How Injured Runners Can Continue Their Cardio Training

Maj. Lee Warlick, 628th Medical Operations Squadron Physical Therapy flight commander, observes an airman walk on a treadmill during a Gait Analysis Clinic appointment at Joint Base Charleston-Air Base, S.C.
Maj. Lee Warlick, 628th Medical Operations Squadron Physical Therapy flight commander, observes an airman walk on a treadmill during a Gait Analysis Clinic appointment at Joint Base Charleston-Air Base, S.C., Jan. 8, 2013. During a session with the Gait Analysis Clinic, a physical therapist will observe a patient walk on a treadmill with running shoes and barefoot. (Staff Sgt. Anthony Hyatt/U.S. Air Force photo)

More than 50% of all runners get injured every year. Chances are, your plan was not personalized for your current abilities, and you ran too many miles, too quickly. These types of injuries occur when you randomly double or triple your running miles per week.

When running, logical progressions are universally suggested at a 10%-15% mileage increase each week -- as long as you have no pain. Typical overuse injuries include shin splints, foot pain, knee tendinitis (patella; ITB, or iliotibial band syndrome; runner's knee), and stress fractures in the most serious cases. Here is an email question about getting back to running after some time off.

Stew. I am doing one month of strength, rehab work and HIIT (high-intensity interval training) to recover from bad iliotibial band syndrome. When I finish, should I repeat the last block from my training program where I left off? Thanks, Tristan

It was smart to take some time off running, but you can still do cardio base training with nonimpact cardio, like biking, using the elliptical machine and swimming, if you experience no pain doing those activities. I would recommend finding a cardio alternative if possible, depending on the severity of the injury. After taking time off from running, I never recommend jumping back in where you left off, especially if you have not run in a month or longer.

There are many approaches to this question. Many jump back in where they left off and typically reinjure themselves. Another option is to adjust your training week while injured by cutting all running miles by 50% for the next 2-4 weeks. Also, continue rehab exercises as a habitual cooldown for the rest of your training day, as the doctor orders. If there is no pain during or after running, then start your logical progression of 10%-15% each week until you are back at your original mileage during the injury. This may take 4-6 weeks in some cases, depending on the total miles you were on when you got injured.

An even more conservative approach is to treat yourself like a beginner. Consider running every other day for a total of 3-5 miles a week. Continue with a weekly progression of 10%-15% for the next month, then go back to your training cycle where you left off but consider cutting the mileage back to be a more logical progression with your four-week, post-injury running miles. If you have the time to do this, you should. It is likely because you did not do this at the start of your running program that you are back to being a "beginning runner" again.

Another approach to consider is the 50-50 approach. If you cut your miles by 50%, replace those missed miles with another form of cardio less impactful than running. One of my favorite conversions is to replace any missing miles on a running plan with 10 minutes of nonimpact cardio activity, such as biking, rowing, the elliptical machine or swimming. This way, you can do cardio workouts with half of the impact. This methodology has saved many injured runners in our local training group over the years and did not negatively affect their running times when they were back to total capacity.

So don't be the person who used to run five miles a day in high school and start running again in your late 20s without treating yourself like a beginner. If you are a lighter person and have not gained weight over the years, you might be able to get away with a more aggressive beginner running plan. Still, any added weight will not be nice to your knees, shins and feet when you start running again after long periods off.

Stew Smith is a former Navy SEAL and fitness author certified as a Strength and Conditioning Specialist (CSCS) with the National Strength and Conditioning Association. Visit his Fitness eBook store if you're looking to start a workout program to create a healthy lifestyle. Send your fitness questions to

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