Injuries are unavoidable. $HiT happens! Whether it’s your knee, ankle, or hip, you need to follow a systematic return to a running protocol to ensure that you’ve built up the adequate strength to run. Getting back to running after an injury without a plan is like running a marathon without building up your mileage. It puts your body at increased risk of future re-injury! Follow these easy steps and you’ll be back to running in no time! This article will simplify how to get back to running.
What Happens After a Running Injury?
After an injury, the tissues (tendons, muscles, ligaments, etc) that were hurt are more sensitive to stress. What this means is that the “easy” 10k run you used to do might not be a cakewalk for your tissues anymore! When it comes to getting back to running, it’s all about gradually applying the load and stresses to your body in a systematic manner – a term called graded exposure. By applying load/stress in a graded way, you not only give time for your body (and brain) to adapt to the demands, but you also allow yourself to objectively determine how much running you can actually handle.
So, if the goal is to get back to running a 10k again, it’s most advisable to start with a smaller run, something like a 1k run would be perfect. Run that a few times and get used to it, and then slowly increase your mileage from there. For someone that is returning to running for the first time after surgery or a big injury, it may be advisable to start with even smaller increments (see below for a more detailed set of instructions).
Injured And Looking To Get Back To Running?
As a runner, the last thing you want to hear is to stop running. With this program, we will help guide you towards healthy, and even more efficient running! A lot of people think that you can just grab a pair of shoes and start running, which can be true. However, failure to prepare may set you up for failure. “You don’t run to get fit, you have to be fit to run.” Without proper training, education, and an understanding of healthy running hygiene habits, issues may arise that can keep you from running. The Running [P]Rehab Program will teach you the best cross-training routine for runners and education to help you maintain optimal running health. Learn more HERE!
Rules to Follow to Return to Running After a Knee Injury
The University of Delaware created a Treadmill Running Program that I typically utilize in the clinic with my post-operative patients. The protocol is divided into seven distinct levels, with certain benchmarks that need to be met before moving forward to the next level.
- LEVEL 1: 0.1 mile walk / 0.1 mile jog- repeat 10 times
- LEVEL 2: Alternate 0.1 mile walk / 0.2 mile jog – 2 miles total
- LEVEL 3: Alternate 0.1 mile walk / 0.3 mile jog – 2 miles total
- LEVEL 4: Alternate 0.1 mile walk / 0.4 mile jog – 2 miles total
- LEVEL 5: Jog 2 miles continuously
- LEVEL 6: Increase workout to 2 1/2 miles
- LEVEL 7: Increase workout to 3 miles
- LEVEL 8: Alternate between running /jogging every 0.25 miles
- Mandatory 2-day rest between workouts for the first two weeks.
- Do not advance more than 2 levels per week
- Two days of rest are mandatory between levels 1, 2, and 3 workouts
- One day of rest is mandatory between levels 4-8 workouts
- If sore during warm-up, take 2 days off and drop down 1 level.
- If sore during a workout, take 1 day off and drop down 1 level.
- If sore after a workout, stay at the same level.
Again, this exact progression is just simply a layout and does not need to adhere to exactly (nor should this be interpreted as medical advice from us). Managing runners can be tricky and we even have devoted an entire podcast to this topic. The important thing to notice is that you don’t go from 0 to 100 in 1 day, and you respect any soreness (joint, not muscular soreness) that may arise in your training. After you get back to running, of the most important things is reducing your risk for future injury, aka [P]rehab. And we’ve got you covered with that below!
Strength Training For Runners
Strength training for runners is absolutely imperative to help reduce the risk of injury and to help injured runners get back to running. While almost any exercise is better than none, we’ll highlight some of our favorite strength training exercises!
More Strengthing Exercises For Runners: Step Downs
Step-ups and downs are amazingly simple, yet truly effective in lower extremity rehab. Adding variability to the classic step-ups and downs is key to movement proficiency and developing a well-rounded athlete.
If These Exercises Are Not A Part of Your Programming Make Sure They Are Now!
This is a great drill for runners as it focuses on calf strength with the hip and knee in an extended position that also incorporates a single leg stability component. Be sure to add this exercise to your training regiment to improve your single-leg strength, balance, and control.
Core Strengthening for Runners
Let’s face it, there are a TON of exercises for the core. A lot of them would likely help with trunk and pelvis stability, but these three have specific implications for runners. Runners should perform core exercises that also target hip abduction and external rotation to help resist dynamic knee valgus.
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Storks for Runners
Here, I’m trying my best to replicate the biomechanics at the hip for a runner. The glutes are our primary controller of frontal plane motion in running. During loading response (when you strike the ground), your glutes need to eccentrically control your femur moving into flexion. As you progress over your foot, it requires the glutes to concentrically move the femur into extension. I added a more forceful concentric phase here to again, try my best to replicate the demands on the hips during running.
After reading this article, the important takeaways are that it is important to listen to your body after an injury, especially with an arduous physical activity like running. Jumping back into training too quickly can lead to a vicious cycle of re-injuries. There is a systematic and approachable way to increase your activity gradually after an injury while also working on what may have led to that injury in the first place! Combining a slow increase in your return to running plan as well as specific exercises to bulletproof your body for running will help you not only optimize performance but prevent further injuries down the road!
Take The Guesswork Out Of Getting Back To Running!
The Running [P]Rehab Program will teach you the best cross-training routine for runners along with [P]Rehab exercises to get you back to running, and more importantly, stay running. Learn more HERE!
About The Author
Michael Lau, PT, DPT, CSCS
[P]rehab Co-Founder & Chief Product Officer
Michael was born and raised in Northern California but now currently resides in Sunny SoCal ever since attending the University of California, Los Angeles as an undergraduate majoring in physiology. After his undergraduate studies, he received his Doctorate in Physical Therapy from cross-town rival the University of Southern California. As a licensed physical therapist with a strong background in strength and conditioning, Michael likes to blend the realms of strength training and rehabilitation to provide prehab, or preventative rehabilitation, to his patients. A common human behavior is to address problems after they become an issue and far often too late, which is a reactionary approach. He believes the key to improved health care is education and awareness. This proactive approach-prehab-can reduce the risk of injuries and pain in the first place. He is a huge proponent of movement education and pain science. Clinically, he has a special interest in ACLR rehab and return to sport for the lower extremity athlete.
Disclaimer – The content here is designed for information & education purposes only and is not intended for medical advice.