Running Strong: A Comprehensive Guide to Injury Prevention and Recovery

June 21, 2023

Nick Hancock

As an ultrarunning and marathon coach and competitive runner myself, I know first-hand that running injuries are an inevitable part of the sport… cue my own ailment back in April of 2020 (anyone remember that bizarre time of our lives?!) where my Achilles tendon was almost at the point where I even put my Garmin watch on eBay because I thought I’d never be able run again! It was THAT bad and I was THAT down in the dumps about it!

However, with an element of calm, patience, working with the right people/professionals and doing all the right things, most of which are listed below, I came back strong… really strong! I have since continued to beat my own PB’s and finish in some respectable positions in some respectable races.

The journey to recovery can be just as challenging as the races themselves, but with the right approach, you can come back stronger than ever, and I can attest to this from my own experience!

In this blog, we will discuss how to safely return to running after injury, even while you are still in the recovery process. So, let us dive in!

The Importance of Injury Rehabilitation

Rehabilitation is the bridge between being injured and returning to running. Its main goal is to restore physical function and fitness level allowing the individual to return to a pre-injury state. The rehabilitation process is vital to prevent chronic pain, reduce the risk of re-injury, and help ensure a successful return to running.

women with an ankle injury while running

Work With a Professional: Why Expert Guidance Matters in Injury Rehabilitation

When recovering from an injury, working with a professional such as a physiotherapist, sports specific medical professional, or suitably qualified sports therapist can make a substantial difference in your recovery journey. Whilst this will inevitably come with a cost implication, it is worth it to get on the correct road to recovery and these professionals are specifically trained to guide you through your rehabilitation process, providing individualised advice and strategies based on your specific injury and overall fitness level.

Now this is where I get on my soapbox… DO NOT… I REPEAT, DO NOT ask for advice on Facebook! Everyone turns into a doctor on the running groups, and it drives me mad! Whilst it can almost help provide some level of mental comfort knowing that someone else has been through a similar injury, we are all different and our needs will be different. So just because someone else has suffered from [insert annoying niggle name here!], their path to freedom may be somewhat different to yours and it’s important to remember that what worked for them may not work for you and could, in fact, cause you more problems!

Work with a professional! Simple as that!

The Role of Professionals in Injury Rehabilitation

Good physical therapists will provide targeted exercises that help restore strength, flexibility, and mobility to the injured area. They can also offer hands-on treatment, such as massage or mobilisation, and educate you on proper form and injury prevention strategies.

Sports Medicine Doctors can diagnose and monitor your injury, suggest appropriate treatment options, and coordinate with other healthcare professionals to manage your care.

Qualified Coaches with experience in injury rehabilitation (its important that this is something they are qualified to do. Not all running coaches are qualified for this, so be wary of a running coach that tries advising on injury rehab without the proper qualifications) can adapt your training plan to accommodate your recovery, gradually reintegrating running and helping you return to your pre-injury performance level.

A study by Chan and Hing (2011) demonstrated the effectiveness of a multidisciplinary approach, including the involvement of professionals like physical therapists and sports medicine doctors, in managing running injuries. They concluded that a team approach, combining the expertise of various health professionals, resulted in better injury management and outcomes for the athlete.

The Benefits of Working with a Professional

Individualised Rehabilitation Plan:

Remember what I said about us all being different? A professional can create a personalised plan that addresses your specific injury, needs, and goals. This approach is more effective than a one-size-fits-all recovery plan.

Safe and Effective Recovery:

A guided rehabilitation plan ensures that your recovery process is safe, effective, and conducive to a successful return to running. You'll receive advice on how to progress your exercises and training appropriately, reducing the risk of re-injury.

Education and Support:

A professional can provide valuable knowledge about your injury, recovery process, and strategies for prevention. They can also offer emotional support and motivation, which can be crucial during the often-challenging recovery journey and is often a role I personally play as a personal running coach when helping an athlete return from injury

Remember, while online resources can be helpful (including this blog post on How do ultra marathon runners avoid injury), they should never replace professional advice. Always consult a professional if you're dealing with an injury.

athlete overcoming a running injury
Overcoming injury to complete 100 miles at Endure24

Address the Root Cause: A Crucial Step in Injury Rehabilitation

Understanding and addressing the root cause of your injury is key to preventing recurrence and achieving a successful and sustained return to running. This could involve minor modifications to your running form, strengthening weak muscles, correcting muscle imbalances, or even adjusting your footwear. Working with a professional, such as a physical therapist or coach, can be invaluable in identifying the underlying issues and developing an appropriate plan to correct them.

Addressing the Root Cause of Achilles Tendonitis – the most common running injury!

Achilles tendonitis, an inflammation of the Achilles tendon, is a common running injury often caused by overuse, inadequate footwear, tight calf muscles, or a sudden increase in training intensity or volume. The steps to address the root cause may include:

Assessing Running Form:

Improper running mechanics, such as over striding or excessive heel striking, can place additional strain on the Achilles tendon. A running coach or physical therapist with gait analysis facilities can help assess your form and suggest necessary corrections.

Improving Muscle Strength and Flexibility:

Weak calf muscles can contribute to Achilles tendonitis. Targeted strengthening, as advised by a physical therapist, can help address these muscle imbalances.

Adjusting Training Volume and Intensity:

A sudden increase in mileage or intensity can overwhelm the Achilles tendon, leading to inflammation. A coach can help devise a more gradual and manageable training progression to prevent overuse.

Evaluating Footwear:

This is an area I am always a little reticent to point the finger at being the problem… studies have shown that footwear is seldom the cause of any injury, so tread carefully here (pun intended!). Should you decide to see the likes of a podiatrist, ensure they area fan of running as I personally find many of them hate running and will often throw orthotics in as the solution to everything!

In a study by Alfredson, Pietilä, Jonsson, and Lorentzon(1998), a 12-week eccentric strengthening program for the calf muscles was found to be effective in reducing pain and improving function in runners with Achilles tendonitis. This underscores the importance of targeted exercises in addressing the root causes of specific injuries.

Remember, while it may be frustrating to modify your training or make changes to your running form, addressing the root cause of your injury is crucial for long-term recovery and prevention of future injuries.

Listen to Your Body: Patience and Progress

Focus on Cross-Training: A Key to Successful Recovery

Remember I mentioned my own issues back in 2020? Well, this is what was the game changer for me! Cross-training is a crucial part of a balanced training plan when recovering from injury. Incorporating low-impact activities, such as swimming, cycling, or rowing, can help maintain your cardiovascular fitness and muscle strength without placing undue stress on your healing body.

The Benefits of Cross-Training for Runners

Research has demonstrated numerous benefits of cross-training, both for injury prevention and rehabilitation:

Injury Prevention and Recovery:

Cross-training can help balance the body's muscle groups, reducing the risk of overuse injuries common in running (Fields, Sykes, Walker, & Jackson, 2010). For those already injured, engaging in alternate activities can allow you to maintain fitness levels while avoiding further damage to the injured area.

Performance Improvement:

A study by Millet, Jaouen,Borrani, and Candau (2002) found that incorporating cross-training, such as cycling, into a runner's training routine could improve running performance. It does this by enhancing the body's aerobic capacity without additional impact stress on the joints.

Implementing Cross-Training

Incorporating cross-training into your recovery plan involves careful consideration of the types of activities that will best support your recovery while maintaining your overall fitness:


Swimming is a full-body, low-impact exercise that works multiple muscle groups at once and can be especially beneficial for runners recovering from lower-body injuries.


This was my own personal choice for my own injury recovery! Cycling offers an excellent cardio workout and engages different muscles than running, providing a balance in muscle development. It's ideal for maintaining lower-body strength and leg turnover without the high impact of running.


Rowing, whether on water or a machine, is another great low-impact, full-body workout. It strengthens the upper body core, and lower body, creating a balance that can enhance running posture and efficiency.

Strength Training:

Incorporating runners strength training exercises into your routine can help address muscle imbalances and prevent future injuries. Start with bodyweight exercises before gradually adding weights as your strength and confidence improve.

In summary, cross-training can be a powerful tool for injury recovery. By providing a safe way to maintain and enhance overall fitness, it allows the body to heal without losing the hard-earned gains that come from consistent running training. As always, it's important to listen to your body and adjust your cross-training activities based on how your recovery is progressing.

The Benefits of yoga for injury prevention

When it comes to injury prevention for runners, the benefits of yoga for runners can't be overstated. Yoga offers a holistic approach that strengthens not only the body but also the mind, cultivating a resilient foundation that guards against potential injuries. Through regular yoga practice, runners gain increased flexibility, balanced muscle engagement, and improved body awareness – all essential components for maintaining proper form and minimising the risk of strains or sprains. Moreover, the mindfulness cultivated in yoga fosters a heightened sense of caution, prompting runners to listen to their bodies and address any warning signs before they escalate. So, if you're seeking a potent tool to bolster your injury prevention strategies, look no further than the harmonious blend of benefits that yoga brings to runners' well-being.

return from running injury
I personally came back from Achilles Tendonitis and now running stronger than ever!

Rest and Recovery: The Cornerstone of Successful Rehabilitation

In the pursuit of improved performance, it is easy to forget the importance of rest and recovery, especially for marathon and ultramarathon runners. Yet, these elements are crucial for the body to repair and adapt, becoming stronger and more resilient. This process is even more critical during injury rehabilitation when the body is working overtime to heal.

The Science of Rest and Recovery

Recent research underscores the importance of adequate rest and recovery in athletic performance and injury rehabilitation:


A meta-analysis by Bonnar, Bartel, Kakoschke,& Lang (2018) highlights the critical role of sleep in athletic performance. The study showed that sleep deprivation can negatively affect speed, accuracy, and reaction times in athletes. In contrast, optimal sleep can enhance performance, mood, and recovery. In the context of injury, excellent quality sleep provides the body with the optimal conditions for healing and repair.

Rest Days:

Regular rest days allow your body to recover from the physiological stress of intense training. Over time, rest and recovery periods lead to performance gains, as the body rebuilds stronger in response to the training stimulus. Rest days also give the body additional capacity to repair any damage, crucial when rehabilitating an injury.

Active Recovery:

Gentle movement on rest days, known as active recovery, can also aid in the recovery process. Activities like walking, light cycling, swimming, or yoga can stimulate blood flow to the muscles, aiding in nutrient delivery and waste product removal.

Making Rest and Recovery Work for You

Here are some ways you can implement effective rest and recovery strategies:

Prioritise Sleep:

Aim for 7-9 hours of sleep per night, creating an environment conducive to decent quality sleep and a routine that allows for enough time in bed. This article from Huberman Lab has some terrific tips on sleep improvement

Schedule Rest Days:

Ensure your training plan includes scheduled rest days. Use these days for light activity or complete rest, depending on your body's needs.

Listen to Your Body:

If you are feeling particularly fatigued, it might be a sign that you need additional rest. Tuning in to your body's signals and responding accordingly is an essential skill for every athlete, particularly during injury rehabilitation.

Rest and recovery are not merely a break from training; they are an integral part of the training and injury rehab process itself. So, make sure you are giving your body the time and conditions it needs to repair, adapt, and grow stronger.

The Mental Aspect of Returning to Running After Injury

Returning to running after an injury is not only a physical challenge but also a mental one. The psychological aspects of recovery can be just as significant as the physical ones. Your mindset can greatly impact your rehabilitation process, making it essential to focus on strategies for mental resilience alongside your physical recovery.

Set Realistic Expectations: The Path to a HealthyRecovery

After an injury, it's important to adjust your expectations and understand that you might not be able to run the same distances or at the same pace as before, at least initially – the good news, is that these things do come back fairly quickly, and if your injury layoff has only been a matter of a few weeks, fitness doesn’t subside as quick as you might think! Learning to be patient with yourself and celebrating small victories can significantly improve your mental wellbeing during recovery.

The Power of Goal Setting

Setting realistic, attainable goals can provide motivation and a sense of purpose during your recovery. A study by Weinberg, Butt, and Culp (2011) showed that goal setting can enhance athletic performance, boost motivation, and improve self-confidence.

When setting your recovery goals, ensure they are SMART: Specific, Measurable, Achievable, Relevant, and Time-bound. This approach will help you make steady progress, maintain focus, and achieve your over all objective of returning to running.

Stay Positive and Motivated: The Mindset for Success

Maintaining a positive mindset and staying motivated can be a game-changer during your recovery journey. Remember, setbacks are (although annoying) a part of the process, and each one brings you one step closer to your goal.

The Importance of Positivity

A study by Ievleva and Terry (2008) found that athletes whom maintained a positive attitude during injury rehabilitation showed greater motivation, better adherence to treatment, and a more successful return to sport.

Surrounding yourself with a supportive community – be it family, friends, teammates, or a running group – can also boost your spirits and motivation. Their encouragement can be invaluable during challenging times.

Do not Compare Yourself to Others: Your Recovery, YourJourney

Back to my above rant about Facebook groups!! Comparing your progress to others can lead to discouragement and impede your recovery. Remember, every runner's recovery journey is unique, and comparing yourself to others will not change your own path to recovery.

The Role of Self-compassion

Research by Mosewich, Kowalski, Sabiston, Sedgwick, and Tracy (2011) indicates that athletes who showed self-compassion during their recovery process experienced less negative emotion, greater psychological well-being, and were less likely to quit. Embrace your journey, show kindness to yourself, and remember that your determination and perseverance will pay off in the long run.

injury prevention runners

Gradual Return to Running

The first step in returning to running after an injury is to ease back into it. This does not mean you should jump right back into your previous mileage or intensity. Instead, consider the following approach:

·      Start with a walk/run routine: Begin by alternating between walking and running during your workouts. For example, you can start with a 5-minute walk followed by a 1-minute easy-effort run and repeat the cycle throughout your session. Gradually increase the running intervals while reducing the walking ones over time.

·      Monitor your pain levels: As you progress, pay close attention to any pain or discomfort you experience. If your pain increases or persists, take a step back and adjust your routine accordingly.

·      Focus on time, not distance: Rather than trying to hit a specific mileage right away, focus on gradually increasing the duration of your running sessions. This allows you to prioritise your body's response and recovery over external benchmarks.

·      Slowly increase intensity: Once you've built up a comfortable running base, you can start to incorporate more challenging workouts, like hill repeats or tempo runs. However, always make sure to increase the intensity gradually and listen to your body's feedback.

·      Track your progress: Keep a training journal or use a running app to log your workouts. This can help you monitor your progress, identify patterns in your recovery, and make informed adjustments to your training plan.

·      Expect setbacks: Understand that recovery is rarely linear, and you may experience setbacks or plateaus along the way. Stay patient and adapt your plan as needed, remembering that your long-term health is more important than immediate results.

Wrapping Up: A Roadmap to Return to Running After Injury

Returning to running after an injury can be a challenging journey, filled with physical and mental hurdles. But with the right approach, it's a journey that can ultimately make you a stronger and more resilient runner. Use it as a time not just to work on the injury itself, but also as opportunity to get stringer in your weaker areas!

Remember, patience is key (not usually a runners best trait!). While it can be tough to resist jumping straight back into your previous running routine, a gradual and thoughtful approach to recovery can significantly reduce the risk of re-injury. Start by seeking the help of professionals such as a sports medicine doctor or a physical therapist. These experts can guide your rehabilitation process and tailor a recovery plan to your specific needs.

Next, address the root cause of your injury to prevent future recurrence. If you're dealing with Achilles tendonitis, for example, it might involve making adjustments to your running form, doing targeted strength and flexibility exercises, or assessing your running volume and training programme architecture.

It's also essential to make rest and recovery a priority. Proper sleep, active recovery days, and listening to your body's signals a really critical components of a successful recovery process. And don't forget about nutrition: eating a balanced diet rich in anti-inflammatory foods can further aid your body's healing process.

Finally, pay attention to the mental side of your recovery. Set realistic expectations for your return to running, maintain a positive mindset, and avoid comparing your progress to others. Embrace your journey, and remember that every step forward, no matter how small, is a victory worth celebrating.

Your return to running after a running injury is a journey unique to you. So, keep these guidelines in mind, listen to your body, and you'll be lacing up your running shoes and hitting the trails and tarmac with confidence before you know it. Here's to a strong, healthy, and joyful return to the sport we all love!

Make sure not to miss out on our comprehensive article that shares effective strategies on how to prevent blisters when running


What is the most common injury in running?

The most common injury in running is 'runner's knee' or patellofemoral pain syndrome. It affects the knee joint and is often caused by overuse, improper biomechanics, or muscle imbalances.

What are runner legs?

Runner's legs" typically refer to legs with lean muscle mass, well-defined calves, and strong quadriceps and hamstrings, developed through regular running and cardiovascular exercise.

What is runner's foot?

"Runner's foot" can refer to various foot-related issues that runners may experience, such as plantar fasciitis, stress fractures, or toenail problems, often resulting from the repetitive impact and strain of running.

Do runners get a lot of injuries?

Runners can be susceptible to injuries due to the repetitive nature of the activity. Factors like training intensity, improper form, inadequate rest, and overuse can contribute to a higher risk of injuries among runners.


Author: Nick Hancock is a UESCA Certified Ultrarunning coach and UK Athletics Coach in Running Fitness (CiRF) and has coached many busy professionals and parents to achieve finishes, top-10s and podiums in events such as London Marathon, Manchester Marathon, Amsterdam Marathon, UTMB, UTS, Centurion events, Endure24, Backyards and many more. Host of the Maximum Mileage Running Podcast and author of the Ultimate Cookbook for Runners

He can be found on Instagram @runwithnick

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