline in performance in the following week.

Julie: If you are coming back after an illness are there important things to remember to prevent injury?

Tim: The American College of Sports Medicine has established guidelines for return to activity or play:

• Pain-free full range of motion: the injured body part should have full movement and flexibility with little or no discomfort.
• Return of strength: the injured body part should be approximately equal (90-95 percent) to the opposite side before returning to full activity.
• Minimal pain or swelling: some mild discomfort, stiffness and/or swelling during or after exercise is to be expected during the initial return to activity. This responds well to ice therapy.
• Functional retraining: you should be able to perform the specific motions and actions required for your sport effectively before returning to activity. For example, retraining a lower-extremity injury in basketball should involve the ability to run, stop, change directions, and jump.
• Progressive return to activity: consider starting at 50 percent of normal activity and progress up as tolerated. An informal guideline you can use is to progress activity 10-15 percent increase per week if the previous level of activity does not result in increased symptoms during exercise or the day after exercise.
• Continue general conditioning with cross-training: using an alternative exercise allows maintenance of general cardiovascular fitness while not interfering with the healing of an injury. For example, ankle and knee injuries may do well with bicycling or swimming.
• Mental confidence in ability to do exercise: you must feel that you and your injury are ready to perform at the level required for your particular activity.

Julie: What are some good exercises to add to your routine to compliment your running while you are building miles?

Tim: Running is a straight-forward, one foot in front of another, linear, lower body, high impact sport. That being said we stress complimentary movements to maintain lateral balance, strength and injury prevention. My favorite compliment to running is swimming. While swimming is still linear in movement, it helps improve VO2 Max, builds upper body strength, and elongates the synergistic muscle groups used in running like hamstrings and quads. Swimming is also a great exercise to reduce the Delayed Onset Muscle Soreness (DOMS) related to increasing training volume.

We also use agility training to build the lateral and medial portions of the legs and gluteals which helps with stability during your run.

Core muscle training is also a huge compliment to running. The core of your hip flexors, abdominals, erector spinae and gluteals  are important for improving speed and efficiency, maintaining balance and preventing musculo-skeletal injury. I teach a core class which uses stability balls, medicine balls, bosu, slider disks, weights, body weight and more to maintain and improve back, abdominal and hip strength for my runners.

Julie: What's your best running tip?

Tim: Periodize and test often!

I always tell my athletes "A person who runs in the dark will soon be an injured runner." By this I mean anyone who runs without keeping track of progress and proper programming according to that progress has the highest potential for injury or burnout.

Periodizing uses a multi-level schedule to plan your year and tells you exactly when you should be pushing hard, when you should be resting, when to run a Long Slow Distance and when to do speed or tempo work based on your goal races.

A good periodized season will be broken down into pre-season, main season, post season, off season training. Each Season will be broken down into various phases typically 3-5 weeks long. Each week of a given phase will be broken down into individual training goals which helps us write the appropriate workout to meet that goal.

A certified coach or trainer will be able to program and track your progress while making appropriate adjustments as needed to prevent overuse injuries and to maximize performance gains.

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Thanks so much for this awesome information Tim!  I’m feeling a big comeback this time!

If you need a trainer or more help overcoming an injury CLICK HERE for Tim's website... Carolina Gold Fitness!

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Have you ever successfully come back from an injury or illness stronger?

Do you have any comeback tips?