When can I start running after an injury? 
“When can I start running again after a lower limb injury?”
This is a question we get asked a lot.
Or….we are helping to treat injuries for people that may have had the wrong advice, or like me, get frustrated and return too soon.
One of the issues about returning to running, or any sport for that matter, after an injury is making sure the timing is right. Too often frustrations get the better of us and we start running too soon and “BAM” we find ourselves back where we started this time with pain in a different area.
You should think about running when again you can single leg press 125% body weight
Let’s start by looking at some of the mechanics behind running to give us an understanding of the forces involved then some progressive markers to help as a guide to return to running .
A study by Miller et al in 2012 found that the forces through the knees whilst running are almost as high as 8x your body weight.
That does not mean that these exercises are bad for our knees, quite the opposite knee cartilage will actually strengthen under high forces, what we need to be careful of is poor joint loading due to strength issues.
Before you return to running you want to aim for a relative strength index (RSI) of 125% and a limb symmetry index (LSI) of 100%.
But what does that mean?
Limb symmetry index (LSI)
In simple terms is how the left leg and the right leg compare to each other in strength. You should aim for a value of 100% or as close as possible.
Single leg press 1RM.
(Small number ÷ large number) x 100 = LSI
( 120 ÷ 150 ) x 100 = 80%
LSI = 80%
Relative strength index (RSI)
This is a number used to track current strength.
Before returning to running Clark et al found that being able to single leg press 1RM 125% of your body weight is a target to aim for.
If you weigh 100 Kg you should be able to single leg press 1RM 125Kg.
Multiply your weight by 1.25 to find the RSI for you.
Training Progression Plan
Want to know how to recover after injury? You want your training to follow this plan, starting from day 1 of training after your injury settles.
- Balance and proprioception. Working on the small movements and the control. standing on one leg and throwing a ball against the wall.
- Neuromuscular control & Movement patterns. Hip and knee control. Single leg dips and step downs.
- Single leg bodyweight. Working on equalising the strength between the legs
- Single leg weighted. Increasing the weight and building the strength. Best done using machines that this stage.
- Big Lifts. Starting on your squats and deadlifts.
- Dynamic lifts. Building up to more dynamic lifts such as cleans and squat jumps.
- Box jumps (up). Working on mid level jumps stepping down from the box. Only working on the up phase
- Deceleration drills (Down). Working on the drop down from the box jump, all about the controlled landing.
- Dynamic. Drop down into box jump or mini hurdles. Working in a straight line
- Lateral dynamic. Looking at lateral jumps and zig zag. This is about the reaction and change of direction.
- Return to running program. Looking at a walk run program building up to steady state.
- Full running. Everyone is happy
Resilience means something different to everyone
Build your resilience together with Riixo
- The capacity to recover quickly from difficulties
- The ability to recover readily from adversity.
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- Lenhart R L, Thelen D G, Wille C M, Chumanov E S, Heiderscheit B C. Increasing Running Step Rate Reduces Patellofemoral Joint Forces Med Sci Sports Exerc. 2014 Mar; 46(3): 557–564.
- Miller RH, Umberger BR, Hamill J, Caldwell GE. 2012. Evaluation of the minimum energy hypothesis and other potential optimality criteria for human running. Proceedings of the Royal Society of London B: Biological Sciences 279, 1498-1505
- Sanchis-Alfonso V, McConnell J, Monllau JC, et al. 2016. Diagnosis and treatment of anterior knee pain Journal of ISAKOS: Joint Disorders & Orthopaedic Sports Medicine 2016;1:161-173.
Long day’s journey into night By Frank Wainwright Ultrarunning is my freedom. The time it takes between start line to finish arch is my
Written By Frank Wainwright September 2020: I was in good shape as a limited number of events came out of hiding. I was in