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Returning to Running After Injury: A Comprehensive Guide


Returning to running after injury can be both exciting and daunting. Whether you're recovering from ankle, knee or hip injuries understanding the nuances of rehabilitation is crucial to prevent setbacks and ensure a smooth return to the sport you love. Here’s everything you need to know.


Common Running Injuries and Causes

Some of the most prevalent running injuries include patellofemoral pain (accounting for 48.8% of knee injuries), tibial stress fractures, IT band pain, and Achilles tendinopathy. These injuries can stem from a combination of factors:


- Biomechanics: Running mechanics play a significant role, affecting how forces distribute through your body.

- Training Loads: Sudden increases in mileage or intensity can overwhelm tissues, leading to injury.

- Tissue Health: The condition of muscles, tendons, and bones influences injury risk.

- Genetics and Psychosocial Factors: Individual traits and psychological stressors can impact injury susceptibility.


Injury Mechanisms and Rehabilitation Principles

The primary cause of running injuries is applying load that exceeds tissue tolerance. Whether you’re a young runner prone to knee and stress injuries or an older runner facing calf or Achilles issues, understanding these mechanisms can guide your rehabilitation strategy.

Returning to running demands a structured approach to manage load and promote tissue adaptation:


- Progressive Overload: Gradually increase training load to slightly surpass your current capacity, fostering adaptation while minimizing injury risk.

- Training Intensities: Aim for 80% low-intensity, and 20% high-intensity workouts. Moderate intensity should be managed carefully to balance recovery and performance gains.

- Periodisation: Build training volume over 2-3 weeks followed by a recovery week (maintaining an 80:20 ratio for training intensity and reducing volume by 20-30%).

- Strength Training: Incorporate heavy slow resistance training to enhance tendon stiffness and plyometrics to improve energy storage and release rates.


Practical Tips for Returning to Running

- Cadence Adjustments: Increasing your running cadence by 5-10% can significantly reduce the forces applied to your body.

- Cross-Training: Walking is an excellent cross-training option, aiming for 10,000-12,000 steps daily, with one block of 4,000-6,000 steps specifically tailored for running preparation prior to the re-introduction of running.

- Managing Variations: Be mindful of hills, speedwork, long runs, and trails, as they introduce varying loads. Consult your physiotherapist to integrate these aspects safely into your routine.


In conclusion

Returning to running after injury requires patience, diligence, and a well-structured rehabilitation plan. By understanding the causes of common injuries, managing load effectively, and incorporating targeted strength and conditioning exercises, you can ensure a successful comeback to the sport with reduced risk of reinjury. Remember, your journey back to running is as much about listening to your body as it is about pushing its limits safely and smartly.


Embrace the process, trust your physiotherapist, and enjoy the rewarding feeling of hitting the pavement once again!


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