calf strain overuse injury in runners

Prolonged rest can make running overuse injuries worse

By Mark Green on 06 Mar 2021

HOW SOON SHOULD YOU START RUNNING AFTER AN INJURY? I have seen quite a few runners in our physio clinic recently who have been told by their health care professional that they will need months off running to recover from their injury. I have also had many emails from injured and frustrated runners who have either been advised to rest, or have already been avoiding running for several months.

The injuries vary from shin splints, plantar fasciitis, stress fractures, achilles tendonitis, chronic glute and hip pain . . . any of the typical runner’s overuse injuries.

I have written on this topic previously, and it is a tricky subject. People need the reassurance and confidence that returning to running is often the correct thing to do. Especially if they have been advised not to by their doctor. They also need guidance to make sure they do the right amount of running at the right time.

I will try to summarise this briefly to help try and explain why sometimes complete rest isn’t always the right thing to do.

Overuse injuries are almost always “gradual onset” injuries. They start off as a niggle, and gradually get worse because you ignore them and hope they will go away!

Acute injuries are injuries like ankle sprains or muscle tears where there is an actual “trauma” that occurs which causes the injury. Acute injuries do need to be rested for a certain period of time.

Overuse injuries often get to the point (usually because you ignored them) where they also need rest. I’m not suggesting that you should try to “run through” every overuse injury, but I am saying that as soon as you can function to a level where you have minimal pain with all your normal daily activities, then you should be able to make a gradual return to running.

Overuse injuries usually involve some sort of tissue degeneration, where a muscle or tendon has lost strength due to the repetitive trauma. Part of the repair process for these structures is to make them strong again.

The typical health care professional approach is to stop you running while you focus on specific strengthening exercises.

My approach is to choose exercises (stretching, rolling, strengthening and stabilising) which make running more comfortable, so that running can then become your strength training.

If you start with the correct “dosage” of running, and you are doing the correct exercises to help your body recover, then you can almost always gradually start ramping up the running again.

Building volume too quickly after an overuse is the biggest mistake that runners make. The most common advice I have heard is that you should “run until it starts hurting, then stop and walk back home”. Unfortunately, if you run to the point where your pain returns, it is already too late. You will have stirred up your injury enough to need another window of rest to let the acute symptoms settle down again.

This guide on how to return to running after injury summarises how to rank your pain level from 1 – 10, and how to use that number to guide your return to running.

If you have an overuse injury that is stopping you from running, and you have been told you need weeks or months of rest, then I suggest that there might be another way.

The Locker Room 10 Week Return to Running Program has been designed specifically to help you.

It starts off with a very low volume of running and builds gradually. It also includes running technique advice, stretches, foam rolling and strength and stability exercises to improve your flexibility, mobility and strength.

I have been using this approach for over 20 years treating runners and I know it can help runners return to running safely.

If you are one of the many frustrated runners I see battling with an injury, or you have a running friend who is struggling, then the Locker Room 10 Week Return to Running Program may help guide you toward a better approach if you have an overuse running injury.

If you are struggling with a niggle or injury, we highly recommend you seek professional help. Getting the right advice and diagnosis can help you recover properly for your specific injury.

The team of physiotherapists at the Body Mechanic are all athletes that understand the demands and desires of people keen to return to their favourite sports. Book an appointment today with one of our physios. We have a clinic in North Sydney and Wentworth Falls, in The Blue Mountains.

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Mark Green

Mark Green

Mark is a highly qualified physiotherapist and an accomplished athlete having competed at the top level in trail running for a number of years. He's the founder of The Locker Room, an outstanding resource to help runners perform at their best.

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