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Running plays a big role in both our physical and mental wellbeing. So when illness forces us to take a break, it’s no surprise that we miss it. Many runners worry about losing fitness and feel a strong urge to pick up right where they left off.

But while it’s tempting to jump straight back in, returning to running too soon or too hard can set you back further. Recovery is personal, and everyone bounces back at a different pace. The key is to return gradually and mindfully. Here, Dr Juliet McGratten shares her expert advice on how to come back to running safely and sensibly after illness.

Guide to returning to running after illness

Am I ready to start running again?

As much as you might like to get out running as soon as you can, you need to wait until you are fully better before you run again. When you’re eager to get back to it, it’s easy to overestimate your abilities and a full recovery may take longer than you think or want.

Doing too much, too soon will only prolong your recovery, so it’s important to be honest with yourself. Obviously, the more unwell you have been, the longer your recovery will probably take. But even if you’ve only had a mild illness, you need to make sure you are both physically and mentally fit enough to run again.

Ask yourself these seven questions:

1. Can I cope with normal daily activities such as showering, cooking and cleaning without feeling wobbly and ready for a lie-down?
2. Can I get through my normal, working day okay?
3. Can I take a brisk walk or run up a set of stairs without coughing or feeling breathless?
4. Have at least 48 hours passed since I had a high temperature?
5. Am I eating and drinking normally?
6. Has my resting heart rate returned to its normal levels? (Only answer this question if you are used to tracking it).
7. Has my fatigue lifted and do I feel strong enough to run?

Being ill is a workout in itself for your body and you shouldn’t add the extra exertion of running until you answer yes to all of these questions.

What are the risks of returning to running too quickly after illness?

Waiting until you’re well and gradually returning to running will help you to avoid the risks of running too soon. These include:

1. Possible injury from weak muscles or unstable joints.
2. Prolonged illness from adding extra strain to a busy immune system.
3. Faintness or abnormal heart rhythms from dehydration, high temperatures and a fast heart rate.
4. Feeling of failure from not meeting your own expectations.

Simply waiting a few extra days and taking things slowly will mean you avoid these problems.

How do I return to running after COVID?

Returning to running after infections that affect your respiratory system, such as Covid-19, need extra caution. It’s important to ensure that your breathing is back to normal and that your energy levels are good. With Covid-19, it’s safer to wait a full week after any fever, to be certain there are no delayed spikes of temperature.

What do I do if I have Long Covid?

Long Covid is a complex and poorly understood syndrome that can occur in people after they’ve contracted Covid-19 and it’s estimated that about two million people in the UK have it.

We spoke to physio Tim Allardyce. He works in a Long Covid clinic, supporting those who have it with rehabilitation.

He told us that that Long Covid does not appear to be related to the severity of the initial Covid-19 infection, and the most common symptom is severe fatigue. Many people are finding symptoms very debilitating and reporting that they struggle to do everyday activities such as walking to the shops. Small amounts of activity cause breathlessness and tiredness, sometimes causing people to feel exhausted for several hours to two days afterwards.

One thing Tim often sees in the clinic is that doing more seems to make things worse, so the first advice is to take things slowly. The length of recovery varies, but he’s seen people suffering for months and some for over a year.

There are no obvious quick fixes but the slow-and-steady approach tends to work best, according to Tim. You can start to run again as soon as you can comfortably walk for 30 minutes.

Start building up to this with something like a five-minute gentle walk before sitting down and taking a break. Increase that by a few minutes a day until you can walk for 30 minutes.

Start with just five minutes of running a day, and if you feel particularly tired after a run reduce that time for your next one. Try the walk/run method or follow a beginner runner’s training plan.

Will illness cause me to lose my running fitness?

There’s good news on this front! Illness often leaves us feeling as though we’ve lost the ability to do even basic life tasks, let alone run a fast 5K. But it’s actually not true. If you were someone who ran or exercised regularly before you got ill, you will have a higher level of basic fitness than someone who has never exercised.

You will lose your fitness more slowly than an unfit person and you will regain it more quickly too. It’s true that the longer you have been off, then the more you will have lost, but be reassured, you won’t be going right back to square one.

Your cardiovascular or aerobic fitness will drop off more quickly than your muscular or structural fitness, but our bodies will be able to quickly regain both if you return to exercise in the right way.

How do I return to exercise after illness?

Walking is the ideal way to start exercising again. You can slowly increase your pace and distance and it leads perfectly into running once you are confident your body is coping with the walking.

1. Start with a short distance locally.
2. Take some water and your phone with you.
3. Always listen to your body. If you feel light headed, shaky or just weak, then have a rest, head home and try again in a day or two.
4. You can also do some light recovery exercises at home to get your brain and body used to working together again.

The other thing to prioritise before you start running as normal again is strength training. During periods of inactivity, muscles become weaker. These include the muscles that keep us stable such as our core, glutes and muscles surrounding our ankles and knees. Rushing straight back to running without strengthening these could mean a higher risk of injury. Thankfully they can be easily strengthened with simple exercises done at home.

How do I get back into running after illness?

It all depends how long you’ve been ill for. If you’ve been taken down by a nasty cold for a week or so, you can return to your previous running schedule, but reducing speed and distance, or swapping in a run for a walk instead until you feel fully recovered.

If you’ve been ill for several weeks, you may want to take things a bit more gently to avoid putting extra strain on your recovering body. Following a full or accelerated 5K training plan can be a great shout, as it provides a focus but also will ease your body back into running.

The other thing you can do is to maintain a healthy immune system to allow your body to recover. Eat a nutritious balanced diet, avoid processed food and reduce your sugar intake. Avoid fizzy drinks and having too much coffee or tea and instead drink plenty of water. Keep your vitamin D levels up during winter, too.

How long will it take to get back to full fitness?

Everybody bounces back at their own rate. That’s partly determined by genetics, but the longer you have been off running, the longer it will take to return to full fitness. After a quick head cold you can be back on form within a week, but expect several weeks or even months after severe illness. It’s usually much quicker than you think though, so don’t be disheartened. Listen to your body. Adapt and adjust according to how you feel and remember you’re likely to feel tired afterwards, so take plenty of recovery days.

How long before I can race again after illness?

If you were halfway through training for a race when you became ill, don’t panic and rush back into your training plan where you left off. Unfortunately, race training doesn’t always go to plan and illness is a part of that.

If you’ve still got lots of time before a race, ease back into your plan slowly – you will still be able to cover a lot of the mileage that you need before the race, and might even be able to do some of those speed or interval training sessions once you’re fully back to fitness. If you have a race booked soon after you’ve been ill that you don’t want to miss, adjust your expectations and perhaps consider it as a training race or social run instead.

Illnesses that have given you high temperatures, diarrhoea or vomiting are particularly prone to sapping your energy, making longer races particularly hard. If you haven’t got a race booked but would like to do one, choose a shorter race for your comeback and ensure you feel comfortable at that distance in training before you race it.