Guidelines, Timelines, and Tips for Returning to Running Fitness After an Injury

Taking time off running sucks. If there’s any single thing runners can agree on, that’s got to be it. Partly, because enforced inactivity is boring. But also because, with each day away from training, it’s hard not to feel that your hard-won fitness is sliding away.

There is, of course, truth to that fear. Inactivity produces measurable changes in physiological variables related to performance, including blood plasma volume, VO2max, and mitochondrial enzymes.

There are times, however, when you simply must take a break from running, whether it be from an injury that won’t otherwise heal, overtraining, mental or emotional burnout, surgery, work or family conflicts, or a glorious vacation to a place where running isn’t really practical. Layoffs happen for all kinds of reasons, and there are times when it’s not only OK to rest, but when it is useful and even necessary.

A Rough Guideline for How Quickly Fitness Returns After a Running Injury

Unfortunately, there are no hard-and-fast rules for how to return to form after recovering from an injury. One person who has researched this extensively—to the extent of reading “180 papers or something like that”—is Mike Caldwell, coach of Asics Greenville Track Club-Elite. “And to be honest,” he says, “we haven’t found a protocol that’s actually proven.”

But years ago, I was taught a rule of thumb I still use as a starting point:

• If you have a really short layoff, you’ll probably feel a little sluggish the first day or two back, but then you’ll be fine.
• If you have a layoff on the order of a week to 10 days, you can probably come back in about the same number of days as you took off.
• If you take two weeks or longer off, it may take about twice as many days to fully bounce back—so about a month. Really long ones might take longer than that.
• If you have been able to cross-train during your layoff (or simply remained significantly active), you might be able to cut the recovery time by as much as half, even from a long layoff.

I was taught this rule so long ago I no longer know the source, but it has stood me in good stead both as a runner and a coach for many years. Caldwell also thinks it’s a good starting point. “It’s pretty general, but definitely within the guardrails that work,” he says.

A Word of Caution: How You Return to Training Can Impact Fitness Significantly

Remember that it is more than just your aerobic system that has detrained. “You’ve got to be careful,” says Thomas Schwartz, a kinesiology professor and cross-country coach at Dickinson State University, North Dakota, because your cardiovascular system will recover more quickly than your muscles, bones, tendons, and ligaments.

One way to deal with this is by including a substantial amount of cross-training in the early stages of the comeback. Schwartz suggests doing so even after a layoff of as little as a week.

“There are a lot of people that would probably be better off doing a 20-minute jog and 20 minutes of cross-training, instead of doing a 40-minute run,” he says. (The next day he would keep the total time constant but increase the amount of running slightly, continuing this until the entire time can comfortably be spent running.)

Schwartz has his own rule-of-thumb for gauging how to start your recovery. If you’ve only taken a week off, he says, start at 60% of normal. If you’ve been off for two weeks, start at 50%. If it’s been three weeks, start at 40%, and if it’s been four weeks, start at 30%. And phase it in over the course of that first week back. “I didn’t say you have to do 60% on day one,” he says.

That said, even 20 minutes of non-stop running can be too much. In these cases, a run/walk approach is probably better. That’s what Caldwell advocates, though he prefers to call it jog/walk because the term “run” can encourage people to go too fast. You want a pace that’s not uncomfortably slow, but not at the expense of running faster than your body is currently prepared to sustain.

Don’t worry too much about how to pattern these run/walks, Caldwell says. “Everybody’s got their own thing.” Some say jog a minute, walk a minute. Others say jog a minute, walk four minutes, though “we think if you’ve got to walk four minutes, you weren’t ready to come back yet,” Caldwell says.

Start with very little total running—Caldwell says that his group starts with only five minutes, even for elites, then if there are no problems after two or three days of that, step it up to 10 minutes, and continue progressing every few days, perhaps on a 72-hour cycle.

I myself have used almost exactly the same approach with people I train, though if it’s been a long layoff, I might have them start by run/walking every other day and cross-training on non-running days. I then move them to a two-days-on-one-day-off pattern, until eventually they are back on their normal weekly schedules. Whatever you do, don’t be dogmatic, and listen to your body.

Post-Injury Comeback Principles to Run and Recover By

There are a few broad principles for making your comeback as smooth as possible, and some reassurance that you’ll likely make it through to the other side of an injury far quicker and better than you likely believe while sitting on the sidelines.

1. You Will Almost Certainly Return to Full Fitness (Likely Sooner and Stronger Than You Fear)

Frustrating as they are, most injuries aren’t career-enders, and even long layoffs can be recovered from with time and patience.

Five-time Olympian Bernard Lagat (1500m and 5000m), for example, famously finished each season in mid-September with the Fifth Avenue Mile, then took five weeks off to do nothing but relax and spend time with his family. He returned to training in late October, and by the time the Wannamaker Mile rolled around in February, he was fit enough to win it eight times in 10 years.

Also reassuring is a landmark study called the 1966 Dallas Training and Bedrest Study. In an effort to test the effects of space flight on the human body, it put five healthy college students in hospital beds for 20 days, with only one brief respite for a shower. At the end of their enforced inactivity, the students were weak as kittens, but eight weeks later, training had restored them to their baseline levels of fitness. Not that they were elite athletes like Lagat, but it is still a remarkable comeback.

2. Try to View the Comeback as Fun

This takes some mental gymnastics, but if you can master them, it will make your return to fitness less frustrating and more exciting.

I once pulled my hamstring badly enough that for some time, I couldn’t run a single step. The first time I tried returning to running, I barely got 50 meters before I had to say “nope, not yet.” Next time, it was 100 meters. Then 200. I could have felt depressed at not being able to run even halfway around the track, but what I thought instead was that it was getting better.

Ask yourself “what can I do right now?” says Jeff Simons, a sports psychologist at California State University, East Bay. “[Thinking] moment-to-moment clears out fear/anger at disappointment, discomfort, and uncertainty. Then good can happen.”

Once you do return to training, your comeback often follows a sigmoidal curve. Initially, progress is slow. Then the constraints relax, and each day is better than the one before. It’s almost like setting a new PR every day. (This is the point where comebacks are fun.) Eventually, progress slows down again, as you close back in on peak fitness, but by then, you are most of the way back, and it’s just a matter of patience.

3. Consider Making Rowing Your Secret Weapon

As discussed above, cross-training can, and probably should, play a major role in your return to fitness. Swimming used to be the go-to, but cycling and elliptical trainers are increasingly popular.

In my experience, however, nothing beats a rowing machine. Rowing is a whole-body exercise that, once mastered, provides a substantially harder aerobic workout than other types of cross-training.

I once used it with a runner coming off a foot surgery that put her on crutches for six weeks. She did it twice a week for 6 weeks before she was allowed to start jogging (3.5 months after the surgery). Seven months later, she ran the best marathon she’d run in years.

“The rowing helped immensely,” she says. (One caveat: if you have never rowed before, get someone to teach you proper technique so you don’t hurt your back by doing it wrong.)

4. Realize That Not All Layoffs Are the Same

There are also layoffs that involve injuries not directly related to running. I once worked with someone coming back from abdominal surgery that had required six weeks off. Once she was cleared to run, she was able to train for the Boston Marathon, where, four months later, she ran a time quite comparable to her qualifying time.

Other injuries are more frustrating, because they have a nasty tendency to recur, or not fully heal. Particularly nasty are navicular stress fractures and sesamoid bone fractures, but thankfully, those are relatively uncommon. Among common injuries, plantar fasciitis can be very slow to heal, and while most ankle sprains heal fairly quickly (so long as you are careful not to re-sprain them), I’ve seen them take months (and in one case more than a year).

The real answer is that the most frustrating injury is the one you have now, and the best response is Simons’: stay in the moment and focus on doing what you can do now, not what you wish you could be doing.