Real World Running Rehab

The Endurance Corner Archives are being cleaned out.

Here is an article from a few years ago — the article has helped a lot of people so I’m saving a copy here…



After two running injuries last fall, I asked our team doc, Jeff Shilt, for a running rehab program. He shared his elite athlete rehab protocol, it was an excellent program:

  • Drills
  • Functional strength
  • Flexibility
  • PowerCranks
  • Gradual ramp of load and intensity

Considering the time commitment required for Jeff’s program, I knew there was zero chance that I’d be able to execute it. Rather than fail, I searched for an alternative plan.

So I asked Jeff, “What is the minimum running load to derive a structural benefit?” He wasn’t sure so I pulled 20 minutes out of the air.

Knowing that it takes me four to six weeks to injure myself I gave myself a target that would take at least three months.

My plan was to insert 20 minutes of slow running with excellent technique. I would handle my aerobic fitness via bike training. I would handle my strength training in the gym.

Over 12 weeks, I managed 50 easy sessions of 20 minutes. I ran mostly on a treadmill with a 1% grade and max speed of 10 minutes per mile. My rehab speed was more than three minutes per mile slower than what I can deliver in a 70.3 race. While I have always been willing to run slow to achieve my goals, my previous goals were closer to 100 mile weeks than quarters!

The 50×20 protocol seems to have worked and my next phase is five-mile runs every other day for 12 weeks. I continue to run slow but have increased my pace cap to eight minutes per mile. I’m off the treadmill and happy to be back outside.

Phase two will take me to June when I’ll shift back to two-mile maintenance runs while I prepare for the Leadville Trail 100 bike.

As an aside, I’m applying the 20-minute target with my reintroduction of swimming. It is early days and a typical workout looks like:

  1. 500 easy with pull buoy
  2. 4x alternate 100 IM no gear with 75 Choice with pull buoy

I managed to keep my large muscle swim strength in the gym but suspect that my little muscles, particularly around my scapula, have atrophied.

Like most of us, my athletic memories and prejudices can cause me to injure myself. I feel lucky to have the opportunity to experiment with slow and steady rehab. I came very close to quitting running and am glad I kept trying to come back.

When more stops working, remember to try less.



Let’s recap Part One.

  1. Start by completing 50 runs of two miles — took me three months
  2. Shorter of five miles and an hour — every other day for another three months

The above will progress you to 7×45 minutes per 14 days. This works out to about 2:40 per week and will give you a base of about 160 minutes per week that you’ll want to repeat for at least six weeks before adding my tips below.

Once you’re ready to add load, you’ll find that 8-16 minutes worth of threshold/VO2 (combined) per week gives you a performance benefit with very little biomechanical risk.

Adding duration doesn’t give you much — keep every session under an hour. I’ve yet to run 10K.

Adding frequency via supplemental, easy, two-mile runs would make sense if you were a runner, rather than a triathlete. Aside from a couple of back-to-back run days (when traveling), additional running means I swim less. I need my swimming more than I need slow running.

So my recommendation is increase running load by adding intensity wisely. Here’s how:

Create some 5K and 5-mile route options. For my basic running, I prefer flat routes. For my weekly dose of intensity, I prefer hills.

Look for two types of climbs. The first is a climb that flattens at the top. The second is a climb that steepens at the top. Both climbs should be 6-12 minutes long; my preference is 8-10 minutes.

Alternate the climb that you use by week:

  • For the climb that flattens, build pace with the goal being 90 seconds Very Quick at the top.
  • For the climb that steepens, build effort with the goal being 90 seconds Very Intense at the top.

For both climbs, be patient, if you’re recovering from injury then you’ve proven that you can hurt yourself. You want to create a new habit of healthy running.

For both climbs and the descents focus on a quick cadence. Achieve speed via quickness — you should feel like you are taking baby steps.

Follow each day that’s biomechanically challenging with a light day. I’ve been traveling weekly so my total volume (SBR and strength) is down. Therefore, my intense running is done on fresh legs.

A weekly dose of 10 minutes of fast uphill running will give you what you need.

Six months of smart rehab will contain five to eight of these sessions in the final two months. At that stage, you should be better off than you started and ready to incorporate intensive aerobic training (Mod-Hard) as well as extending the duration of your longest run.

Replace the habits that lead to breakdown.


Midlife Fitness

I found this in my drafts folder. I wrote it four years ago and it’s a great summary of my late-40s approach to fitness.

Looking back, I had forgotten how many times I recovered from severe injury – three times in my 40s, each one a doozy! That’s about 65 weeks of rehab in the last decade.

Each time, I wondered “is this it?” Each time, I came back, eventually.

Avoid long gaps, rehab your injuries, keep it simple and persist.

Your future self will thank you.

What follows is from Sept 2016…

2016-09-16-12-31-17I finished summer by spending a week riding from Telluride to Moab.


I was coming off the most severe bike crash of the last five years and a summer of unstructured training. As such, I was pleasantly surprised by my fitness.

My current regime is simple…

  • get out the door twice a day
  • move in nature
  • strength train twice a week


The crash had me thinking about why orthopedic intervention often fails my friends.

#1 – Many athletes come to their doctor seeking relief so they can make a rapid return to the lifestyle that injured them in the first place.

#2 – How may of us are willing to undergo a sustained plan to strengthen the area that was hurt?

In my case, I landed hard on my left shoulder. Eight weeks after the crash, and six weeks into rehab, things have settled back to normal. By “normal,” I am a pain-free, slightly weaker, version of my prior self.

I find the lack of pain is reducing my motivation to strengthen myself.


Real taboos are evidenced by what we don’t talk about. As such, the topic of personal hormone supplementation rarely comes up in a group setting.

But I am asked in private and I share…

#1 – it takes a tremendous amount of effort, time and money to safely override Mother Nature. There are numerous examples of large-scale medical harms being caused with good intentions (interesting read linked). Steer clear of elective medication.

#2 – Separate from the risk of screwing up your health, my friends are at a place where judgement at work, and kindness at home, is a priority. Giving yourself the blood chemistry of a teenager greatly increases the likelihood of a massive unforced error.

Whether it’s sleeping pills, hormones or some other additive. Consider phasing it out.

As I age, what I truly value is time with good friends in nature.


We ended the trip with a nice dinner halfway between Moab and Boulder.

A buddy, in his early 30s, was celebrating his birthday. He’d been listening to the “nearly-50s” all week and asked what all this meant for his racing. Was he wasting his time?

When I was your age, the ONLY thing I cared about was training all day, every day. It cost me a few relationships but I had a blast. You’re doing great and there’s no rush to live like a middle aged man. Just keep your eyes open if things stop working so well.

I then launched into my spiel, which was my article on passion.