Couch to Comeback – Returning to Exercise Post-Injury

At some point in your life as a runner, you are likely to find yourself fighting an injury. It might be a brand of injury that nags you and requires some extra stretching and strength training without actually disrupting your normal training. But you may also be dealing with an injury that requires that you run slower or less frequently while you recover. In the case of serious injury or illness, you may land right back where you started when you picked up that first Couch-to-5k training plan… on the couch!

Speaking from experience, the most frustrating part about returning to running post-injury (other than being confined to the afore-mentioned couch) is how what used to be your easy-run pace feels as difficult as race pace.

The worst thing you can do is to compare your current post-injury fitness to the fitness you had when you were able to PR at every race. These comparisons tend to encourage us to put unhealthy expectations on our post-injury workouts. For example “I’ve been running 10 miles easily every weekend for the past few years, so I should get back into my Saturday long-run routine now that I can run again.”

Such unrealistic expectations will tempt us to run further or faster than our bodies are ready for, and possibly set us a step or ten back in the recovery process.

If you are facing an injury that requires a significant amount of recovery time, including recovering from a surgery, a broken bone, or torn cartilage, and you had a race or several on the calendar, consult your physician, physical therapist, and possibly a running coach before you resume training for these events.

And if you have to skip some of these races, it is normal to be disappointed and downright angry about missing out. But it’s unwise to push yourself to compete just because you paid race entry or because your friends are all running in the event.

Contact the race director about deferring your entry to the following year. It’s very likely that the organizers of the race will understand if you explain your injury to them. And consider cheering for your friends from the finish line while you recover.

If your injury is such that you can walk and if it isn’t negatively affecting your work or social life, you may even be able to walk in the race. This approach works best for 5 and 10ks. Walking a half marathon or further would still require a certain level of fitness, so be smart about participating in those distances!

And don’t forget, there is a difference between “participating” in a race and “competing.” Enjoy this time as a participator and focus on getting healthy and strong again, rather than emphasizing competition that you may not be ready for!

No competing? Now what?!

Consider this your chance to give back to the running community by volunteering at races or coaching. If it’s too difficult to return to the running scene without participating in races yourself, opt to spend time with family and friends instead. You know, those people who have made time to be at the finish line cheering for you, and supported your pursuits even when you insisted on getting up at 4 am the first day of vacation to get a run in! 

Meditation, yoga, strength training, and physical therapy are all great options for staying in shape while recovering from an injury. When it comes to finding something to do in your free time, you can use this time to develop a new skill or cultivate a passion that has always been on the back-burner. Take music lessons, learn to paint, or take a cooking class!

And follow a Couch to Comeback training plan like the one below. It might look a lot like the Couch to 5k plan you used when you first got into running.

Fun fact: The original Couch to 5k training plan was started back in 1996 by Josh Clark. Clark created the plan to successfully get new runners with little to no running experience to the finish line of a 5k race. Still popular with beginners today, Clark’s plan included three workouts per week for 20 to 30 minutes.

For many of us, resorting to our old 5k training plan for beginners just seems unnecessary. Why would an experienced runner need a Couch to a 5k training plan? Physical Therapist Tyler Patrick of Therapydia explains that when you are forced to take time off from running to recover from an injury, you lose conditioning in your ligaments, muscles, and tendons. A Couch to 5k training plan provides your body ample time for this conditioning to occur.

The amount of time it takes to regain conditioning and build your mileage back up and run at the pace you are accustomed to will depend on how severe the injury or illness, and on how much time you had to take off from running to rehabilitate and recover.

More time on the couch simply means that you will have to practice patience and listen to your body as you return to running. Be aware of the weakness in the musculoskeletal system, which can lead to re-injury if you try to pick up where you left off in your training plan pre-injury.

The good news is that since you started from scratch and transformed yourself into an experienced runner once, you can do it again. So embrace running slower and running less mileage, and honor the rest days on your return to running training plan, knowing that your training won’t look like this forever!

And for those of us who just can’t bring ourselves to dust off the old Couch to 5k plan, below is a fresh take on the concept that takes into consideration the recovery process and the experienced runner. It includes strength and mobility component and emphasizes running for time rather than running for mileage, as the latter can lead to poor running habits if an athlete is not ready for the prescribed distance.

Couch to Comeback Training Plan

WEEK  1:

Monday

Warm-up by walking for 5 minutes. Alternate running for 1 minute and walking for 1 minute for a total of 10 minutes. Cool down by walking for 5 minutes.

Tuesday

Warm-up by walking for 5 minutes. Alternate running for 1 minute and walking for 1 minute for a total of 15 minutes. Cool down by walking for 5 minutes.

Wednesday

Strength and mobility training. See your physical therapist for injury-specific exercises, or work with a personal trainer to ensure that you are performing the exercises properly. Injury permitting, walking lunges, box jumps, and kettlebell deadlifts are all fantastic exercises for developing general strength in runners.

Thursday

Warm-up by walking for 5 minutes. Alternate running for 1 minute and walking for 1 minute for a total of 20 minutes. Cool down by walking for 5 minutes.

Friday

Warm-up by walking for 5 minutes. Alternate running for 1 minute and walking for 1 minute for a total of 25 minutes. Cool down by walking for 5 minutes.

Saturday

Warm-up by walking for 5 minutes. Alternate running for 1 minute and walking for 1 minute for a total of 30 minutes. Cool down by walking for 5 minutes.

Sunday

Rest or gentle yoga.

WEEK  2: 

Monday

Warm-up by walking for 5 minutes. Alternate running for 2 minutes and walking for 1 minute for a total of 20 minutes. Cool down by walking for 5 minutes.

Tuesday

Warm-up by walking for 5 minutes. Alternate running for 2 minutes and walking for 1 minute for a total of 30 minutes. Cool down by walking for 5 minutes.

Wednesday

Strength and mobility training. See your physical therapist for injury-specific exercises, or work with a personal trainer to ensure that you are performing the exercises properly.

Thursday

Warm-up by walking for 5 minutes. Alternate running for 3 minutes and walking for 1 minute for a total of 20 minutes. Cool down by walking for 5 minutes.

Friday

Warm-up by walking for 5 minutes. Alternate running for 3 minutes and walking for 1 minute for a total of 30 minutes. Cool down by walking for 5 minutes.

Saturday

Warm-up by walking for 5 minutes. Alternate running for 4 minutes and walking for 1 minute for a total of 20 minutes. Cool down by walking for 5 minutes.

Sunday

Rest or gentle yoga.

WEEK  3: 

Monday

Warm-up by walking for 5 minutes. Alternate running for 4 minutes and walking for 1 minute for a total of 30 minutes. Cool down by walking for 5 minutes.

Tuesday

Warm-up by walking for 5 minutes. Alternate running for 9 minutes and walking for 1 minute for a total of 20 minutes. Cool down by walking for 5 minutes.

Wednesday

Strength and mobility training. Injury permitting, walking lunges, box jumps, and kettlebell deadlifts are all fantastic exercises for developing general strength in runners.

Thursday

Warm-up by walking for 5 minutes. Alternate running for 9 minutes and walking for 1 minute for a total of 30 minutes. Cool down by walking for 5 minutes.

Friday

Warm-up by walking for 5 minutes. Alternate running for 14 minutes and walking for 1 minute for a total of 30 minutes. Cool down by walking for 5 minutes.

Saturday

Warm-up by walking for 5 minutes. Run easy for 30 minutes without stopping if possible! Cool down by walking for 5 minutes.

Sunday

Rest or gentle yoga.

For the first few weeks of the Couch to a Comeback training plan, try to run on a firm but irregular surface, such as a cross-country course. Avoid exceptionally hard surfaces and hilly courses if possible.

If symptoms related to your injury flare up, do not progress to the next workout! Go back one workout and repeat that day’s workout or take an additional rest day until symptoms calm down. If you are concerned about re-injury, consult a physical therapist.

The Couch to a Comeback training plan is ideal for anyone who has had to take 3 to 4 months off from running and is essentially starting from square one. If you only have to take off 1 week or less, you should be able to pick up your training where you left off (unless this causes you pain or aggravates the injury). If you are couch-bound for 30 days to 3 months, start running at 50 percent of what your previous mileage was before the injury or illness.

The good news is that you likely didn’t lose as much fitness as you feared, at least in terms of your cardiorespiratory fitness or maximal aerobic capacity (VO2max). Research suggests that if you are on the couch for 2 weeks, you only lose 5 to 7 percent of your VO2max. Even an injury that has you sidelined for 3 months will only cost you 25 to 30 percent of your VO2max.

When you return to running, be intentional about sticking to the training plan and letting it do its job of building up the endurance and muscle memory that you need.

Remember to be patient and have fun as you cultivate the strength and health you need to make it back to the start line!