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When can I Return to Running After An Injury

As a physical therapist, I am often asked by runner’s, “When will I be able to run again?” As a runner myself, I understand it is hard to take time off from training. We live and breathe by our weekly mileage and training plans while we continue to grind through the pain. At some point, some of you might realize that all the Kinesio-tape and foam rolling may not get rid of your pain. Could it be the dreaded plantar fasciitis or runner’s knee? No, that couldn’t possibly happen to me. It will go away with time and I can run through it. After weeks or even months of running with pain, you realize it’s not getting any better and maybe even worse, causing an interference in your training. This leaves you with two looming question: How do I recover and when do I know if I am ready to run after an injury? If you are still having running knee pain, read here, if you have running ankle pain or ankle sprains, read here.

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6 Checkpoints  Before you Return to Running After an Injury

Now if your injury is severe enough to stop your training in its tracks, here are a few rules of thumb to keep in mind when you are thinking about starting back up:

1. No Pain at Rest, Without Painkillers
  • Painkillers can block the reality of how you are feeling. If you have to load up with ibuprofen or something stronger in order to be pain-free, chances are you are not ready to go back to training yet.

2. Ability to Put Your Full Weight Through Your Foot
  • First, you crawl, then walk, then jog, then run. If you can’t put full weight on your foot without pain, your body is not ready to accept the additional load that running requires.
  • Each step taken during your average run creates a 3x bodyweight impact force that travels up your leg.

3. Full Pain-free Range of Motion
  • Running requires increased motion at all joints (hip, knee, and ankle) of your lower body compared to walking.
  • If you don’t have full movement potential in your joints, your body is amazing at adapting and finding a way around your limitations. However, over time these compensations can lead to other injuries in the future.

4. Able to Perform Bodyweight Squats and Lunges
  • This rule of thumb connects all previous requirements- strength, mobility, and tolerance of increased weight throughout your lower body.

5. Good Balance (A.K.A. Hip Abductors)
  • Ever heard of runner’s knee or plantar fasciitis? Weakness in your hip abductors is often the root cause of issues further down your body.
  • Your hip abductors are the most important muscles related to injury prevention in running. Every time you stand on one leg, your hip abductors prevent your body from collapsing and allow you to transfer force to the opposite leg. Without this stability, you’re at an increased risk of having your knees collapsing in. This causes increased stress to be translated through your feet, ankles, knees, hips, and even back! Luckily, with training, you can prevent this from happening! 
  • How do you tell if you have good hip stability? Can you do a single leg pistol squat without letting your knees touch? Have a friend take a video of you running and take a look if your knees are coming in contact with each other. 

6. Double and Single Leg Hopping in All Directions
  • Running is all about repetitive impacts. If your lower body can’t tolerate more than 100 single leg hops, how is it going to be able to handle the 1000-2000 steps it will have to take in a mile?

Conclusion 6 Checkpoints Before you Return to Running After an Injury

There are endless reasons why more than 60 million Americans make running a part of their weekly routines. Running gives you more energy to get through your day, the confidence from getting fitter and stronger, and the drive to keep pushing yourself to the limit. It is devastating to not be able to do what you love and we understand that. Unfortunately, the repetitive nature of this activity can take a toll on your body without proper training and recovery. Running with pain does not have to be a norm in your life. Physical Therapy can get you back on your feet in no time and running faster than ever! If you or someone you know is dealing with any of these issues, come on into COR for a free trial to discuss training plans, screen for injuries, and get you moving better than ever!

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References:

  1. Resistance Running. Chris Johnson, PT. Zeren PT.
  2. Variability of Ground Reaction Force Characteristics for Slow Running Speeds. G. A. Smith, FACSM and J. B. Fewster. Oregon State University.
  3. Return to Running Program.  Steven L. Cole, ATC, CSCS. College of William and Mary.