Run happy again! The secrets of making a running comeback after an injury or illness

Hey Runners! 

How many of you are training for at least one race this summer in Alaska?  Me too! Now, how many of you are struggling with aches and pains in your ankles, knees, hips, or low back and are worried that the pain may lead to time off from running? 

In this blog, I share my tried and true secrets of making a running comeback after an injury or illness, so YOU, can run happy again! (PLUS A FREE DOWNLOADABLE GUIDE!) 

I know a thing or two about comebacks

One of the most common questions I get asked as a Running Specialist Physical Therapist is this:

“I am injured (or sick) but am training for a race, should I keep training or take time off? How do I know when it’s safe to start running again?” 

Runners are goal oriented, and barriers like injuries and illness that get in the way can be our worst nightmare (especially when a race is right around the corner)! 


Believe me, I get it. If you didn’t know my story,  I sustained a severe ankle injury that my doctor thought I would never be able to run without pain again.  Here I am, racing all summer!  I sustained a severe near career-ending shoulder injury that my doctor thought I would never be able to dive or climb without instability again.  Here I am, breaking diving records and making “dyno” moves on the overhanging walls.  I sustained an ankle tendinitis after my first Alaska mountain run last summer and I thought I can’t hike or run trails again, here I am just hiking up and running down O’Malley Peak!  

I’ve had my fair share of comebacks, and am passionate about helping others do the same. 

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How do we get injured in the first place?

There are many ways we can get injured, by an acute one-time onset or a sneaky and gradual increase in pain and ache that is “talking to you” but doesn’t seem to go away until it becomes worse and is now affecting your training and performance.  From a systematic review, there is emerging moderate evidence that the relationship between a sudden spike in training load within 4 weeks is a big risk factor for injuries.2 

If you are injured and the race is 4 weeks away, do you panic?

A peer-reviewed study that collected data from 654 trail runners who were injured or ill four weeks before a race. The study found: 

  • The most indicated machanism of injury was “gradual onset” (41.6%)
  • The most indicated anatomical area: Knee Pain (33.2%)
  • At least 85.4% of trail runners changed their training following injury 
  • 79% indicated the belief that their injury would affect their competition performance(1)  
  • Surprisingly, there was no significant difference in the healthy, injured-recovered, and i’ll-recovered runners’ perspectives on their performance by the time they have recovered and raced.(1)   

Getting injured is more common than you think. Having to take time off is more common than you think. The belief that that time off will affect your competition is more common than you think. Guess what, you are not alone! Guess what, you can still crush that race by taking the right measures in altering your training plan. 

If you become ill and the race is 4 weeks away, do you push through?

In another study, 12 long-distance runners were interviewed immediately after completing a championships finals for their tactic to manage symptoms of ill health. 

The tactic is called “educated flexibility” where the runners rapidly adjusted their load and had the strong incentive to learn from experience and professional advice.  Adjustments that were made include:

  • Reduced load
  • Increase sleep and rest
  • Increase good nutrition
  • Avoid any triggers of environmental strain feeding into vicious cycles of being injured or ill. 

Their main strategy to stay well and sustain their performance is by constantly paying attention to symptoms of ill health, listening to medical advice, and not letting environmental strain or personal stress interfere with adjustment of sports load.(3)  This also includes bio-psychological models of optimism, motivation, and self-discipline to rest and recover as needed.

Rest and Recovery is Key

After a significant injury or illness, give yourself at least 48 hours of rest to let the inflammation calm down. This will allow your body time to switch gears and dedicate extra energy toward tissue healing and recovery. 

Does this mean to eat less?  No. You will need to eat more and have a well-balanced nutrition to generate a speedy recovery.  

Between 48 hours and 7 days when the inflammatory phase has completely calmed down, you can begin testing suggested by your physical therapist to see if it’s safe to get back into your training plan. 

Listen to your body and tolerance.  Be flexible with your training program.  Be kind to your body. 

6 Tips to guide you through a successful running comeback

I’ve put together my tried and true tips to help you return to running again safely and avoid the yo-yo run-pain cycle. This guide is your ultimate blue-print for running happy again! 

The best part? This report can be downloaded for FREE! 

Just click HERE

By: Dr. Natalie Snyder, PT, DPT, OCS, CSCS

Board-Certified Orthopaedic Clinician Specialist
Certified Strength and Conditioning Specialist
Shoulders Specialist
Female Athlete Specialist
Running Specialist 

natalie synder


  1. Gajardo-Burgos R, Monrroy-Uarac M, Barría-Pailaquilén RM, Norambuena-Noches Y, van Rensburg DCJ, Bascour-Sandoval C, Besomi M. Frequency of Injury and Illness in the Final 4 Weeks before a Trail Running Competition. Int J Environ Res Public Health. 2021 May 19;18(10):5431. doi: 10.3390/ijerph18105431. PMID: 34069583; PMCID: PMC8160869.
  2. Drew MK, Finch CF. The Relationship Between Training Load and Injury, Illness and Soreness: A Systematic and Literature Review. Sports Med. 2016 Jun;46(6):861-83. doi: 10.1007/s40279-015-0459-8. PMID: 26822969.
  3. Bargoria V, Timpka T, Jacobsson J, Halje K, Andersson C, Andersson G, Bermon S. Running for your life: A qualitative study of champion long-distance runners’ strategies to sustain excellence in performance and health. J Sci Med Sport. 2020 Aug;23(8):715-720. doi: 10.1016/j.jsams.2020.01.008. Epub 2020 Jan 30. PMID: 32061524.
  4. Roche, David and Megan. How to Return to Running After an Injury. Strava stories. Date published: unknown. Date accessed: 31 May, 2022.,Only%20then%20increase%20frequency.
  5. The Running Clinic. New Trends in the prevention of running injuries. 2015.

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