So, you’re injured. Initially, you’ve probably followed the age-old RICE principle:
This principle still has its place in rehab, but it is not the “holy grail” it once was! Even Gabe Mirkin, who introduced the regime in 1978, has withdrawn his support of the it due its ability to delay healing! Therefore, the first common mistake most runners make post-injury is prolonging this phase beyond the first 2-3 days. After the initial inflammation and pain is under control, the RICE principle becomes far less helpful due its negative effects on healing!!
The next stages of rehab should involve the MEAT principle:
Movement (Regular & Gentle)
Exercises (Safe & Effective)
Analgesics (Not Anti-inflammatories!)
Treatment (Self or Professional)
This principle aims to restore normal MOBILITY, STRENGTH & FUNCTION in the shortest possible timeframe.
- MOBILITY: Before you begin running again, check that you have full range of movement (ROM) in the joints surrounding the affected area. Compare ROM to the unaffected side! There should be little or no swelling, or pain. Both will limit normal ROM. A daily regime of prescribed mobility exercises will help speed up the return to normal.
- STRENGTH: The injured area should feel strong & stable prior to a return to running. The MEAT principle above will help promote this gradual strengthening process. Before you hit the road again see if you can do the following pain free:
- Walk briskly for 30 minutes
- Balance on one leg for 30 seconds
- Perform 15-20 controlled single knee dips
- Do 20-30 single leg calf raises
- Perform a lunge matrix (forward, side, reverse, diagonals)
This is especially important with any type of fracture, ligament injury or after surgery. Again, compare to the unaffected side!!
- FUNCTION: So, you feel ready to hit the road again, how do you return from injury without once again ending up on the Physio’s couch? The injured tissues are healing and therefore cannot tolerate the normal amount of stress, strain & load. Therefore, you must modify the amount of load to reduce the risk of recurrence yet still stimulate the healing tissues. How you plan your return will depend on the nature and severity of your injury and the length of time you’ve been out for. It should be gradual and graded. The more severe the injury, the more gradual and graded it needs to be. Initially, a walk-run-walk-run regime is advisable.
If you’re just returning from a slight niggle or have had less than 2 weeks out with a minor injury you may not need to be so cautious with your return. That said, even in that situation, returning straight to pre-injury level is a common mistake that can cause more serious injury. Begin running at your comfortable pace initially and progress from there. These 4 tips will help:
- Work below your ‘break point’
- Allow a rest day between each run and after a rehab day.
- Change 1 thing at a time (speed, distance, surface or elevation)
- Progress gradually when ‘comfortable’ to do so
These three key indicators will help you decided when its safe to return to running, however, if you are still experiencing pain or symptoms despite normal mobility, strength and daily function, always seek professional advice. Our expert clinical team see loads & loads of running related injuries and will be able to get you back to your best in the shortest timeframe possible.
Contact us to discuss your specific injury in more detail.