Run-Walk protocol after injury: BS or not?

Our program has something similar. I bet most of the time it isn't really necessary. I think it's tailored so that there is basically a 0% chance of reinjury while on the plan. I bet you could do a little more running.

Or maybe stay on their plan while supplementing with biking, swimming, elliptical, etc.

Yes, it’s a conservative protocol to get the body slowly reacclimated to the pre-injury load, so they do do something, which is to reduce risk of re-injury. The counter argument is that stress reactions are normal and are frequently observed in college athletes even without any pain, so you don’t have a problem unless it manifests as pain.

The reality is that stress reactions are the first step towards a seemingly sudden fracture if left unattended, so the way to think about risk is probabilistic, not as a binary of healed vs. not-healed. You should be conservative for the next few months backing off aggressively at any sign of resurgence.

Your athletic trainer is right. Follow his/her course of action if you want to recover and rehab without any setbacks. What you're doing is the correct and sound protocol.

it does "seem" dumb because it feels like you're wasting some of your finite time (the time you have to compete in college). Now imagine you get that same advice in your 50s (I did); we're not going to live forever and it sucks to give up months of more-vigorous training when we only have so much time left.

But that's the same advice I got last year. Freaking tedious, but I built up slowly and didn't bring the injury back. I'll probably do that this year, now that I'm in a position to overdo it again. ;-)

You ask if the one-minute walks do anything because they're so facially minor. Think of it a different way: for every workout you do with this structure, you're taking away 25% of the pounding (and, of course, some amount of mileage, but you can supplement with non-impact activities). Good luck with your recovery.

The trainer's job is to prevent re-injury above all else, instead of prioritizing performance. Nothing wrong with that necessarily, but I'm surprised that your coach is deferring to the training room entirely.

Anecdotally, I also had a tibial stress reaction in college that was caught early. I was back to running in three weeks, didn't bother with run/walk, and I managed to stay healthy that season. With that being said, I've dealt with on-and-off shin splints ever since that make it tough to increase mileage consistently. Maybe that could've been avoided if I was more patient, but who knows.

You said you've been off for five weeks, so you're probably fully healed. I get that it's frustrating, but one thing you can do is up the cross training. Biking is good, but I find that getting in the pool comes the closest to simulating running. When I had the stress reaction, I would do an hour steady on the bike in the morning, then an hour of aqua jogging intervals in the evening.

Good luck!

Agreed. Give it a chance to get completely better.

How about 3:00 walk, 1:00 jog?

Don't listen to your coach, just do what you think it's best for you.

In three weeks you will be re-injured and you will have even more time to reflect why you had a coach in the first place.

If you bothered to read the post you're responding to, you'd know that it isn't even the coach making this plan.

It's actually good for kids to ask questions, and coaches who think otherwise are a plague.

I would take issue with the concept that a coach should overrule the athletic training staff when it comes to injuries. That is a great way to get sued and get fired.

It has happened that coaches have not allowed ATs at workouts where people were seriously injured or died.

I would think most universities have a policy that the training staff takes charge in these situations to avoid potential lawsuits.

Why not just run on the alter G?

It's about slowly increasing the weight bearing activity to help the bones, tendons, and tissues adapt. One problem with getting really fit biking is that it makes running feel pretty easy when you come back so it's really easy to get reinjured or injure something else. Do the protocol but keep up on the biking to stay fit.

If you're not feeling the workouts, you can add some plyos.

Had a tibia stress reaction a year ago, just ran on turf for the first 3-4 weeks back running to keep the impact low. Felt weakness in my tibia at first but it subsided after a week or so. From my experience, walk / jog is great for muscle related injuries where if too much continuous stress can cause it to cramp / seize. Follow it or don't, I don't think it matters much but running straight through won't cause any issues from my experience, good luck!

I think there's a happy medium. I've had 7 stress fractures in my running career (poor choices, underfueling) so I've been through the return to run a bunch. I've found the best way to start out is a 10-15 min run on soft surface with 2 to 3 one or two minute walk breaks within that. So I may run for 5 minutes walk for 1 or 2, run for another 5, repeat. I'd do that every other day for two weeks, adding 5 minutes.

Most return to run protocols are agonizingly slow and unnecessary, especially if you've only been off 5 weeks. But I'd still start out pretty conservatively for a few weeks, then ramp up.

I think other posters’ cautionary remarks are largely reasonable. You don’t want to mess around with a diagnosed stress reaction. But, that said, a clinician may err a bit too far on the side of caution. I had a soft tissue injury a few years ago that prompted my MD to suggest a decrease from my 60 mpw to 25-30, with a 4-week ramp up to regular mileage and intensity (I’d had 7 days off before the appt). He gave me a scrip for PT and suggested one with an alter-G, thinking maybe my first 2 weeks would include alter-g to lessen the amount of running.

PT: Nope. Another week off running. Start with 10 min, 1 x walk, 1 x 10 min./mi. on regular treadmill.

After 1 week, he said I could progress to 15 min. Me: well, I did 15 miles yesterday at a nice easy 8 min pace, so where should we go from here, please?

Make sure your medical personnel are familiar with running.

I think ur coach is stupid n ur athletic Trainer smart. But dont listen to me, im just a 1:53/3:55 guy with every imaginable injury under my belt. A few even above Belt.

It always depends. The longer your body is out of the game the slower you have to take it on re-entry. Five weeks is not a lot. Early stress reaction isn't a big deal. You will probably be able to ramp up quickly. Listen to your body and the wisdom of people around you.

I do the same. Xtrain and do the plan. If you google "return to run protocol" you will see that every major sports med clinic has the same-ish hand out. Cleveland clinic, Stanford, Boston U....Takes like 5 weeks to run an actual mile non stop even though the total minutes might be 25. Do not recall the evidence base for this. It may have to do with the idea of building total time but never crossing a stress threshold before walking to allow adaptation?

Devils advocate- Most return to running after stress frac is around 6-8 weeks assuming pain free. Bone absolutely does not heal in 8 weeks or likely even 12 weeks. I know, I see xrays. We usually say at 8 weeks AND no pain, return to running. So really, the slow build up can be seen as running while tech you are still healing! Look at it that way. Its not that you cant handle the mileage. Its a slow application of stress with, hopefully, the body reacting positively. In other words they could say just no running for 12 weeks. If they thought you were 100% healed of course you could start back running right away 20,30,40 mpw...