Running Injuries Recovery Time Lines

Picture from Interplay

I feel that we live in an instantaneous society now where you snap your fingers and you want things done. Fast food, fast internet and fast access to pretty much everything. 

I have many patients who are new to running and want to be a great runner, fast. Many runners expect to improve their times with short periods of training and end up doing too much too soon.

Then there are those who are injured and try to accelerate rehabilitation and recovery beyond normal time lines. I would like to caution that effective recovery will take time and cannot be rushed or forced. 

The 2 times that I fractured my spine, I too hoped to heal faster. However, I cannot accelerate healing and rehabilitation beyond what biology will allow. I can only optimize it.

Back to running injuries. I looked at a study that studied average recovery times for common running injuries. When you look at the study the numbers may surprise you and many of the healthcare professionals that read this.

140 runners out of 839 sustained a running injury in this 24 week study (Mulvad et al, 2018). Runners in the study reported levels of pain in different body parts on a weekly basis. The injured runners attended a physical examination by a physiotherapist who provided a diagnosis. Examples are medial tibial stress syndrome (MTSS or shin splints), Achilles tendinopathy (AT), patellofemoral pain (PFP), Iliotibial band syndrome (ITBS) and plantar fascia pain (PF).

The median time to recovery for ALL types of injuries was 56 days. Yes, you read correctly. Actually let me show you the average recovery times the study found.

Plantar fascia - 35 days

Calf injury - 49 days

PFP - 49 days

AT - 56 days

ITB - 56 days

Gluteus medius tendinopathy - 56 days

Shin splints - 70 days

Hamstring - 74 days

Medial meniscus - 89 days

Surprised or shocked? You should know that effective recovery takes time. Tendons, cartilage, muscle  and especially bone will nor respond to any "magic recovery hacks" or when you try do more. They will respond to patience and appropriate loading. 

When you try to rush your rehab, it usually does not shorten the time line. It will increase the risk of flare ups, setbacks and recurrence.

Now please take note that good and correct rehab is not slow, just appropriately paced. Not everyone will take the same time to recover like those quoted in the study. Recovery is not passive, you can still train. Can't run, stationary cycling should be fine. The healthcare professional treating you should be able to give you alternatives, otherwise you should find another. It is definitely not one size fits all. 

The devil is always in the details. Only 140 out of 839 runners got injured. "Recovery" was self reported by the runners based on return to running without symptoms not performance goals.

The study did not review load management, rehab quality or whether the injuries presented early or late. Neither was training age, sleep, stress levels, nutrition nor psychology taken into account.

The goal is to work within and with the time line, not to beat it. You want the recovery to be boring but steady.

Do not believe anyone who tells you they can give you a short cut.

Reference

Mulvad B, Nielsen RO, Lind M et al (2018). Diagnoses And Time To Recovery Among Injured Recreational Runners In The RUN CLEVER Trial. PLoS One. 13(10): e0204742. DOI: 10.1371/journal.pone.0204742

An Alarming Health Trend In Our Children

Picture from QMHC

I have noticed an alarming trend. Quite a few young patients I have seen in our clinic recently have hypertension (or high blood pressure). This is supported by a recent study showing that childhood hypertension rates are rising significantly around the world. 

The researchers analyzed 443, 914 young subjects aged 1-19 from 21 different countries from 96 studies. Sub-group analyses were performed by sex, age, urban versus rural settings, investigation period, BMI group. Ready for the results?

High blood pressure nearly doubled between 2000 and 2020 in children, rising from just over 3 percent to more than 6 percent. Many young children show early warning signs. Around 8 percent had blood pressure levels that suggest they may be at risk of developing hypertension in the future. 

Some children had 'masked' high blood pressure. 9 percent of children and teenagers had normal reading when tested in a clinic. They however, had higher levels when measured at home or when tested with specialized monitors suggesting that they can be overlooked.

They also found that blood pressure increased during early teenage years. Levels tend to peak at around 14 years, especially in boys. Weight plays a major role. Almost 1 in 5 children with obesity had high blood pressure compared to less than 1 in 40 children with normal weight.

This matters since the increase in blood pressure can continue when they become adults leading to a risk of heart and kidney problems. The study also highlights the fact that this condition is more common than realized and more must be done to to detect the 'masked' cases since early detection can lead to early treatment. Preventative action can be implemented in countries where childhood obesity is increasing.

Picture from Nature

The need for reliable detection, consistent measurement and effective prevention needs to standardized as high blood pressure increases among children and adolescents under 19, now that we know the scale of the problem. They are after all our future.

Reference

Zhou J, Shan S, Wu J et al (2025). Global Prevalence Of Hypertension Among Children And Adolescents Aged 19 Years Or Younger: An Updated Systematic Review And Meta-Analysis. The Lancet Child & Adoles. 10(1): 11-21. DOI: 10.1016/S2352-4642(25)00281-0