Injury to 5km PR (15.23) - A case study

With the increasing number of people signing up for marathons/half marathons and the like, we see an increased number of Athletes/recreational runners getting injured or reinjured.

Whilst I don't have any issues with this, I do tend to see a lot of clients who have had repeat Calf/hammy and are not doing adequate rehab/ return to run programs- 1- to prevent these injuries and 2- return to running at a standard as good or even better than before.

So, with that being said – I'm going to take you on a journey of one of my Clients who stuck to the process and went from barely being able to walk post-injury to a new 5k TT personal best in only 18 weeks.

I'm going to call my athlete – Athlete 1

Athlete 1 came to me after they were sick of having repeat calf Injuries – having 7 in the space of 18 months- 4 on the left and three on the right; they all ranged from minor to the worst being the one he asked me to help with.

On MRI, the report showed a Grade 2 Soleus involving intramuscular aponeurosis- hearing this is never a good sign as This injury has the slowest timeline and the highest reoccurrence rate. According to research, this injury has a 63.2% reoccurrence in the first two months.

My first thought was Fuck you've done a ripper job.

Next, we worked together on creating a plan – and I fully disclosed to this athlete that if you complete my Rehab, you'll commit fully and, most of all, be Patient.

Weeks 0-2

·         Rest !!!

·         Pain-free walking took nine days.

·         Daily isometrics exercises

·         Progressive strength program

I will post only some exercises this athlete completed - this isn't a how-to-do-your-rehab guide. GET SOME HELP! (from me if you want)

Week 3-

We went with an Anti-gravity treadmill – I wanted to reduce the body weight % for the first few run sessions – Purely to reduce the tensile load on the calf and Achilles and a bit of confidence for the athlete. These started from 70% total BW to 90%.

Week 4

We run outside – YAY!! This, to me, is why 99% of recreational athletes don't seek help, because it's like we are taking your life away when we say you can't run for four weeks. I've no doubt lost a few of you reading this case study because it isn't what you want to hear. Be Patient!!!!

Athletes' goals (with no timeframe)

·         Pre-injuries were running anywhere between 50-70km Weeks –

·         They wanted to try to run a solid 5km TT- athletes usually complete Saturday morning park runs.

·         Wanted running structure

We went back and took his best 5km TT he had done this five years ago. With this data, I did some approx—calculations to gather some training zones for him to stick with.

I went with three zones only, as I do in 98% of all my running clients – as it is simple and effective, plenty of people around the world have had success with these zones - see any of Stephen Seiler's work.

With this, we had three zones – so let's get started with the program-

Week 4 – 8 – we built a training load from 10km outside to 35km purely running in zone 1 only; this zone is effortless, and most of my athletes struggle to run so slow, but trust me when I say running slower will make you run faster in the long term. Why? Because you can back up day to day/ week to week. When life stress gets in your way, running doesn't have to suffer.

See a perfect photo again by Sports scientist Stephen Seiler –

So now we are eight weeks post-injury, let's revisit what we have done.

·         Rested

·         Isometrics

·         Progressive strength

·         Intro on anti-gravity treadmill

·         Run outside with progressive load in zone 1 only.

Things we now need to complete.

·         Introduce more intense running Zone 2 + Zone 3

·         Build training load back to Athletes' goals.

·         Retest

During this time, I'm following the 80/20 running program – 80% in the green and 20% of total running days in the more intense zones. See Mat Fitzgerald's 80/20 book to learn a shit ton about running slower to end up running faster, ultimately.

So weeks 4-8 were 100% in zone 1 (green)

Weeks 8 to 18, including retest, will be approx. 80/20

This is where you think it gets complicated – but it doesn't-

Zone 1 running increases as weeks go on; we keep the same number of sessions per week (the athlete was running five times a week) and increase the load in those sessions – e.g. Saturday zone 1 run started at 4km in week four, and progressed by 2km each week to a maximum of 20kms. This was another request by the athlete- have a Saturday long run to kick off the weekend.

We add Threshold and Threshold + running in 1 session a week, then add load to that session.

Then, after a few weeks, we add another threshold session into the weekly plan and progressively overload that session.

Ultimately, we have a weekly session layout that looks like this –

Five sessions

3 zone 1 run sessions ranging from 10km to 20km run per session.

2 Threshold sessions that ranged from 1km work to 5km work in zone 2+3

This ended up totalling – 50km Zone 1, 8-10km Zone 2+3

Which equates perfectly to 80/20 in Kms But doesn't equate to 80/20 from a session's point of view (60/20). I'm a terrible man. – but we didn't just jump to this – we slowly progressed the running load pending how the athlete was feeling, life stress and making sure we stayed consistent with daily calf strength and a progressive simple gym Program.

We then did a retest – I wasn't expecting this outcome of a new PR, but I continued to educate the athlete on not to put a ceiling on the result, let the training do its talking, stay confident and see how your body responds.

And here we are. With a new 5kmTT PR and consistent running load that is manageable most weeks, athletes can recover quickly from running sessions due to correct running intensities. Load is reasonable.

Post his Personal best – he asked me, "Why do people overcomplicate training?" – great question.

Fast forward – 4 months from this test (it takes me ages to write shit down) – This athlete has gone six months + without injury – you readers might not think that's a long time, but from someone who had 7 Calf injuries in 18 months, this is HUGE. He still runs 50-60km a week – his training zones have changed, and he wants to run a sub 15 5km TT- no doubt he could right now, but as he states – "I just want to run for enjoyment and not worry about the test, I'll do it when I feel I want to flex".

My takeaways –

I'm not here to boast about my program – but know you can return to your best if you stick with the plan, commit, and communicate with your coach.

Patience with injuries, especially ones with high recurrence rates

Run Slow to run faster ultimately.

Seek a professional to help you get better- most success comes from working with a team, Physio, S&C and even a run coach.

Stop doing the same shit you have done previously. If it didn't work, then look to make changes or ask the question to your coach, "What can we do differently?".

Consistently retest – from strength testing to running testing for these reasons-

Is your run program currently working for you?

Is your strength program maintaining or increasing strength?

Old mate down the road can market their run program on Instagram that produces results- but does it?? Challenge your coach!!

Anyway, If you are still here – Well done; I plan to write a few more case studies and thoughts in the coming months, so if you have suggestions, please let me know.

Special mention to researchers- Stephen Seiler, Mat Fitzgerald (80/20 running book)