Learning About Returning to Running After a Knee or Ankle Injury

Getting back to running after a knee or ankle injury is a step-by-step process. The goal is to help the injured area gradually handle the demands of running without delaying healing or causing another injury.

Your doctor, physical therapist (a specialist who helps you move better and get stronger), or athletic trainer will help you decide when it may be safe to start. Their guidance is especially important if your injury was serious or if you had surgery.

Before you start running again, your doctor or rehab team may check:

• Your strength in the injured knee or ankle.
• How much pain you have during movements that are like running.
• The way you walk, jump, and move.
• Whether you have swelling during or after activity.
• How far you can move your joint. This is called range of motion.
• Your overall fitness level.

In some cases, your doctor may order an imaging test, such as an X-ray or MRI, to see how well your injury has healed.

Your doctor or rehab team may ask you to do some simple checks before you start running. A flat, even surface, such as a track or treadmill, is the safest place to start. You may need to work on movement problems first, such as limping.

Hopping on one leg, jumping with both legs, or jumping side to side can show whether your body is ready for the impact of running. Being able to walk for 30 minutes with little or no discomfort is another good sign. Any swelling from your injury should be gone. And swelling should not come back when you do your normal daily activities.

Your plan should fit your injury, your body, and your goals. Your rehab team can help you plan your warm-up, your walk-run intervals, how many rest days to take, and how to keep track of pain. Here are some things to remember.

• Many people rest for more than one day between runs, especially early on.
• Walking or doing another low-impact activity is fine on rest days.
• Keeping up with strength training also helps protect your knee or ankle.
• It also helps to warm up with 5 to 10 minutes of brisk walking and cool down with 5 minutes of easy walking.
• Mild pain that fades within 24 hours may be okay for some people. Pain that gets worse while you run, changes the way you move, causes swelling, or lasts more than 24 hours is a sign to ease off.

Here is one example of a daily walk-run plan. If your rehab team gives you a different plan, follow theirs. Each session often starts with a warm-up and stretching. You do a level once a day for 1 or 2 days. Rest at least 1 day between runs.

• Level 1: Walk 4 minutes, then run 1 minute. Repeat 5 times.
• Level 2: Walk 3 minutes, then run 2 minutes. Repeat 5 times.
• Level 3: Walk 2 minutes, then run 3 minutes. Repeat 5 times.
• Level 4: Walk 1 minute, then run 4 minutes. Repeat 5 times.
• Level 5: If you are pain-free, try a light 30-minute jog without walking breaks.

If pain is mild and goes away within 24 hours, moving up a level may be okay. If pain is stronger or lasts longer, staying at the same level or going back to an easier one is often the safer choice.