Injury Rehabilitation

This page was born out of the frustration of not being able to get sufficiently good running injury rehabilitation advice. I had a minor shin injury in 2001, but lost in excess of two months training/competition because of a stop-start return to running.

Rehab advice was far too vague. A highly motivated athlete, who is used to following a daily training schedule, needs a similar ‘rehabilitation schedule’ that they can follow on a daily basis.

(Shin) Injury Rehabilitation -a suggested programme that worked for me and my coaching clients.

Consult your health professional before copying this schedule

For an injury rehab programme I VERY STRONGLY recommend that a treadmill be used. This is where the treadmill really comes into its own. The precise control of speed and inclination is perfect for a controlled return to walking and running. Furthermore, if things go wrong you can stop and get off immediately without incurring further damage. This is vital when gradually building up training to the point of pain and NO FURTHER.

1) Shin soreness, even minor episodes, can linger on and be very difficult to clear unless a very aggressive rehabilitation program is followed. Assuming soreness is present.

2) TREATMENT: Stop running immediately for 5-7 days and maintain fitness with cross training: walking/marching on treadmill or grass; aqua jogging; turbo – all provided there is no pain during the activity. Continue with circuits twice a week.
Take Iboprufen 1600mg/day for 7 days. Use Theraband twice a day provided no pain. Use theTENS unit. Ankle stretch. Cross-frictions on alternate days x 2; Ice 20mins every two hours for first 48hrs or until inflammation has gone – then use Infra-Red lamp 15mins twice a day.

3) REHABILITATION: Firstly the mental attitude has to be right.

You must accept that a too hasty build up will result in another 7 –14 days off from running and a further delay in return to competition. Philosophise that it is better to be running less than you want, but able to keep doing it every day (during the rehab program) rather than starting with too much, resulting in a rapid injury breakdown and more time off.

When no pain is felt doing shin/ankle exercises and during palpation of the injured area, return to running with interval sessions on treadmill or soft ground – 5 mins run/5 mins walk.

You need to try and find the maximum before soreness returns. This will probably be 20-40 mins. The use of intervals is to gradually re-introduce the injured area to the bouncing/ballistic action that caused it in the first place.

4) Then increase by 5 mins every other day whilst training every day. This is a ‘stepping’increase as opposed to a gradual increase. There is one day’s consolidation after each increase.

Using this 5%-10% increase rule, significant increases in training time can be made over just 2 weeks e.g. 20mins -> 55mins & 45mins – 95mins.

Restrict speed at this stage to not more than 6kph (walking) and 11kph (running).

5) (Optional and only if you were already using XL) After 60mins has been reached, introduce XL (XL Extra Load = Weight Vest) on every third day continuing with 5/5 intervals.

6) After 70mins has been reached change to continuous running starting with 35mins and building up as before. A 5/5 interval routine can be continued using 5mins faster running/5mins slower running. Continue with XL sessions every third day.

7) Finally, when 60mins of continuous running has been reached (10 days after commencement of continuous running) slip back into normal training schedule with reduced intensity and duration. On the fast, long XL runs in particular, creep up the duration using the 5-10% rule each Sunday.

8) With a starting run/walk training time of about 40mins, one would be right back into full training, with very little loss of muscle strength or cardiovascular fitness, after about 3- 4wks of following this rehab programme.

9) Finally check training schedule and/or post-race recovery programme. The main consideration is to prevent a repeat of the injury.

10) Don’t confirm immediate plans for the next competition. Keep an open mind – enter races and book flights (but don’t pay for them). When you have successfully done a fast 2hr XL run, then decide your next race.