When Will You Run Again?

One of the most common questions we hear from clients following surgery of the knee or ankle is, "When can I run again?" If you like to run, it won't matter what type of surgery you've had. After surgery, you're ready to hit the road, the track, or the woods. You just want to run.

Many runners think of surgery as a "fix"; something was stitched, removed, cleaned up, or re-arranged,  and the problem that once nagged them has been silenced. Surgery without rehab, however, may leave you feeling ready but you're not "game" ready. Rehab gets you game ready. Professional athletes know this and spend months in rehab following a knee or ankle surgery (Carson Palmer's injury is a good example).

To get "game" ready, you have to follow certain rules. The first set of rules governs the healing of the surgery itself. To simplify the scientific research on wound healing, consider this guideline:

• at 30 days, your surgical wound (tissue trauma from the surgery, the incisions and suturing), will be approximately 30% healed.
• at 60 days, 60% healed.
• at 90 days, 90% healed.

The second set of rules governs the return to a higher level of function or sport. They can be found in the answers to the following questions:

• Do you have enough motion?
• Do you have enough strength of the injured body part as well as connected body parts (e.g. for the knee, are your hip and trunk muscles strong enough)?
• Do you have sufficient balance, coordination and reaction time?

Consider this story. A young man who loved to run, tore his Achilles tendon and had it surgically repaired. He was convinced that in six weeks, he could return to running. I'm not sure how that idea wiggled its way into his head but there it was firmly entrenched. Surgical and rehab approaches vary, but typically after an Achilles tendon repair you'll wear a special boot for at least six weeks and often twelve weeks. After twelve weeks, the surgical incision and tendon will be nearly healed but a long way from withstanding the forces produced by running. Being healed and being ready are not the same thing. Depending on the quality of your rehab and level of your commitment, you may begin jogging again in six months. The tendon must be functionally re-conditioned to withstand up to 10 times bodyweight forces*.  So, when can you run again after an Achilles tendon repair? At the earliest, it will be 9 months from surgery before jogging even enters the picture.

Surgery is a necessity for an injury like an Achilles tendon tear but remember that surgery prepares your body for the changes that rehab creates.

To return to running, you need to be "game" ready. Are you game ready?

Make today count.

Doug Kelsey

*Komi, P. V., M. Salonen, et al. (1987). "In vivo registration of Achilles tendon forces in man. I. Methodological development." Int J Sports Med 8 Suppl 1: 3-8.