Returning to Running After Injury or Surgery

Returning to running after an injury or surgery is often frustrating to the runner, and also to their doctor! Most veteran runners start back too much, too soon and too fast. The opposite can also be true; newbie runners are often afraid to re-injure themselves so often are extremely cautious making themselves borderline paranoid in their return to sport. Which is better? Neither! Somewhere in between is the most prudent, and less frustrating way to return to activity; especially after surgery!

God’s basic rule of bone healing is that the average person takes at least 8 weeks to heal a fracture or a surgically cut bone. It is important to understand that it’s his rule, not mine - made up to torture my patients! It is also important to understand that age and extent of injury can make this 8 weeks longer! Yes, I said that bad word – age! Listen to your doctor and don’t try to run too soon, or you may cause yourself a set back laden with swelling and more pain!

So you’ve been cleared to return to running! Yea!!! But what does that really mean? Well, it depends. Great answer, I know J. The rate at which you can return to running is limited by your soft tissues ability to adapt to increasing stress. Gradual increase in running stress is paramount to this adaptation.

Here is a good basic plan to return to running after an injury or surgery:

Walk 5-7 minutes to warm up, run 5 minutes, walk one minute, run 5 minutes, and then walk 5-7 minutes to cool down. If you have no pain during this walking and running (Important tip! IF NO PAIN); then progress by one more interval each day. Day two would be walking 5-7 minutes, run 5 minutes, walk one minute, run 5 minutes, walk one minute, run 5 minutes, and finish with walk 5-7 minutes. You get the idea.

The next question is always, “When can I get rid of the walk breaks?” If you are under the age of 50 and a veteran runner, the walk breaks can be eliminated after you can walk:run with no pain for 45 minutes or so. In my opinion (and understand this is just my opinion), most newbie runners and those over the age of 50 should continue walk:run either forever (Yes, I love the Galloway method) or until they can comfortably walk:run for an hour.

Another good tip is also to start with a pace that is comfortable, even easy; then after you can walk:run for 45 min to an hour with no pain - then you can start increasing your pace. Long, slow distance is good for your adapting muscles, tendons and bones.

I know this seems very slow to many of my readers, but return from injury can be fraught with setbacks. This is a plan to continuously move forward in your fitness and avoid more time off! You will progress quickly through this algorithm if your body is healthy and sound - ready for the running challenge! Listen to your body and progress at your own pace!

Update on the Running 2,015 miles in 2015 Challenge: Art and I are still going strong! We reached 600 miles just before the end of April, and although we were slightly less than our target of 671; we are planning on doing quite a bit of racing this spring and summer, so I think we still can easily reach our goal! Next race is Ironman 70.3 Chattanooga next weekend! Full race report to follow!

Run Happy! Run Strong!

When is a Bunion not a Bunion?

When is a Bunion not a Bunion? When it's hallux limitis!


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Will I Be Able to Run After Bunion Surgery?

Running After Bunion Surgery?

Great question! I hear this question at least several times a month from my active, athletic patients. Of course, my first response is always, “Are you able to run now?” This is not sarcasm, but a true fact finding mission. If you are unable to run before your surgery, due to the pain in your bunions, then if you can run afterwards - I am a hero! The same goes for the opposite. If you are running pain free before surgery, and really only want your bunions fixed due to the fact you think your feet are ugly, if you can’t run afterwards - you really don’t like me very much!

Let’s talk about this a little more in depth. A bunion is the result of undue stress on the big toe joint, which causes a protuberance of bone or tissue around that joint. Bunions can be very painful, inhibit normal walking, and make it difficult to fit into some shoes. Contrary to popular belief, bunions are aggravated, not caused, by tight shoes. They usually are due to inherited faulty foot mechanics which put abnormal pressure on the front of the foot. Pain is the primary reason patients seek medical attention for bunions. A majority of bunion surgeries are performed on women because they wear tight-fitting, high-heeled shoes that worsen the underlying foot problem and cause abnormal stress to the joint.

There’s good news for anyone considering bunion surgery. A survey in 2003 by the American College of Foot and Ankle Surgeons (ACFAS) had surgery performed by a foot and ankle surgeon to correct bunions within the past 6 to 24 months found more than 90 percent of patients who had the procedure say they experienced significant pain relief, increased their physical activity, and would recommend it to others.

Many runners who can benefit from the surgery avoid it and continue to endure pain because they have heard that surgery doesn’t work and is excessively painful. Their biggest fear is that they may not be able to ever run again! The truth, as evidenced by the survey results, is that advanced surgical techniques have allowed us to effectively correct bunion deformities with excellent outcomes in terms of pain relief and improved quality of life.

Ninety-six percent of the survey respondents identified pain relief as a desired outcome of the surgery, and 86 percent also said they hoped to improve their walking and increase their physical activity following surgery. On a scale of 1 to 10 with 10 representing “much pain,” the survey respondents averaged a score of 7 when assessing their pain before surgery, and the average score dropped to 2 when they assessed their pain six months after the operation. Ninety-two percent said they were able to increase their physical activities -- walking, golf, tennis, exercise -- and 90 percent said they would recommend bunion surgery to others.

That being said, in most cases, we can treat the pain caused by bunions conservatively. In fact, we feel strongly that surgery should be a last resort. We surprise many bunion patients with our ability to help them avoid surgery when they have been told previously they have no choice but surgery. A custom foot orthotic to off weight the bunion in your shoes is often very helpful. Many patients run for years pain free in orthotics before they decide to have surgery. If you have tried all conservative treatment, however, and bunion pain is causing pain or limiting your activity, surgery as you can see, can be a very effective option.

If the pain in your bunions has caused you to decrease or eliminate running from your life, contact our office for alternatives. Do not let the pain in your bunions change your life!

Run Happy!