Basic Return to Running Guideline
Ideal for runners returning from being off running 4+ weeks
• This program is designed for end stage rehabilitation return to running in order to reacclimatize tissue to
loads associated with running without exceeding the load capacity of the runner’s musculoskeletal
system.
• The clinician should use their own clinical judgment to determine when it is safe to begin and is
encouraged to modify the below hop and run progressions to tailor the program to the individual.
• Factors to consider when adjusting running volume: Injury severity, time away from running, pre-injury
fitness level, running experience, running mechanics (Forefoot strike → Achilles/Calf; Over-striding →
PF joint).
• ROM: full, pain-free joint ROM, symmetrical with the uninvolved limb
Criteria to • Strength: Strength: MMT 5/5 OR Isokinetic or hand held dynamometry testing with 80%
initiate
limb symmetry index for involved muscle groups and proximal muscle groups
jumping
program • 20 heel touches on 8 inch step with good mechanics
• Weight bearing: normalized walking gait mechanics
Functional Hop Progression
Double Leg Single Leg
Hop in Place Forward/Backward Hop
Forward/Backward Hop Triple Hop
Triple Hop Side-to-Side
Side-to-Side Lateral Bounds
Scissor Hops Box hop down
For OSUWMC USE ONLY. To license, please
contact the OSU Technology Commercialization
Office at https://tco.osu.edu.
Criteria to • Met the above criteria for initiating jumping program.
initiate • Hopping drills with appropriate landing mechanics and without increased pain or swelling.
running • Able to tolerate 200-250 foot contacts (equivalent to 1/3 mile of running).
progression
• Able to walk 30 minutes without pain and normalized gait.
• Audible rhythmic strike patterns and no gross visual compensation with brief (10-20
seconds) run in the clinic.
Basic Walk to
Run Program Walk Run Repetitions Days
Phase 1 4 minutes 1 minute 3-6 2-3
Phase 2 3 minutes 2 minute 3-6 2-3
Phase 3 2 minutes 3 minutes 3-6 2-3
Phase 4 1 minute 4 minutes 3-6 2-3
Phase 5 0 30 minutes 1 3
A dynamic warm-up should be performed for 5-10 minutes before the workout.
The run is to be performed at comfortable run effort.
The runner is to take at least one day off in between running days.
The runner can progress to the next phase once they are able to complete 6 reps of
the run time without increased pain or swelling.
Guidelines • Do not progress phases if any one of the following occurs: sharp pain during run, pain that
for worsens as patient continues running, pain is so severe that it causes patient to alter gait
progression • After completion of Phase 5, increase weekly mileage by 10-30%.
of running • Once back to 50-60% of runner’s pre-injury weekly mileage, gradually increase speed and
program introduce hills.
• Once back to 75-80% of runner’s pre-injury weekly mileage, can resume normal training.
Run
Progression Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7
Week 1
Week 2
Week 3
Week 4
Week 5
To be completed by the physical therapist taking into account the runner/injury and
mileage progression of 10-30% per week.
For OSUWMC USE ONLY. To license, please
contact the OSU Technology Commercialization
Office at https://tco.osu.edu.
Basic Return to Running Guideline
Walk to Run
Program Walk Run Repetitions Days
Phase 1 4 minutes 1 minute 3-6 2-3
Phase 2 3 minutes 2 minute 3-6 2-3
Phase 3 2 minutes 3 minutes 3-6 2-3
Phase 4 1 minute 4 minutes 3-6 2-3
Phase 5 0 30 minutes 1 3
A dynamic warm-up should be performed for 5-10 minutes before the workout.
The run is to be performed at comfortable run effort.
The runner is to take at least one day off in between running days.
The runner can progress to the next phase once they are able to complete 6 reps of
the run time without increased pain or swelling.
Run • Do not progress phases if any one of the following occurs: sharp pain during run, pain that
Progression worsens as patient continues running, pain is so severe that it causes patient to alter gait
• After completion of Phase 5, increase weekly mileage by 10-30%.
• Once back to 50-60% of runner’s pre-injury weekly mileage, gradually increase speed and
introduce hills.
• Once back to 75-80% of runner’s pre-injury weekly mileage, can resume normal training.
Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7
Week 1
Week 2
Week 3
Week 4
Week 5
To be completed by the physical therapist taking into account the runner/injury and
mileage progression of 10-30% per week.
For OSUWMC USE ONLY. To license, please
contact the OSU Technology Commercialization
Office at https://tco.osu.edu.
Authors: Melissa Gallatin, PT; Megan Graver, PT, DPT
Reviewers: Kelly Henschen, PT, DPT; Chelsea Lahman, PT, DPT
Completion date: October 2019
References
• Buist I, Bredeweg S, van Mechelen W, Lemmink K, Pepping G, Diercks R. No Effect of a Graded
Training Program on the Number of Running-Related Injuries in Novice Runners. Am J Sports Med.
2008;36:33-39.
• Bredeweg S, Zijlstra S, Bessem B, Buist, I. The effectiveness of a preconditioning programme on
preventing running-related injuries in novice runners: a randomized controlled trial. Br J Sports
Med.2012; 46:865-870.
• Nielson R, Parner E, Nohr E, Sorensen H, Lind M, Rasmussen S. J Orthop & Sports Phys Ther.2014;
44:739-748.
• Ramskov D, Rasmussen S, Sorensen H, Parner E, Lind M, Nielsen R. Run clever- No difference in risk
of injury when comparing progression in running volume and running intensity in recreational runners: A
randomized trial. BMJ Open Sport & Exercise Medicine. 2018:4:1-9.
• Chumanov E, Heiderscheit B, Thelen D. The effect of speed and influence of individual muscles on
hamstring mechanics during the swing phase of sprinting. J Biomech. 2007;40:3555-3562.
• Chumanov E, Heiderscheit B, Thelen D. Hamstring musculotendon dynamics diring stance and swing
phases of high-speed running. Med & Sci in Sports & Exerc. 2011:525-532.
For OSUWMC USE ONLY. To license, please
contact the OSU Technology Commercialization
Office at https://tco.osu.edu.
