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Returning from Injury

by Mark
(Little Rock, AR)

Due to an injury I have not run for seven weeks. What advice do you have for starting back?

I began running in July and was in fairly good shape when I started - 38 years old, active in flag football, coaching kids' soccer, etc.
However, I am definitely a beginning runner.

I started off slowly, and as I was enjoying it started keeping a log at the beginning of September.
By then I was doing about 10-12 miles a week.
I got sick in late September and took about 2 weeks off.
I started back in October and feeling good I kicked up my miles pretty quickly, going to 15 miles a week and a long run of 6 miles.
My knees hurt a little at that time, but not so much that I thought much of it.

I ran mostly on roads that (in hindsight) were sloped slightly and several hills. As I started increasing my miles my knees began to hurt more (on the outside) and tried to cut back to shorter distances, but still had the pain start as soon as a mile.

I self-diagnosed it as ITBS. I feel ready to get back out there.
What advice do you have for starting back? Distances? Build up? Etc.


Answer by Dominique:

Thanks for your question. It is an important question.

Your self-diagnosis sounds right. It was probably Iliotibial Band Syndrome.

When such an overuse injury occurs, you cannot just simply go back to where you finished seven weeks ago. And that is for two reasons :

  • You have lost stamina

  • Your body was stressed too much by your training at that point in time

  • To start with the last point: something needs to change.
    Maybe your mileage.
    Maybe the intensity of your training (speed and/or hills).
    Maybe your gear (e.g. start using running insoles or get new running shoes).

    It is important that you try to pinpoint the cause of your running injury so that you know how to prevent it in the future.

    Judging from the information you give me it most likely is a combination of a quick build up of mileage and the hilly terrain.

    Getting back to training you can best start up slowly and with a much lower mileage, e.g. 33% of your normal training load, for at least two weeks and slowly build up from there.
    Jack Daniels, in his fine running training book Daniels' Running Formula, gives a few rules of how to get back into training again and build up to your latest training load.
    However, for you, your "latest training load" might well be one of the causes of your injury, so I suggest that you take a look at my page on how to safely increase your mileage and, I might mention it a few times on that page as well... :)

    ... to listen to your own body.

    Build up slowly, take your time. Many beginning runners suffer from their own enthusiasm and take on too much, too soon. You have got plenty of time to run long distances, try not to get there within the first few months of your running career.

    Good luck, stay injury-free and enjoy your running!


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