Real World Running Rehab
The Endurance Corner Archives are being cleaned out.
Here is an article from a few years ago -- the article has helped a lot of people so I'm saving a copy here...
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PART ONE
After two running injuries last fall, I asked our team doc, Jeff Shilt, for a running rehab program. He shared his elite athlete rehab protocol, it was an excellent program:
Drills
Functional strength
Flexibility
PowerCranks
Gradual ramp of load and intensity
Considering the time commitment required for Jeff's program, I knew there was zero chance that I'd be able to execute it. Rather than fail, I searched for an alternative plan.
So I asked Jeff, “What is the minimum running load to derive a structural benefit?” He wasn't sure so I pulled 20 minutes out of the air.
Knowing that it takes me four to six weeks to injure myself I gave myself a target that would take at least three months.
My plan was to insert 20 minutes of slow running with excellent technique. I would handle my aerobic fitness via bike training. I would handle my strength training in the gym.
Over 12 weeks, I managed 50 easy sessions of 20 minutes. I ran mostly on a treadmill with a 1% grade and max speed of 10 minutes per mile. My rehab speed was more than three minutes per mile slower than what I can deliver in a 70.3 race. While I have always been willing to run slow to achieve my goals, my previous goals were closer to 100 mile weeks than quarters!
The 50x20 protocol seems to have worked and my next phase is five-mile runs every other day for 12 weeks. I continue to run slow but have increased my pace cap to eight minutes per mile. I'm off the treadmill and happy to be back outside.
Phase two will take me to June when I'll shift back to two-mile maintenance runs while I prepare for the Leadville Trail 100 bike.
As an aside, I'm applying the 20-minute target with my reintroduction of swimming. It is early days and a typical workout looks like:
500 easy with pull buoy
4x alternate 100 IM no gear with 75 Choice with pull buoy
I managed to keep my large muscle swim strength in the gym but suspect that my little muscles, particularly around my scapula, have atrophied.
Like most of us, my athletic memories and prejudices can cause me to injure myself. I feel lucky to have the opportunity to experiment with slow and steady rehab. I came very close to quitting running and am glad I kept trying to come back.
When more stops working, remember to try less.
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PART TWO
Let’s recap Part One.
Start by completing 50 runs of two miles -- took me three months
Shorter of five miles and an hour -- every other day for another three months
The above will progress you to 7x45 minutes per 14 days. This works out to about 2:40 per week and will give you a base of about 160 minutes per week that you’ll want to repeat for at least six weeks before adding my tips below.
Once you’re ready to add load, you’ll find that 8-16 minutes worth of threshold/VO2 (combined) per week gives you a performance benefit with very little biomechanical risk.
Adding duration doesn’t give you much -- keep every session under an hour. I’ve yet to run 10K.
Adding frequency via supplemental, easy, two-mile runs would make sense if you were a runner, rather than a triathlete. Aside from a couple of back-to-back run days (when traveling), additional running means I swim less. I need my swimming more than I need slow running.
So my recommendation is increase running load by adding intensity wisely. Here’s how:
Create some 5K and 5-mile route options. For my basic running, I prefer flat routes. For my weekly dose of intensity, I prefer hills.
Look for two types of climbs. The first is a climb that flattens at the top. The second is a climb that steepens at the top. Both climbs should be 6-12 minutes long; my preference is 8-10 minutes.
Alternate the climb that you use by week:
For the climb that flattens, build pace with the goal being 90 seconds Very Quick at the top.
For the climb that steepens, build effort with the goal being 90 seconds Very Intense at the top.
For both climbs, be patient, if you’re recovering from injury then you’ve proven that you can hurt yourself. You want to create a new habit of healthy running.
For both climbs and the descents focus on a quick cadence. Achieve speed via quickness -- you should feel like you are taking baby steps.
Follow each day that’s biomechanically challenging with a light day. I’ve been traveling weekly so my total volume (SBR and strength) is down. Therefore, my intense running is done on fresh legs.
A weekly dose of 10 minutes of fast uphill running will give you what you need.
Six months of smart rehab will contain five to eight of these sessions in the final two months. At that stage, you should be better off than you started and ready to incorporate intensive aerobic training (Mod-Hard) as well as extending the duration of your longest run.
Replace the habits that lead to breakdown.