Return to Running Timeline
Running injuries are frustrating, especially when we consider the timeline back to pain-free running, and unrestricted running can vary widely between individuals due to many factors. Looking at these timelines, I want to discuss some reasonings and concerns I see in clinical practice with these common running injuries and whether they are reasonable so you can better understand if you, unfortunately, find yourself dealing with one.
Before we dive into each condition listed, it is worth noting that all studies have limitations. The Run Clever Trial outlined here does not mention what each runner did for their condition, how long or if they took any rest time, and if the diagnosis was accurate. That being said, this study did cover a decent sample size, leading us to understand that if the appropriate actions are taken and a diagnosis is correct, these timelines should be reasonable. But… there is always a but…everyone is different. Your results and timeline will always differ from those of your running mates because you are different people with unique physiology.
Plantar Fasciitis:
This timeline seems very short for those who have had to work through an actual plantar fasciitis issue. From a clinical perspective, I disagree with this timeline the most.
Plantar fasciitis is often misdiagnosed as a lazy way to address any ‘foot pain.’ I have found that a more accurate diagnosis in most runners is posterior tibial tendinopathy or a neuropathy issue. Because of this, it is necessary to address not only the foot but the whole lower leg in your rehab efforts.
It is vital to get an accurate diagnosis so that you don’t spend months working on the wrong problem. In the meantime, supportive shoes, frequent attention to the foot and lower leg, and a reduction in training volume can help.
Runner’s Knee - Patellofemoral Pain Syndrome & IT Band Syndrome
I’ve lumped Runner’s Knee and Iliotibial Band Syndrome together as they are both knee pain issues that result from running too much too soon and have a hip weakness and capacity issue component to their onset and recovery.
The listed timeline (49-56 days) is consistent with what I see in the clinic, assuming the runner is doing all the necessary things to recover and build the capacity needed to handle the stress of running.
As you begin your rehab journey with Runner’s Knee and IT Band Syndrome, a decrease in running volume and intensity is necessary, as is avoiding downhill running for a period of time. Research supports starting your return-to-running process on a treadmill set to an 8-10% incline and slowing reducing over the first full weeks, assuming a lower incline and eventual flat ground are pain-free.
Rehabilitation to return to pain-free running with Runner’s Knee and Iliotibial Band Syndrome should focus on building hip strength, warming up appropriately before each run, and maintaining daily mobility habits in all areas involved.
Achilles Tendinopathy:
Based on what I read in the research and see in the clinic, this timeline feels the most right. What is interesting about all these injuries, especially Achilles Tendinopathy, is that we can often maintain some running. This is important for Achilles injuries as tendons require load (walking, running, strength, plyometrics) to heal. Remember that when you consider complete rest for a common running overuse injury.
Tendons like heavy, slow loading at first. I like to start with seated calf raises and progress as the tendon responds, emphasizing heavy, then progression.
Heavy lower leg work > Basic Plyometrics > Slow Return to Running > Progress Strength > Progress Plyometrics > Progress Running.
Shin Splints - Medial Tibial Stress Syndrome:
I will be completely honest: this seems WAY too long of a timeline at first glance. However, as I’ve gained insight into this condition and its progression to more complicated bone stress injuries, this timeline is spot on. First, it is essential to understand that inside-the-shin pain in a new runner and true medial tibial stress syndrome are not as alike as one would assume. Both often result from a training error, but the latter occurs from ignoring the initial signs and symptoms of shin pain, pushing through your training, and ending up with the beginning of a bone stress injury. Left unaddressed, this becomes a bone stress reaction (forced time off) and, if still ignored, a stress fracture (a long time off!).
Preventive measures are necessary as we start on our running journey or look to increase to a new distance. Your habits around warming up, mobility, strength, and rest are as important as your actual running.
Don’t ignore this common pain as ‘common.’ This is how your body communicates with you, letting you know that your current workload is too much and that your body is breaking down faster than it can rebuild. An emphasis on slower progression in workout duration and intensity, as well as easy days and recovery efforts, is necessary.
Running injuries are common. Statistics tell us that we have a 40-80% chance of having one each year—a setback that disrupts normal training for 2+ weeks. However, most of these problems are preventable if we are reasonable about our ability and training progression.
However, even with the most perfect training plan, injuries still occur. Learn from them, alter your program, and press forward.
If you need help with any of these running injuries, we have created rehab guides to help you form positive habits that support your running so you can not only recover from these injuries but also prevent them in the future. You can find them by clicking here.