The most common response to a running injury seems to be rest. Whether it’s a chance to let it settle, avoiding activities that hurt or just good old fashion denial, a brief period of rest gives the injury a chance to begin its recovery. But how long is too long to rest an injury? And what are the hidden negative effects of resting?
Let’s go step by step on the effects of rest and what changes, good and bad, occur over the course of the month.
What happens when you stop running for three days?
Muscle fatigue passes and any reactions to training, like DOMS, has passed.
Tendons and connective tissue around joints have improved their elasticity, giving you your bounce and efficiency. This is the spring in your step and the ability to effortlessly prance along during a run.
If you’ve sustained an injury, the body’s acute inflammatory process is finishing after 3 days. That means that the swelling has probably peaked and is beginning to be absorbed back into your system. The pain-producing chemicals that were released have left the area and your soreness is decreasing.
Bone stress injuries, including stress reactions and stress fractures, are virtually unchanged after three days, although the pain they cause will ease slightly due to the reduction in loading.
Overall your body’s had a chance to recover from fatigue and most acute reactions have passed. It’s a step in the right direction.
At this point, most runners will feel confident enough to give the injury another test. But the reactions are still present and behave in much the same way as your last session. So the thinking goes, “if three days off wasn’t enough, maybe I need to give it a week.”
What about after one week off?
The beneficial effects of having a few days off for recovery begin to reverse as the lack of loading starts to show.
Your strength starts to diminish as muscles quickly adapt to a less demanding environment.
Movement patterns (including running technique) start to get a little rusty and inefficient due to a lack of practice.
Your connective tissues, tendons and joint structures, begin to lose their bounce. You feel a little less spring in your step.
Acute inflammatory reactions have eased, so any soreness from ligament and muscle tears has reduced. They may still hurt to load but the constant aching at rest should have gone.
Symptoms from bone reactions, most common in shins and heels, have started to ease by this stage but the underlying bone reaction hasn’t changed much at all.
Overall your aches and pains have reduced. Unfortunately your capacity and tolerance to loading has also reduced. It’s the start of the negative effects of resting. And that’s not a good thing when you’re already carrying an injury…
A week after your last run, you give it another shot. “Surely the injury has passed by now…”. Unfortunately the result is the same or even worse. The initial signs were good, pain free for a little while. But then that familiar feeling returned.
Part desperation, part frustration, you decide to give it a full month. “That’s got to be long enough for any injury to recover!”
That’s it! I’m taking a month off…
One month later… It seems like an eternity since you’ve run. All your symptoms have gone away but you feel like you’re starting from scratch. After resting from training for a month, lots has changed.
Strength and fitness have significantly declined. After a month, you’ve lost around 3 months of training gains and you’re still declining.
Your movement patterns have lost their smoothness and efficiency so tasks require more effort for less output.
Your connective tissue has lost even more spring and elasticity, making movement feel flat and heavy.
With less strength, less bounce and less efficiency, it combines to make it much harder to complete any activity. That’s why your first run back feels like your running in cement shoes.
On a good note, pain-causing inflammation has eased off, although usually not fully resolved, but it doesn’t cause pain in your daily activities.
Bone reactions begin to resolve, requiring more force to aggravate them. They’re virtually pain free throughout your recent (non-running) daily activities.
The big upside is that at this stage, your symptoms have all but disappeared. Unfortunately you’re also less capable of generating and tolerating loads with a significant loss of strength, bounce and efficiency.
That means your risk of overloading the injury has increased and the return to running needs to be extra slow to avoid flare ups. Recovering the lost gains from a month of rest will usually take around three months. But you’ll need to take it slowly due to the reduced loading capacity, so that typically doubles to six months.
Suddenly the month off seems like a very short sighted “solution”, right?
If I don’t stop running, what’s the plan?
Now for the good news – there’s a better way! All the negative stuff can be avoided with a few simple tips.
Firstly, if you have a niggle or injury from running, your best initial response is to reduce or alter your loading. You don’t need to take it away entirely! Just begin to shorten your runs, add in a rest day or avoid hills and speed. You need to find the level that your body is currently able to handle, but that rarely means stopping completely.
Secondly, find a non-running option to fill in the gaps. If you’re dropping one run a week, add in another form of exercise that doesn’t bother the injury. It might be a bushwalk, bike ride, rower, whatever. It’s not just about getting the ticker going – it might be assisting recovery (like swimming), improving mobility (like yoga) or just a good outlet for your frustrations (like boxing). Remember that running is physical and mental so don’t do something you hate (deep water walking, anyone?).
Lastly, strength training. This can’t be emphasised enough. It helps to support the injury. It improves running technique and efficiency. It manages weight and body composition. It maintains bone density and connective tissue bounce. It can replace your missing running volume and means that you’re ready to ramp up as soon as that injury resolves.
Can Physio help? Will they just tell me to stop?
As Physios, we get involved to advise you on what types of running won’t aggravate your injury. We design strength programs to support the injury and maintain your running performance. We help you structure your program to rebuild load tolerance.
What we don’t do is tell you to stop, sit down and wait for the storm to pass. Because sitting down just makes the storm clouds grow bigger.
Pete has over 20 years experience as a Physiotherapist and specialises in running biomechanics and complex injuries. He believes that you must identify and fix the underlying cause of an injury, to recover faster, prevent recurrences and improve performance.