Run/walk buildup when coming back from injury

Here’s a question for those who have come back from a long-standing injury or who have experience watching others do so (@JTuori, @esambo?).

It’s often recommended to start with a run/walk approach, where you start adding short jogs into a walk. That’s easily enough done, but since this isn’t a couch-to-5K situation, where the person is likely somewhat aerobically limited, how quickly and in what way do you ramp up?

Right now, for instance, I’m walking for (at least) 15 minutes, with 1 minute of walking and 1 minute of jogging, and I’ve gotten up to 7 minutes of jogging total. All with no additional pain the next day, which I’m using as the primary metric of success.

Would it make more sense to increase the length of the jogging repetitions, perhaps to 90 seconds and then 2 minutes, or to just keep increasing the number of 1-minute repetitions? Either way, it seems that it’s meeting the goal of more time on my feet, but I can’t tell if one approach would be better than other.

If I was doing this for aerobic training reasons, I’d increase the length of the repetitions since that would be more helpful in moving toward a longer run. But aerobic conditioning isn’t an issue—I could easily run a few miles if I had to; the question is how to ease my plantar fasciopathy-affected foot back into real running.

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@adamengst great question, and the answer is highly variable and context-specific. The reason there’s no gold standard “return to run program” is because of the influence of training age, injury type, and adaptability of the runner. What I often emphasize to runners returning from an injury is that the return to run program isn’t for your aerobic system (assuming they kept a decent amount of aerobic fitness while injured)- it’s a test of load tolerance for the injured area. I’m typically a fan of increasing the length of the intervals at least until they get to 5 minutes (albeit an arbitrary number, admittedly). Once someone has worked up to that point, they’ve likely just accumulated enough sessions with success to show that the injury has stabilized. The question is then whether to manipulate the work:rest ratio. In highly sensitive injury cases, I’d like to only change one variable at a time, so rest ratio would remain the same if interval distance increases. There’s always somewhat of a guess and check approach to it, we just try to use the context of where the runner is coming from to inform how the program would start.

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What I did getting back from long term injury this spring was starting very similar to you are now, Adam. Started at 15-20 min total with 1 min run 1 walk. Then I started increasing to 2-3 minutes run, 1-2 minutes walk. Once I was comfortable with that, I started to gradually increase the number of reps. Once I could do 45 min of 3 min run, 1 min walk, then I did one run per week where I gradually increased the running time. But I kept the other 2 runs per week as only 2-3 minutes at a time. Once I could do a 30 min run non-stop once per week, I started increasing the running intervals on the other running days. Now I’m able to run the whole time on all my runs, 3-4 times per week. One thing that was important at the beginning for me was keeping the time walk/running flexible depending on terrain opposed to being strictly sticking to the watch. If certain terrains like uphill have a history of bothering your foot more, make sure you are walking up these sections.


Thanks so much for the thoughts, Jason and Jullien. Sounds like I’m on at least the right track (heh), and I’ll start increasing my run rep length. It’s not like there’s anything to train for right now anyway, so it will be easier to take it slow.

Sorry to make things more complicated, but I will offer another perspective. When I couldn’t run after a back injury all I did was hike uphill (since that didn’t hurt) for an hour plus and then throw in a very short run (20-60 steps) here and there. When I was finally ready to start trying to run, I would still hike 15-20 min, then 1min run, 1 min walk x 5-10 and try to gradually increase number of reps. That was three years ago and as you can see by looking at my sessions on Strava, I still start every session with 15min of hiking, then at least 10min of 1min runs with 30s walks. Typically in my long sessions, I run 80+min and hike 15-20min but don’t do run intervals much longer than 5min. My workouts and races I do run continuously but I think it’s important to keep the run intervals short with a chronic injury because once you force yourself to make it longer, if you get a twinge you might keep running through till you hit that time. If you run a minute and then take a quick walk break, it’s usually just enough to check your form, evaluate how you feel and hopefully go again. Keep in mind, I run almost exclusively on trail and/or on snowshoes so the walk breaks on that terrain still keep the heart rate up pretty well. So that’s my experience and advice for what it’s worth. Thanks for asking and thanks Jason and Jullien for your perspective.

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Interesting perspective, Eric, thanks! I’m hoping in my case that the plantar fasciopathy will not prove to be truly chronic once I’ve recovered (the other foot took 18 months to heal in 2012 and 2013 but it’s totally fine now). However, your point about being able to check better while walking is well taken.

What I’ve decided to do is work my way up to 10 reps of 1 minute walk, 1 minute run, and then start turning the reps into 1 minute walk, 2 minutes run. The twist is that I plan to add the 2-minute reps on the end, so the first day I’ll do 9x1 minute and then make the final rep 2 minutes. The next time I’ll do the last two reps at 2 minutes, and so on until all 10 are 2-minute reps. I figure that will let me use the shorter reps as more warmup, and be able to bail out of the 2-minute reps more easily if I feel a twinge.

Adam, I think that’s a good plan. My typical 30-40 minute easy running session always starts with 10 x 1min run, 30s walk and then goes into 10 or more x 2min runs with 30s walk. If I feel OK, I might do more, but usually that’s enough. On a bigger day I may progress to longer continuous runs but not until doing the shorter run intervals first…or as I can them “onesies” and “twosies.” Hope everythings goes well for you!

Yet another approach… after a hip replacement last year, my doc was skeptical about my starting to run again. So we agreed on a simple rule: I started running 250 m 4x per week and increased by no more than 15% per week.

It sounds s o o o o slow, but if you do the math, that’s a doubling every 5 weeks, and I was up to 10 K in under 6 months with no pain at any time.

For what it’s worth…