How Long Do Running Injuries Take To Heal?

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Lois was flying high after a half marathon in the fall.

Now that she’d retired, she was running more than ever and felt amazing.

But then everything changed.

She was dancing the night away on a cruise when she twisted her knee and it gave way.

She’d been unable to run for 6 months now.

“Even going up and down the stairs a few times, my knee just hurt”

Her doctor ordered an MRI and when the results came back, Lois’ heart sank: 

“They told me I have a meniscus tear and arthritis”

Lois loved hiking with her friends almost as much as running. She had her annual trip to Algonquin Park booked for the fall…

She had to cancel it.

As for the 10k she had booked…

No way.

“I was just really frustrated, I didn’t know what more I could do. How come I’m getting stronger but I still feel pain even after a short walk?”

She was doing her PT exercises every day. Her leg was getting stronger…but the pain just wouldn’t change.

Six months out of running now and she wasn’t making any progress to get back to it.

Lois had reached out to me because she felt hopeless.

“What the heck is going on? Why is it not getting better?”

I could relate. I’ve heard this story hundreds of times. 

You get pain in your knee and can’t run for a while. You go to PT and do the exercises and presume you’ll be back running in a few weeks.

After a few weeks, your knee feels better walking around and stuff so you try to run. But it still hurts.

So you wait a bit longer and keep doing the PT exercises. A few weeks later you try to run again. Pain is still there.

So you rest a few more weeks…and on and on the cycle goes.

6 months later you’re still no closer to running.

I explained to Lois that all of this rest of the last 6 months had let the structures of the knee become weaker.

The knee joint cartilage, bones, tissues and ligaments are all living structures. When you rest from running, they get weaker. Then when you go back to running, they can’t handle the pounding. 

It was time to start running again.

Lois was nervous to even attempt it. After our first conversation, she decided to give it another month doing the PT exercises. So we agreed to meet again in a few weeks.

By that point she was feeling really frustrated. 

She’d continued the PT exercises and could feel her muscles getting stronger. Her Single Leg Deadlift and Star Balance were rock solid.

But she still couldn’t run. 

By this point, even walking was painful.

Lois had been doing a fantastic job at strengthening the muscles that support her knee. This is a huge part of knee pain rehab and one of my 3 Critical Components.

But it’s not the only one.

Build the Muscles, Strengthen the Structures, Refine the Biomechanics.

Strengthening the Structures is just as important as Building the Muscles.

And the only way to Strengthen the Structures so they can tolerate running is to run.

So, if Lois wanted to run…she’d have to run.

Running is the Rehab.

Confront the pain. 

Don’t run THROUGH the pain.

Learn to train WITH the pain.

We started with just a few minutes of run:walking. Then we increased the amount of running very slowly and steadily each week.

Progress was slow, Lois had to be very patient. But she trusted the process. She understood that she was Strengthening the Structures of her knee. It would take time but they would adapt.

She could see the small improvements. A little more running each week. A little less pain.

After a month she could run:walk for 30 minutes with only green-light pain.

This is an important point. Lois was not pain free. She was run:walking 3 times a week with pain on every run. But it was green-light pain.

Green light means keep going.

A month later she was running for 30 minutes without any walk breaks. With only green-light pain.

The following month was the holidays and Lois wasn’t as consistent with her training as usual. However, she was still able to tolerate the 30 minute runs with minimal pain.

So over the next month we added a little bit of exposure to faster running. We used Fartlek workouts to gradually introduce running in zones 3 and 4 in very small doses. We also slightly stretched out the Sunday run from 30, to 45 and the 60 minutes.

All the while, we monitored the pain closely and Lois knew that she had to back off if it went into the orange.

That month went ok but Lois was still a little inconsistent with her workouts. We had a chat about it and she said that she was feeling frustrated that after 4 months with us it still hurt when she ran.

Of course she was frustrated! She’d rested from running for 6 months and now 4 months into working with us, the knee still hurt. 

So I asked her how much she was able to run 6 months ago…

“Not at all”

And it hurt when you walked right?

“Yeh”

So how much can you run now?

“About an hour for my long run”

And does it hurt when you walk?

“No, not anymore”

This really cheered her up. All I did was draw attention to all of the progress she’d made. Yeh, it was slow and the knee still hurt, but she could run way more now and the knee didn’t hurt as much as before.

Running injuries take months, not weeks. Lois was on the right track. She just had to keep going.

That month she really knuckled down and hit all of her workouts.

That’s when the needle really started to move. She started to feel more and more confident on her runs. Now that she was hitting every workout, the weekly mileage was starting to creep up and the knee was responding.

The structures of the knee adapted to the running. In response to “all that pounding” the body made the knees stronger and less sensitive.

By the end of the following month, Lois was finally logging some pain-free runs!

Lois was starting to feel better about her knee and even felt ready to plan a race! At this rate, she felt like she’d be ready for a 10k in the Spring. 

So now the fun would start. 

We got Lois to do a 20-minute time trial so we could calibrate her heart rate and pace zones. Then we got her doing threshold intervals in zone 4. This did a couple of things. First, it got Lois doing some focused training for the 10k to build her fitness back up. But it would also allow us to slightly increase the stress on the knee even more.

Those faster intervals caused more stress to go through the knee as a ground reaction force each step. That’s because faster running equals more stress per step. We titrated the dose of those zone 4 intervals to keep Lois in The Adaptive Zone. Not too much, not too little.

We knew we were in The Adaptive Zone because we would monitor the response to each workout. As long as we were getting green or orange pain, we’re in the zone. Any red light pain, and we’d back off.

By the end of that training block, it was time for the race.

She crushed it! She had a great race and was able to push as hard as she wanted.

The best part?

“Absolutely no knee pain”

I wanted to share Lois’ story in detail to illustrate an important point. It was 16 months between the day Lois hurt her knee on the cruise and the day she ran that 10k pain-free. 

Running injuries can be extremely stubborn sometimes. They can take a long time and progress can be very slow. Think months, not weeks.

That being said, if you follow a proven process and remain committed, you can get back to running as much as you want. But it’s really important to look month on month.

Ask yourself, how much could I run last month and how much did it hurt.

If you can run more, and it hurts less. You’re on the right track. Keep going.

But, if you can’t run more than you could this time last month. Or it hurts more. You’re doing the wrong stuff and you should look at other options.

Lois was heading for a life without running. Missing out on races and hiking trips with her friends…

She felt stuck. Frustrated, hopeless and no closer to running. Dreading the thought of a life without running and hiking. 

To lose that part of her life … that part of herself…was unthinkable.

Now she’s running 10ks … pain-free! 

That hiking trip to Algonquin she had to cancel last year…it’s already booked for the Fall. 

And…oh yeh…she’s training for a half-marathon.

Congratulations Lois. It has been a long road back to running for you and your commitment is inspirational.

We’re so excited to help you prepare for the half marathon this fall.

If you’re stuck with your injury and it seems to be taking forever to get back to running, don’t give up. It usually takes months not weeks but you should see progress every month. If you’re not seeing that progress and you’d like to find out why, just click the button below to book a free call with us and we’ll see what’s going on.