So you’re coming off a surgical procedure or injury that has stopped you from running (while we don’t always recommend a complete stop, it happens). How do you know when it’s time to return to running? There are 4 criteria that I look at to see if you’re ready.
- Pain
- Range of motion
- Motor Control
- Confidence
1. Pain
If you are experiencing pain after an injury and cannot run without doing so, continuing to run normally does not help. Many times, it makes things worse. Pain is my number one target when it comes to treating an injury. If we can treat pain and make it go away, range of motion, motor control, confidence will most likely improve.
2. Range of Motion
If you are coming off a knee injury and have limited range, you should have at least 100 degrees of knee flexion (that’s bending the knee) and at least 0 degrees of knee extension (straightening the knee) before running. When you can bend the previously injured knee at least 100 degrees, that gives the hamstrings enough reduction of force in the initial swing. If 0 degrees extension is present, that means the quadriceps muscle can relax when initial contact is made, reducing the chances of patellar tendinopathy. Once you have the range, motor control is needed to stabilize the motion.
3. Motor Control
Motor Control is defined as the ability to initiate, direct, and grade purposeful movement.1 I test motor control for running by having my patient perform a one-leg step down from a box. You should be able to step down without dynamic knee valgus (the knee caving in). Dynamic knee valgus is predictive of poor motor control and should be corrected. After your motor control is fixed, confidence is needed to get back on the trail.
4 . Confidence
Lastly, you need to feel confident to run. Kinesiophobia, fear of pain due to moving, is most common due to knee and back pathologies. Normally, the 3 aforementioned criteria help improve confidence, but not always. When confidence is a lingering issue, it is then my task to educate and show how confidence can be built despite breaking down the other barriers.
Conclusion
If you are struggling to get back to running after an injury, reach out. We are happy to see if you are ready to head back or require more recovery. Schedule your next appointment HERE.