Run-Walk protocol after injury: BS or not?

The walk run protocol is good advice for the first two to three weeks. Your bones have been detrained for 6 weeks plus. You need to give them time to get strong again. You can still bike to supplement your aerobic fitness but dont overdo it. I would also try to develop a sensible weight training program with your coach and trainer.

Realize that around 1/2 of college runners who get a stress fracture get another one within 12 months of returning to competitive training. For those that do get repetitive stress fractures, it's usually the end of their effective career.

Don't blow a stress reaction/fracture off. While they are a one off event for some, a stress reaction shows that at a basic level your diet/ training regimen is not sustainable. You should be taking vitamin D, magnesium, and calcium supplements. Take whey protein after every run.Get plenty of sleep. Avoid heavy drinking. Look at your diet for lactose, gluten, etc allergies.

Within 3 weeks you should be able to run 20 mins continuously 4 times a week with a healthy dose of biking and strength training. Within 6 weeks you should be back to 35 miles a week and able to slowly add in reasonable workouts and long runs. At 3 months post return to running you should be at pre injury training levels provided you have corrected the nutrition/strength issues that led to the stress reaction in the first place.

If you hit 40 miles a week 2 weeks in and 70 miles 3 weeks in, you will get hurt. If you are returning to training now, I would redshirt outdoor track absent super compelling reasons. You could jump in a 5k unattached late season just to get some turnover but I would set any competition goals earlier than fall xc.

Good luck-

Good suggestion. Get your D and Ca.

As frustrating as a slow recovery from a sports injury is, there's much more to be lost by coming back too fast and having your bone injury progress to a full break of your lower leg, than there is from a cautious recovery. You risk losing a few weeks from an overly cautious recovery. You risk losing months if you develop a full break and may never be the same again.

You see it all the time with kids coming from a heavy swimming background. The heart and lungs out pace the bones and joints and tendons. Crush it at first and always end up injured.

OP here. Thanks for all the feedback. I'm still puzzled by a couple of things, though. My first week of cross country as a 9th grader, I ran about 15 miles or so. So did everybody else new to the team. Everybody I know had a similar start to their running. Nobody started on a walk-run program. None of us got hurt, even though we had never run before. Now I'm starting at 6 miles / week when I have much better strength and training background. The doc says my reaction is completely healed. What exactly is the risk of 20 miles / week?

Also, many of the responses here (thanks again), suggest that if I rush the return, I'll get another stress reaction at some point down the road. But does a stress reaction really start now, stay undetected and pain free for 2-3 months, and then develop into a fracture when I hit full training? That doesn't make sense to my understanding of how stress fractures work.

Good question. Not a doctor, but I believe bone remodeling and resorption follows a 3-4 week cycle, which is why a number of return to run program have a reload week about a month in as well.

From my experience, if you are going to develop another sfx, it'll be within the first month or two of return to run, which is why people err on the side of caution. Stress fractures will take at least several weeks (sometimes months for a bigger bone like the femur) to develop to a point where they cause pain, which is the reason behind the cautious approach.

Good article on this:

ncbi.nlm.nih.gov

Preventing bone stress injuries in runners with optimal workload

Bone stress injuries (BSIs) occur at inopportune times to invariably interrupt training. All BSIs in runners occur due to an ‘error’ in workload wherein the interaction between the number and magnitude of bone tissue loading...

Open link

This is true--after my marathon I took some time off and had to start walk-running on/off to just get to 3 miles non-stop in January (31 minutes). But I was ok with that. I just jogged slowly and put in 30 minutes a day once running slowly.

Build the mileage up slowly--and cutback weeks are A THING! Once I felt I could handle running straight through, my weeks were 14-20-24-28-32-40-40-33 (cutback). I don't plan on going more than 40 for quite some time...and most of it is really slow (9:30-10:20 pace), just by HR (under 145) and by feel.

I am afraid of going more than 50 miles a week and getting a stress fracture. I'd rather just build a consistent base and get strong (even if I'm slow at first). Slow but strong means at least I can get my daily run in for the day and stay healthy.

How much did you weigh in 9th grade?

How much were you growing in 9th grade?

What pace did you run on training runs in 9th grade?

Now answer those questions about yourself currently. You are almost certainly heavier, producing less hgh, and running faster average paces. Running puts more stress on your body now while you have lower bone production remodeling capabilities.

You probably won't get injured running 20 miles a week off the bat but you might. The more you focus on weight training and limit running at the beginning of your training cycle the more bone density you can build up before going into serious training.

Do you think running 20 miles a week instead of 10 the first two weeks in April will let you run a sub 14 5k by your conference championship meet? If not, what exactly do you think a quick return to running will achieve for your team or yourself?

As background, I had a femoral stress fracture at age 19, returned to running within 2 months did OK for 6 months but did not change my diet or drinking habits and got another femoral stress fracture in the opposite leg 9 months later and was out of the sport at age 20. Story of one but not all that uncommon.

Google Michael Woods Tour de France for the story of an elite runner having to switch sports because of recurrent stress fractures. Everything worked out for him but I wouldn't model my career after him.

For the sake of controlling the amount of load you're putting on everything in the buildup and ensuring that you're setting yourself up to continually progress (think of a graph that looks like a set of stairs going from the first floor to the second floor) as opposed to trying to force a linear progression (think of a 45° angle on a graph)...yes.

Give yourself a chance to truly rebuild and solidify your base.

The other way to think about it is how much does an extra minute of jogging really matter? Or how much does a 16:00 run matter compared to a 12:00 run?

The point is not to regain fitness. The point is to get your tissue (all the small muscles, tendons, etc that you take for granted) re-acclimated to bearing weight after a period of time on the shelf. This can take a while and if you neglect this process you will develop asymmetries that will definitely lead to a cycle of injuries that, honestly, disrupt most college athletes' careers because they are immature and tend to try and push through everything. This is especially important if you are still aerobically fit and your engine will destroy your chassis if you give it half a chance. I would not be going to your athletic trainer six weeks before conference and asking them for workouts, but I would ask that person how to recover from an injury. You will avoid a lot of heartache if you keep your dick in your shorts and be patient.