Most endurance athletes will attest that their best performances and biggest improvements have come after extended chunks of consistent training.
When you have long training blocks with no interruptions due to illness, injury, or otherwise, you can continually make gradual progress in the forward progression without losing any ground from time off.
However, as much as we’d all love never to be sick or hurt again, unfortunately, illnesses and overtraining injuries are somewhat inevitable at some point (well, maybe not injuries if you’re training smartly).
If you’re forced to take time off from running or working out, how do you return to training when you feel better?
Jumping back into the key workouts you did before you got injured or sick is likely too much for your body, depending on how long you were inactive. So, how should you adjust your training plan after time off to rebuild to your previous fitness level?
We’ll discuss how to adjust your training plan after time off due to injury or illness, from just a few missed workouts to over three months of inactivity.
How To Adjust Your Training Plan After Time Off Due To Injury or Illness
As a running coach, the following guidelines are what I use with my athletes for how to get back to running after time off:
1-3 Days Off
If you took a day or two off, you shouldn’t need to adjust your training plan and be able to jump right back in, provided you feel back to 100%.
You have not lost any fitness at this point; if anything, your body is a little better from the extra rest and ready for your next workout.
However, if you had an illness with a fever, vomiting, or respiratory symptoms, you should listen to your body and expect yourself to feel somewhat weaker.
You should wait at least 24 hours (ideally 48-72 hours) after a fever breaks before going for a run. If you have vomiting and severe diarrhea, ensure you’ve hydrated aggressively with fluids and electrolytes before you try running.
If you’re feeling completely back to normal and just had a minor niggle or felt a little under the weather and missed one workout or two, you can resume your training cycle exactly where you were.
If your return-to-running day falls on a hard workout, however, you might want to shift the workout a day or so and swap it with an easy run that day; just go get your “sea legs” back under you.
4-7 Days Off
Generally speaking, if you took 4-7 days off from training due to injury or illness, you can resume your training plan where you left off, as if you had taken just a few days off.
Taking less than a week off from running will have no impact on your aerobic fitness (VO2 max) or your muscular strength and endurance. In other words, you’re just as fit as you were before you stopped training, whether it’s cardio or strength training.
Heed the same advice regarding returning carefully after fevers, respiratory illnesses, and vomiting illnesses. Make sure you give yourself enough time to recover.
One Week to 10 Days Off
If you take a week or so off, it’s natural to start to worry that you’ve lost some fitness and won’t be in top shape anymore. Rest assured, studies show that you don’t lose any fitness unless you’re sidelined for at least two weeks or so.
With that said, if you had an illness or injury that had you resting for 7-10 days, there’s a good chance that it was more than the mildest of sicknesses or pains, so you can expect that you might not be feeling your best the first run back.
Although taking 7-10 days off from training doesn’t in and of itself obligate you to adjust your training plan because your fitness hasn’t really declined, it’s usually a good idea to take your first 1-2 days back easier than you usually would.
Slow your pace or just run by effort and time rather than distance. Also, consider shortening the distance of your run. Don’t do a speed workout such as an interval workout or long run—just stick with an easy base run.
Stop and walk if you feel tired or notice symptoms like dizziness, breathlessness, or pain. Focus on recovery by hydrating and getting a high-protein snack or a nutritious meal.
Try the next day again, meeting your body where it is. If you train smarter, you’ll recover faster.
2 Weeks Off
Once you hit roughly the 2-week mark in terms of time off from running, you’re starting to venture into territory where some amount of aerobic fitness has been lost.
Studies show that you lose about 5-7 percent of your VO2 max after two weeks of inactivity.
This isn’t necessarily a ton, but it can affect how you feel when running. Your heart rate and respiration rate will be higher than previously at similar submaximal paces.
As a result, you’ll need to adjust your training load after two weeks off.
Take a full week to get back up to speed, literally and figuratively. Depending on why you took time off from running, you may even need a full two weeks.
As a general rule of thumb, run about one to two minutes per mile (45-90 seconds per kilometer) slower than your usual pace.
Moreover, run about 50-75% of the distance or time you would have run before your time off, gradually increasing this percentage over that first week back as tolerated. This will help prevent muscle soreness and get your legs accustomed to running again.
3-4 Weeks Off
You start to lose aerobic fitness (VO2 max) fairly rapidly after two weeks, so by 3-4 weeks off from running, you can expect your VO2 max to drop by at least 7%.1Coyle, E. F., Martin, W. H., Sinacore, D. R., Joyner, M. J., Hagberg, J. M., & Holloszy, J. O. (1984). Time course of loss of adaptations after stopping prolonged intense endurance training. Journal of Applied Physiology, 57(6), 1857–1864. https://doi.org/10.1152/jappl.1984.57.6.1857
Evidence suggests2Mujika, I., & Padilla, S. (2000). Detraining: Loss of Training-Induced Physiological and Performance Adaptations. Part I. Sports Medicine, 30(2), 79–87. that detraining results in a rapid loss in maximal oxygen uptake (V̇O2max), blood volume, ventilatory efficiency, increased reliance on carbohydrate metabolism during exercise, lowered glycogen levels, reduced lactate threshold, decreased capillary density and oxidative enzyme activities in skeletal muscles, among changes in hormones.
Furthermore, evidence suggests3McMaster, D. T., Gill, N., Cronin, J., & McGuigan, M. (2013). The Development, Retention and Decay Rates of Strength and Power in Elite Rugby Union, Rugby League and American Football. Sports Medicine, 43(5), 367–384. https://doi.org/10.1007/s40279-013-0031-3 that you start to lose muscular strength after three weeks of inactivity.
The muscles, tendons, ligaments, joints, and bones in your feet, legs, arms, and core will need to adjust to the forces and stresses of running again, since some adaptations in these tissues are lost after 3-4 weeks of disuse.
When considering adjustments to your plan, it’s around this time—3-4 weeks off—that significant changes are typically needed.
Expect it to take at least two weeks to return to your prior volume and intensity if you took three weeks off from exercise and three weeks to come back to full training after a month off.
Depending on your prior fitness level and overall training plan, this may be slightly more conservative than it ultimately will be. Still, it’s a good rule of thumb to set reasonable and healthy expectations.
Coming back too aggressively to your prior workout routine is likely to result in injury.
1-3 Months Off
After a month of rest due to injury or illness, you will have to essentially restart your structured training plan by rebuilding your base.
One study4Pedlar, C. R., Brown, M. G., Shave, R. E., Otto, J. M., Drane, A., Michaud-Finch, J., Contursi, M., Wasfy, M. M., Hutter, A., Picard, M. H., Lewis, G. D., & Baggish, A. L. (2018). Cardiovascular response to prescribed detraining among recreational athletes. Journal of Applied Physiology, 124(4), 813–820. https://doi.org/10.1152/japplphysiol.00911.2017 examined the effects of four weeks of inactivity (less than 2 hours per week of exercise) after an 18-week training program culminating in the 2016 Boston Marathon in 21 male runners.
Among the most notable changes, subjects experienced an average decline in plasma volume of 6%, left ventricular wall thickness of 8.1%, left ventricular mass of 10.3%, and right atrial area of 8.2% after four weeks of detraining.
Another study5Coyle, E. F., Martin, W. H., Sinacore, D. R., Joyner, M. J., Hagberg, J. M., & Holloszy, J. O. (1984). Time course of loss of adaptations after stopping prolonged intense endurance training. Journal of Applied Physiology, 57(6), 1857–1864. https://doi.org/10.1152/jappl.1984.57.6.1857 demonstrated that VO2 max dropped to 16% below the initial value achieved during training after eight weeks of inactivity.
However, it stabilized, and no further appreciable losses in VO2 max were noted at the 12-week mark of inactivity.
Moreover, although VO2 max had dropped significantly (16%), it remained higher after 12 weeks of inactivity than in sedentary control subjects who had never trained.
Therefore, although aerobic fitness drops quickly, fitness losses slow after two months or so.
Decreases in VO2 max during detraining were attributed to decreases in stroke volume, plasma volume, and ventricular muscle fiber strength.
All this is to say that after 1-3 months off due to illness or injury, expect to start back slowly.
Take about 3 weeks off for a month, or 4-5 weeks for 2 or 3 months, to regain your fitness and build back up to training.
During the first week, run every other day. The second week, start running two days in a row, followed by a day off.
The first two weeks should focus on base-building, with aerobic runs. Run at least 1-2 minutes per mile slower than your previous pace, and keep the weekly volume to 50% or less of your lower weeks in your prior training schedule.
For example, if your previous training schedule averaged 30 miles per week and peaked at 45 miles, run no more than 15 miles weekly for the first two weeks.
Then heed the 10% rule (don’t increase your mileage by more than 10% weekly) if you’re tired or breathless on your runs. Otherwise, you can potentially scale up by about 15%.
In the third training week, you can work back into fartleks, tempo runs, hills, and strides, gradually returning to your prior paces and intensities as tolerated.
More Than 3 Months Off
At this point, congratulate yourself on returning to running, but restart your training as if you are a beginner.
As you start back up, run no more than every other day, keeping your mileage low and your effort level easy.
Above all, when adjusting your training plan after illness or injury, listen to your body and use your physical cues to gauge how much you can run and when to dial it back.
Err on the side of caution, be patient, and enjoy the journey.
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