I felt a little silly sitting on the table at the physical therapist’s office talking about my knees when there was absolutely nothing wrong with them. As suddenly as my knee pain appeared, it also disappeared. Never in a million years had I expected pregnancy and breastfeeding hormones to play tricks on my joints. After all, they were supposed to just relax my hips/pelvis so the baby could come out, not relax my knees and ankles so I couldn’t run after recovery. In an effort to control the controllables, I proactively saw a knee specialist and now a PT. The PT looked at me trying to figure out why I was there (and probably secretly thinking I was a little insane, as Baby rUnladylike sat in a carrier at my feet).

This was the first time I had ever been to a physical therapist. I know, I can’t believe it either since I’ve been running marathons and half marathons since 2009. I credit it to trying to not make these common running mistakes and really doing the little things to remain injury free. After ruling out any issues with my knees, the PT proceeded to do a complete assessment of my gait and muscle strength to identify any imbalances that could affect my running. Here’s what we found:

• My left glute is weaker than my right.
• My right hip flexor is weaker than my left.
• When I run, I swing my right arm back significantly more than the left.
• When I run, I’m landing on the outer edge of my foot, but I’m not over-pronating in my current stability shoes (Brooks PureCadence 5).
• My arches are a little weak, and my feet are close to being on the flatter side.

My physical therapist and I had a great conversation about returning to running and my running goals. We mapped what I feel is a solid plan for the next four weeks.

My Running Comeback Plan: The First Four Weeks

This week marks the first official week of my running comeback after a few bumps in the road. I’ve been able to continue cross-training and strength training, but I’ve finally reintroduced running back into the mix. Here is what the next four weeks will consist of:

1. PT exercises every other day

Every other day, I will perform the following exercises. I’ll share a video with you on how to do these next week so you can benefit from them too. They are customized to address the issues the PT found, including strengthening my weak glute, hip flexor, arches and abdominals.

• Single leg standing kicks with band (with standing leg on a block or step): 2-3 sets of 15 to 20 reps per side first with toe pointing out and then with toe pointing in
• Clamshells with band placed above knees: 2-3 sets of 15 to 20 reps on each side
• Bridges with alternating single leg kicks (can add band above knees over time): 2-3 sets of 15-20 reps per leg
• Lying hip flexor pulls with band (band around feet and bring one leg up to chest): 2-3 sets of 15-20 reps per leg
• Dead bugs (lying on back with legs in table top position, extend opposite leg and opposite arm at same time, hold for 5-10 seconds and repeat): 2-3 sets of 12 reps
• Standing arch raise, big toe raise and remaining toe raises: 2-3 sets of 15-20 reps each

2. Gradual run-walk intervals that increase week-over-week

When I first started running again after getting the green light from my doctor, I took a conservative approach. I started running 2 to 3 miles at a time with walk breaks as needed. Running proved to be the only exercise that was causing more stress to my joints and the hormones that were still swimming in my system. I’ve decided to take a more structured approach with run-walk intervals to avoid adding too much stress at once. Here are what the next four weeks will look like with my running:

Week 1: Run three times per week alternating one minute of running and one minute of walking for 30 minutes

Week 2: Run three times per week alternating two minutes of running and one minute of walking for 35 minutes

Week 3: Run three times per week alternating three minutes of running and one minute of walking for 35-40 minutes

Week 4: Run three times per week alternating four minutes of running and one minute of walking for 40-45 minutes

If everything still feels good after four weeks of using run-walk intervals and doing my PT exercises, I will begin running continuously without the walk intervals during week five.

3. Foam roll before runs

Although I use my foam roller after runs (truthfully not as often as I should), the PT encouraged me to start using my foam roller before runs as well to loosen things up (in addition to a dynamic warm-up). I’m going to make a consistent effort to do this.

4. Alternate shoe styles

The PT found that I may benefit slightly from more stability in my shoes than the PureCadence offer. Also, while at Brooks Altitude Camp, the elites talked a lot about wearing heavier/traditional shoes to train and lighter shoes for faster paced workouts and, of course, racing. I’m going to apply both advice and begin doing my easy runs in the Brooks Ravena which are heavier and offer a bit more stability than the PureCadence and then continue to race and do my faster workouts in the Cadence.

5. Continue strength training and cross-training

In addition to running three days per week and doing my PT exercises, I will continue to cross-train about three times per week, including spinning, elliptical and boot camp. I will also incorporate at least two additional days of strength training with barre, strength classes via ClassPass or at-home videos.

I’ll report back in four weeks to map the next four weeks and keep you posted on my progress. I’ll also share my weekly training recaps and Tuesday Transformation posts.

What approach have you used to return to running after injury or pregnancy? Do you see a PT regularly? Where do you find your muscle imbalances to be?