A Return To Running Program

Return To Running Program

Rehabilitation of an injury requires returning the individual to pre-injury activity levels. Achieving this frequently involves a return to running. Below is a simple outline I use in my clinic for returning patents running. Where running is an important component of their training, sport (and life). Obviously this is not a “one size fits all” return to running program. Just a useful guide to help slowly progress the rehabilitation in some patients. Where the goal is to safely include some running in their training.

Who Can Use This Return To Running Program?

Specific conditions I have used this return to running program successfully on include; patients with patellofemoral pain syndrome (runners knee), ITB frictional syndrome, Achilles tendinopathy and plantar fasciopathy to name a few. The program can also work well in lower limb post surgical rehabilitation such as following significant fracture, ankle surgery or ACL reconstructions…

Be Guided By Your Treating Practitioner

Implementation of any return to running program should be guided by your physiotherapist. Or appropriately skilled treating practitioner such as sports podiatrist or sports medicine specialist. This program is not a substitute for previously prescribed rehabilitation exercises. Generally speaking any prescribed rehab exercises should still be continued throughout the return to running program. Unless advised otherwise by your treating practitioner. This return to running program is generally only appropriate:

• When the individual can walk at a fast pace with out a limp for at least 30 mins pain free.
• Where an individuals injury has almost fully healed.
• When indicated as ready by your treating physiotherapist, or practitioner.

The return to running program begins at stage 1 and is broken up into four five minute blocks consisting of some walking and some jogging totaling 20 minutes of activity. Over subsequent stages the jogging to walking ratio is progressively increased until at the completion of the program (stage 19) consists of 20 minutes of continuous jogging. Example: Stage 1: Walk for 4 and a half minutes then jog for half a minute, repeating this cycle four times without rest between the cycles.

Stage	Walk (Mins)	Jog (mins)
1	4.5	0.5
2	4.5	0.5
3	4	1
4	4	1
5	3.5	1.5
6	3.5	1.5
7	3	2
8	3	2
9	2.5	2.5
10	2.5	2.5
11	2	3
12	2	3
13	1.5	3.5
14	1.5	3.5
15	1	4
16	1	4
17	0.5	4.5
18	0.5	4.5
19	0	5

 

When To Progress To The Next Stage?

Ideally the program is performed 2-3 X a week with 1 – 2 days recovery between each session. Progressing to the next stage 2-3 days after the last session. Providing that the current stage was performed without any increase in your symptoms during or after the session. Please Note: When looking at the table you will notice that the walk to run ratios are repeated over two stages, meaning stage 1 and stage 2 are the same and then Stage 3 and Stage 4 are the same and so on… This is intentional, DO NOT skip stages! Simply because you completed Stage 1 successfully does not mean you jump directly to Stage 3. There are no shortcuts. The return to running program should take around 6-8 weeks to complete. Clearly this is dependent on the frequency of training, and accounting for any minor setbacks.

My Symptoms Have Increased What Do I Do?

If you experience an increase in pain, or symptoms during or after one of the stages. It is recommended you have a few recovery days to allow your symptoms to settle, then drop back to the last successfully completed stage. With a lower jogging to walking ratio, and look to build up again from there. Generally it is always advisable to contact your physiotherapist if you have any concerns around how to progress your program.

A Simple Tip For Returning To Running After A Long Hiatus

How fast should you return to running when you are first starting out. As running distance is clearly not the only variable to consider. Ease into a routine with a simple talk test approach. Slow down your running until you can pass the talk test. Which as it sounds, means being capable of carrying out a conversation while running. This talk test can be used in accompaniment with the above return to running program.

Other Return To Running Programs

Clearly the above guidelines are far from being the only approach for return to running after an extended break, low fitness levels, or injury…

• Some of my patients also follow a “couch to 5Km” training plan. This is a running plan tailored for beginner runners, and those returning to running after a long break. Not as suitable for the injured, rehabilitating population.
• Another guided method to return to running, and improve running in current athletes is the MAF method. A method that was devised by Dr. Philip Maffetone. It is based on 40yrs of clinical and scientific research. This MAF Method uses heart-rate training to build your fat-burning engine. But has some great guidelines that I find make it really suitable for returning people to running successfully following injury.

Disclaimer: Sydney Physio Clinic provides this information as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance on A Return To Running Program should consult his or her physiotherapist or otherwise appropriately skilled practitioner.