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Missed The Return To Running Webinar? Here’s The 3 Min. Recap

academic clinical pearls forefoot running return to running running gait anlaysis running injury Dec 12, 2023
Missed The Return To Running Webinar? Here’s The 3 Min. Recap

In case you missed the webinar, “Ready, Set, Run: Crafting A Successful Return To Running Program” we discussed returning to running after injury. In this 3 minute recap we’ll cover the fundamental principles of a return to run program, how to assess a patient’s readiness to return to running and interventions to improve return to running success. Also, our panel of surgeons, physicians and physical therapy running experts analyzed running case studies and explored topics such as running gait analysis, PRP shots, cortisone injections, therapeutic exercise, gait retraining, training regiments and the latest evidence based research to improve running outcomes.

The Principles Of Returning To Running

The principles of returning to running are based on integrating clinical reasoning into running duration, frequency and exertion. A typical return to run program assumes that all runs will be performed after a 5 minute walking warm up, without pain and at a zone 2 intensity (able to easily carry a conversation). Running experts MUST provide specific instructions to runners on run vs walk durations and the amount of rest days between each run. Evidence shows starting with 5 repetitions of 2 minutes of running followed by 1 minute of walking is beneficial. Strength training and gait retraining should also be integrated into a return to run program depending on injury type and running gait deviations. Gait retraining feedback should decrease throughout the return to run program. 

Readiness To Run

Another important factor when implementing a return to run program is determining if a patient is ready to start running. Two very important ways of determining a patient’s readiness to run is to use functional tests and the limb symmetry index (LSI). Many running experts are familiar with functional tests when determining if a patient can start a return to run program. Give special consideration to functional tests specific to the runner’s injury location and functional limitations. For example, a runner recovering from achilles tendinopathy would potentially benefit from testing both SL heel raises (reps) and single leg jump (distance). Once these special tests are measured the clinician can use the limb symmetry index to determine the performance of these tests on both the left and right lower extremities. Runners appropriate to start running should score >90% on the LSI. 


Watch the full webinar here:

Panelist Discussion

After learning about how to successfully return patients to running, our webinar panelists including orthopedic surgeons, physicians and physical therapists examined three complex running case studies. These patients included injuries such as ACL reconstructions, PRP shots and cortisone injections. Our discussion included patient specific strength training routines, gait retraining techniques and timeframe of recovery after PRP and cortisone injections. Here are several clinical pearls for running experts:


  • ACL patients benefit from utilizing functional tests such as single leg squat, jump drop test and the hop test cluster to determine if they are ready to return to running.
  • After a PRP injections to the achilles a patient should have a gradual return to loading affected tissues over 8 - 12 weeks. 
  • Cortisone injections to the gluteus medius can mask the symptoms of weak and inflamed tissue. Even if the runner is able to run pain free, strength training to improve hip stability and running form are essential to reduce further injury. 

Resources For You To Become A Running Expert

If you would like to improve patient outcomes when returning to running check out the continuing education course: The Essentials of Running Gait Analysis


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Grab the “Runner’s Knee Handout” for ready-made patient education. Pro tip: attach your business cards and contact info to these and hand them out at running events.