How to Start Running Safely After an Injury

The majority of runners experience at least one injury each year, with many falling into the category of overuse or repetitive strain injuries. Taking time off may seem like the right move, but it’s not always the best one.

Extended breaks from running can place added stress on your joints, potentially worsening an injury that hasn’t fully healed and prolonging your recovery. To reduce this risk, it’s important to be thoughtful about how and when you return to running.

How Much Pain Is Too Much?

Many minor running injuries improve with a week or two of rest. From there, it’s up to you to honestly assess your pain level and determine how quickly you should ease back into your running routine.

A few helpful guidelines include:

• Ask yourself whether you feel pain after a light job and how intense it is.
• If your pain rate is a 3 or higher, the injury may be more severe and should be evaluated by a doctor or physical therapist.
• If pain lasts longer than 24 hours after your light walk or jog, it’s best to pause running and seek medical guidance.

For reference, some of the most common running injuries include:

• Runner’s Knee: Aching pain around or under the kneecap.
• Shin Splints: Overuse-related pain along the shin bone.
• Achilles Tendonitis: Inflammation or strain of the Achilles tendon.
• Plantar Fasciitis: Heel pain caused by strain on the foot’s connective tissue.

If you’re pain-free after rest, you can begin testing your readiness by trying to:

• Hop in place for 20 seconds without pain
• Run in place at an increasing pace for 20 seconds
• Walk for one minute, then run for one minute – gradually progressing to five minutes each
• Complete a 20-minute run at a consistent pace on flat terrain

After each test, reassess how body feels. Ideally, discomfort stays below a “3” and resolves within 24 hours. To prevent unnecessary strain at this stage, skip back-to-back running days and allow at least one recovery day between sessions.

Gradually Increase Your Training

Once your body is responding well and recovery feels predictable, you can slowly build your mileage. For now:

• Keep runs under 10km and on flat, even surfaces
• Increase distance by no more than five minutes or 1km each week
• Limit yourself to one long run per week, keeping it about 10% longer than your other runs
• Add challenges, like hills or speed work, only after you’re consistently running 10km comfortably
• Avoid hard surfaces and downhill routes when possible
• Take extra rest if you feel drained rather than energized

A few additional tips to keep in mind:

• If hills are overwhelming, try 20 – 30 second intervals on a treadmill to gauge how your joints respond.
• Use this time to build better habits, like staying hydrated, choosing appropriate clothing and prioritizing recovery
• Mix in strength training, cycling or other low-impact activities to support cardiovascular fitness without overloading your joints

What If You’re Still In Pain?

If pain persists, recovery may need to move at a slower pace. Many runners benefit from starting with walks – often on a treadmill or other controlled surface – before progressing to outdoor terrain.

From there, you can gradually introduce variables like gentle hills or uneven surfaces. As symptoms improve, a combination of plyometric exercises and short jogging intervals may help rebuild strength.

During this phase:

• Understand Your Pain: Muscle soreness or stiffness that goes away within 24 hours is common.
• Watch for Warning Signs: Limping, altered stride, pain that starts immediately or pain that disrupts sleep may signal a more serious issue.
• Recognize Overtraining: Ongoing fatigue, elevated resting heart rate, poor sleep, excessive sweating or joint swelling often indicate the need for more recovery time.

Don’t Overlook Injury Prevention

As you return to running, stay mindful of factors that increase injury risk, including:

• Increasing mileage too soon – stick to the 10% rule
• Wearing worn-out or unsupportive running shoes
• Running exclusively on hard or uneven surfaces
• Relying only on running instead of cross-training or strength work
• Skipping warm-ups and cool-downs – set aside three to five minutes for each

Need help navigating your recovery? The team at Integrated Rehab is here to support runners at every stage. Contact us today to learn how physical therapy can help you get back into your routine safely.