How and Why to Make an Injury Recovery Plan

When physical therapist and running coach Dani Curtis, DPT, starts working with a sidelined runner, she assesses their injury and works with them to determine the best treatment. She also sits them down in front of a whiteboard in her practice at Magic City Athletics in Miami and writes out a weekly schedule.First, she asks what their training looked like before they got hurt—say, a track workout on Monday, easy run plus strength training on Wednesday, a long run on Saturday. She then replaces those sessions with elements like rehab appointments, home strengthening exercises, and appropriate cross-training.She tells athletes they’re free to modify, within reason, but notes that it’s helpful to start with a solid framework. “Most runners are your typical type-A personality, so they operate their entire life with routine and structure,” Curtis tells Runner’s World. “I try to reframe the idea that they’re in rehab, and instead shift the mindset into, okay, this is a modified training plan.”That type of mental adjustment and organization can keep you from feeling lost when injury derails your goals, says certified mental performance consultant Carrie Jackson, my coauthor of the book Rebound: Train Your Mind to Bounce Back Stronger from Sports Injuries.“You are still an athlete, and your recovery is now your sport,” she says. “All that energy that was going into training and competition now goes into recovery. For that to be true, you have to have a plan.”If you’re looking at some time away from running, here’s how to create a blueprint that gives you the best chances of a successful return.Surround Yourself With SupportThis starts with your medical team. Ideally, you’d consult with a sports medicine physician, physical therapist, or similar medical professional on your diagnosis and treatment. If possible, find someone who treats runners frequently, so they’re familiar with the demands and the mindset, Curtis says.If you don’t have access to ongoing care, some clinicians and coaches may offer one-time or short-term consultations. “I have runners who will see me once a month or once every two months, and we just have that connection point,” says Kate Baird, MA, ACSM-CEP, CSCS, an exercise physiologist and running coach on the HSS Sports Rehabilitation and Performance team in New York City.Medical professionals are only one piece of the puzzle. Injured athletes typically need four kinds of support, Jackson says:Informational: providing details about your injury and treatment protocols (this is where your doctor or PT plays the biggest role)Tangible: assisting you with physical tasks, like rides to PT or carrying something if you’re on crutchesMotivational: encouraging you and boosting your confidenceEmotional: listening and offering empathy and compassionNo single person can provide all of these, all the time. For example, maybe your partner is great at tangible support, but if they’re not as active, they may not be able to offer the same emotional support as your running buddies.Think through the people in your life who are skilled in each area, and don’t hesitate to reach out and ask them for help when you need it or even before, says Jackson, who’s also my cohost on The Injured Athletes Club podcast.Set New GoalsIt’s important to consciously shift your goals to match your new reality. Of course, your ultimate aim is probably to get back to training as soon as possible. But focusing solely on that objective can leave you thinking more about what you can’t do than what’s within your power to change right now, Jackson says.Plus, healing doesn’t always follow a straightforward trajectory. While your medical team can give you a general timeline of when you’ll be running again based on the type and severity of your injury, your body also has a say in the matter. If the process takes longer than you expect, you may feel like you’re failing, even when you’re making progress.So, ask your doctor or PT about markers you’ll hit along the way and set goals surrounding them, Jackson recommends. These might include:Moving on to the next phase of treatment, such as getting rid of crutches or walking without a bootImproving your function in daily life—for instance, climbing stairs, picking up your kid, or sitting or walking without painMobility metrics, like increased range of motion after knee surgeryStrength benchmarks that support your running—those include being able to do 40 single-leg heel raises, holding a plank for 60 seconds, and holding a single-leg bridge for 30 seconds, Baird saysStarting—and progressing—a return-to-run program that builds from walking to run-walking to continuous runningBreaking your bigger goals into smaller steps makes each one more manageable and predictable. Still, you may not know for sure how long it will take to reach each mini-goal, so think short-term and stay flexible, Jackson recommends.Map Out a Pain ProtocolA big challenge injured runners face when rehabbing or returning to the sport is knowing which types of discomfort are “normal” and which signal it’s time to take a step back. Generally speaking, when you’re getting back into training, minimal to no worsening pain during and after running is a green light to proceed. Pain that’s severe or progresses during and after training is a sign to back off, Curtis says.However, the specifics may vary depending on your injury, and you also may have questions about what you’re feeling during rehab exercises. Plus, it’s not always easy to quantify pain when you’re anxious, and tension can intensify pain sensations, Jackson says.She often suggests athletes work with their healthcare team on a specific pain protocol that takes some of the guesswork out of the equation. “It’s like a personalized if-then flow chart: ‘If I feel this kind of pain, I do this next, and then if this happens, then I do this next,’” she says. “Creating your own flow chart—actually writing it down—is often incredibly helpful.”Create Process GoalsWhile you don’t have complete control over your body’s timing, you do have agency over your daily actions and habits. Once you have new outcome goals—results you’re hoping to achieve—another helpful step is to set process goals.These specify how you’ll work toward the objective, and the more detailed you make them, the better, Jackson says. For instance, if you can’t yet run but you’re doing rehab and cross-training, you can plan to take your gear to work and go to the gym for a 20-minute bike ride and strength training before you head home on Mondays, Wednesdays, and Fridays.Setting up a day-by-day plan like the ones Curtis develops with her patients is helpful to ensure you’re sticking to (but not overdoing) your rehab exercises.You can also set process goals for other lifestyle habits that contribute to recovery—for instance, going to bed earlier, meditating for 10 minutes daily, or fueling properly to support healing—or for using appropriate home modalities, such as a foam roller or a Strassburg sock for plantar fasciitis.Even when you’re training, “you’re only running probably 10 percent of your day,” Curtis says. “What are we doing the rest of the day that we can be proactive?”Celebrate When You Get ThereEach time you achieve a new milestone—buh-bye, boot!—honor and recognize it. treat yourself to a new piece of running gear or trumpet it on your Strava (where you can now track your physical therapy activities) or to your friends and family.“Take that moment to go, ‘Wow, I know I have a ways to go, but look at how far I’ve come, and look what I can do now that I wasn’t able to do last month,’” Jackson says. Celebrating small wins helps overcome the brain’s negativity bias so that instead of fixating on the fact that you can’t run, you’re building momentum and boosting hope and confidence.One note about Strava and similar sites: In some cases, continuing to post and follow friends and pro athletes while you’re injured can be motivating. But at other times, you may find it triggers feelings of comparison or frustration that aren’t helpful to healing. Be honest with yourself about the impact and know that it’s okay to step back from running content temporarily, Curtis says.Don’t Forget the Fun StuffYou’re still a runner, even when you’re injured. But you’re also much more than that—you’re a friend, a partner or parent, and a human being. If you’re solely focused on your rehab, you risk neglecting other areas of your life.Jackson recommends setting aside time for hobbies and creative pursuits. “Sometimes it’s doing something totally new, because we’re wired to enjoy the process of mastery,” she says. “Or it could be reconnecting with something you haven’t had time to do, or you kind of put on the back burner because of all the time it took for training.”Another thing you might be missing while injured, especially if your recovery is long, is something to look forward to. If that resonates, Jackson suggests scheduling at least one event per month that you’re eagerly anticipating, such as a concert or dinner with a friend.These occasions might feel like luxuries, but in fact, they’re critical to alleviating stress, which can boost your immune system, Jackson says. “We’re not just caring for the physical body, but we’re caring for your overall physical, mental, and emotional health,” she says. “It’s all part of the healing process.”Cindy is a freelance health and fitness writer, author, and podcaster who’s contributed regularly to Runner’s World since 2013. She’s the coauthor of both Breakthrough Women’s Running: Dream Big and Train Smart and Rebound: Train Your Mind to Bounce Back Stronger from Sports Injuries, a book about the psychology of sports injury from Bloomsbury Sport. Cindy specializes in covering injury prevention and recovery, everyday athletes accomplishing extraordinary things, and the active community in her beloved Chicago, where winter forges deep bonds between those brave enough to train through it.