When can I run again after my knee surgery/injury?
This is a fantastic question and is one of the first things people ask us as Physical Therapists, especially if they were a runner before. Thankfully, some really good research has been conducted over the past few years to help determine how to safely transition back into running. Use the below guideline (with doctor or Physical Therapist supervision) to determine if it’s time to safely return to running.
Strength:
Strength is one of, if not the biggest, indicator you are ready to run. Your therapist will likely perform isokinetic testing with some sort of bluetooth device that measures force output on your affected quadriceps compared to your non-injured quadriceps. Your injured side should be able to produce AT LEAST 70% of the strength of your non-affected side to begin jogging.
Properly strength testing before starting running can help reduce patellar tendon/knee pain as you begin your return. The goal is to be at least 95% symmetrical when you are close to being done with rehab.
Movement patterns:
There are a few movement tests that are considered “quad dominant movements” that essential mimic the demands of running on the knee. These can include but are not limited to: single leg squat variations, lateral step downs, light bounding and lunge variations.
When we look at running mechanics, it is essential to possess the ability to achieve knee over toes (Tibial anterior translation). That is the purpose of the above mentioned exercises, it safely assesses readiness to run without a lot of stress on the joint.
Endurance
Commonly used endurance testing includes the ability to complete at least 25 unbroken single leg glute bridges and 25 single leg calf raises without rest breaks. Again, this is a quick screen that shows if the muscles that primarily support the knee can handle initiation of jogging.
Plyometrics:
Last, but not least: low level plyometrics. As you get closer to starting a jogging program, your rehab should begin to incorporate low level plyometrics to make sure the tendons in your leg are ready for the demands of jogging and running. When we run, we place up to 5-8x our bodyweight on our lower extremities, which is why it is so important to have that baseline strength we mentioned before.
Examples of this may include: light bounding, band assisted pogos, jump rope, high knees, butt kicks, etc.
Big picture:
If you are thinking about beginning to run again after an injury, these are some safe and well researched guidelines that can help assess readiness. Obviously, there are some other factors such as time, complexity of injury, running pattern (overstriding, weaving, etc.) that may play a role, but your physical therapist will be able to help guide you back to a jogging program safely.
If you or someone you know had a knee injury and wants to get back to running, reach out to us at 512-481-2777 and let us help get you back on the right track safely!
Image: Courtesy of Mike Hughes Physiotherapist
**** Disclaimer: this is not medical advice and returning to run after a knee injury is highly individualized. Please seek appropriate medical attention to determine readiness to begin jogging****