I need some advice from the brain trust of slowtwitch.com. I realize in an ideal situation I would consult my physician, but I am not in a situation (crappy insurance, one income family) where that is an option. My main question is where do I start building back up my running as far as weekly mileage or time goes?
This past season I ran in the range of 30-40 miles per week from January to August. I finished a local half marathon in 1:19 which was a PB. My running after August became fairly spotty. In the middle of October, I began to start running again. I started with 20 miles and worked up to 30 miles where I ran for about 2 weeks in a row. This mileage came in 4 runs per week. This didn’t seem like crazy jumps in training to me. I was running on some shoes that were a bit on the old side and all my running takes place on asphalt. All pain indicators pointed to having a stress fracture in the lower third of my left tibia. It was a spot pain, and I had no pain in my right leg. I stopped running. I started swimming with a pull buoy and pushing off the wall with just my right leg, and all of my biking was done on the trainer at 50% of FTP. I have worn a walking boot for about half of the time since my last run. I have started walking on a treadmill this week. I have had no lingering soreness, but I do get little twinges of pain/burning sensations around the spot of my injury. I have searched the web for typical “build up” plans, but there were not a lot of offerings.
What advice do you have for how I should begin running again? I have a race (HIM) that I would like to compete in on May 18th. I’m not signing up for the race to finish, so I am wondering if I have enough time to get some confidence back in my running. Any experiences or advice is appreciated.
You can read some of my posts on how I recovered from lower extremity pain. I would read it but my main idea is barefoot drills and strides in the grass two times a week. Lots of recovery between drills keep things short and sweet A little bit will go a long ways and you can gradually return to running at the same time. I helped an athlete who had two stress fractures and 50lbs overweight return to running pain free and more durable then before the injury. After 18 months just ran 25:xx for 8k at the NAIA national champs. It was very gradual and he only worked his way up to 40 mile weeks this summer and fall. Your fitness will come back quick if you are strong and pain free.
Is 12 weeks pretty typical rest time for this type of injury? Most of what I have read recommends a 6-8 week recovery. I thought I was being conservative with waiting 8 weeks before starting jogging, but I questioning that thinking now.
During your third week back to running, what is your typical total weekly mileage? You said you have 5 miles for a max run, but how much other running is taking place?
Do you have any insurance? If so and it covers a visit to a Sports Medicine Dr ( you may have to find one who is part of a primary care group) who can scan you with diagnostic ultrasound over that area, they may be able to properly diagnose the issue. If it is indeed a tibial stress fracture, be careful about this. Time to focus on the swim and bike, do some pool running, slowly build up to doing some laps around grass fields and make sure you have come well-cushioned shoes.
When I had a stress fracture (2nd metatarsal shaft), the return to run program prescribed to me by a sports doc went like this (four walks/runs a week):
wk1: 1 mile 1 minute walk/1 minute jog x 4
wk2: 1.5 mile 1 minute walk/1 minute jog x 4
wk3: 1.5 mile run x 4
wk4: 2 mile run x 4
then increase mileage 2 miles week max; increase long run by 1 mile week for two weeks, then by 2 miles week max
and there were three rules:
mild pain (0-3/10) OK to continue running; if moderate pain (4-6/10) reduce activity until pain is mild
pain that decreases with activity is OK; pain that increases with activity is bad and time to stop or reduce activity
No limping! If pain alters gait, time to stop or reduce until normal biomechanics return.
I think I wasn’t cleared to run for 3 months after diagnosis. During that time I could swim, cycle and aqua-run.
My advice is to adjust your expectations for a May HIM (eg, complete instead of compete, aqua-bike instead, etc) or just pass on it. If you focus on competing, you may find yourself making decisions based on what you want to do to be competitive, rather than what you need to do to stay healthy for the long run.
PS 0 to 20 miles a week running is a big jump, which is how you say you started running again in October.