‘Rehab Running’ & Why it is Crucial to Returning to Sport

If you have sustained an injury while playing sport, you may have heard of the term ‘rehab running’ before. But what exactly is it, and why is it important to implement into my return to sport rehab protocol?

Having worked in local and semi-professional sport settings for several years, it has become clear that rehab running can be the difference between a successful return to sport or the recurrence of symptoms and subsequent re-injury. It may sound redundant at first glance, you’ve been completing all of the exercises prescribed to you by your physio and/or EP (exercise physiologist), and your strength scores are off the charts. Surely you’re good to go back to playing next week’s game, right? However, without completing any rehab running, you may find your symptoms unchanged during training or matches. Not to worry, as this is your guide to rehab running and why it is crucial to returning to sport.

 

The term ‘rehab running’ refers to the process of gradually returning to sport or running based activities. This part of the rehab process is often overlooked for the everyday community level athlete, or the exercise enthusiast preparing for their next big event. Similar to a traditional resistance training rehab protocol, rehab running involves progressing your workload as you are exposed to varying levels of running activities. This is why rehab running is important to return to sport, it is specific! Not only do you become conditioned for these activities again, but we find it also builds confidence which is key to proper technique. Each sport or activity requires a unique set of movement patterns and skills, making each rehab running protocol different. However, there are some general running parameters consistent across all rehab running plans.

What’s Included in a Rehab Running Plan?

1. Volume

Arguably the most important parameter. When first re-introducing some running into your training, it is vital that you don’t overload the body straight away. When determining the volume of a rehab running session, we are considering what amount of load your body is currently able to tolerate. This may start as little as 800 meters at a light jogging pace, especially if you’ve spent a long time off-feet, before building into higher total distances.

2. Speed

Next is introducing some higher intensity running. This usually involves repeated efforts of building up speed to a specific pace, then holding that pace for a set distance (usually between 40-60 meters). The focus is not to accelerate quickly (that comes later), but rather how fast you can go without any symptoms. Again, we may start at around 70% maximum speed, then gradually progress when allowed.

 

3. Acceleration/Deceleration

Now we move into the more ‘explosive movements’. This parameter is focused on how well you can take off and put on the brakes. During these movements, there are high amounts of loading going through the body in a short time period. The time spent working on this parameter is dependent on the injury. For example, injuries involving the ACL will require a lot of exposure to acceleration/deceleration drills, as these movements place a lot of stress on the ACL.

 

4. Change of direction

The last core parameter in rehab running is change of direction. This is key in sport to respond to all the different game scenarios that may occur. A good rehab running plan will involve varying difficulties of change of direction drills during the majority of the plan, from simple ‘S’ or ‘Z’ shaped running, then progressing to some lateral change of direction, before lastly including elements of unpredictability to mimic game scenarios

No matter what stage you are at, you need to be completing your activities without any discomforting symptoms. This includes any constant or worsening pain, pulling, tearing, and tightness. Additionally, you cannot have any swelling or abnormal soreness the following day. If you have any of these symptoms, it simply means that the amount or intensity of running was too much. In this case, it’s best to apply ice, rest for the day, and try again the following day.

There are also some other factors to consider during rehab running, including:

 

a. Running technique

This is a major contributor to most non-contact injuries. We mostly see poor technique during change of direction drills, which results in increased loading to parts of the body such as the knees. Without addressing poor running technique, your risk of re-injury remains very high.

 

b. Load Management

After sustaining an injury, you’re most likely sitting on the sidelines during games and field training sessions for some time. Returning to a full training load without gradually building back into it will likely result in setbacks due to an intolerance of the sudden spike in load. Even in instances where your injury isn’t significant, it is wise to reduce your load. For example, you could complete the first 45 minutes of training, or you could complete the entire training session, but limit your intensity to 80% maximum.

 

c. Contact/kicking

This heavily depends on the injury and sport, but can be a major factor in your rehab running. Early stages of some rehab running plans will necessitate a ‘no contact’ or ‘no kicking’ period, before reintroducing them with controlled drills.

 

d. Activation Exercises

This is where your traditional, gym-based rehab comes into play. It is important to remember that with any running-based activity, a proper warm-up is crucial in the prevention of injuries. Certain exercises act well as a warm up before moving into your rehab running. Some of these exercises may be the same as you have been performing already (think exercises like crab walks and Spanish squats), some may be entirely specific to running or your sport.

Now that you have a better understanding of rehab running and what it involves, what should my rehab running look like? If you’re currently going through your own rehabilitation or simply want some advice on how to manage any issues (no matter how minor), come into Sport & Spinal Physiotherapy. One of our experienced Exercise Physiologists can tailor a rehab running program just for you.