Returning to Running After Injury: The Case for Introducing High Speed Running Early in the Running Progression. Part 2

By Mitch Hauschildt, MA, ATC, CSCS

In Part 1 of this series, we discussed why you should be introducing running at 80% of full sprint as their reintroduction to running when returning your athletes from an injury. If you haven’t read that post, do it here because it has important information as to why we do this. The goal in Part 2 is to explain how we do it safely and efficiently.

The easy answer as to how we do it is with progressions. Everyone should be training with progressions. If you aren’t, you are doing both your athlete and yourself a disservice. You aren’t putting them into a position to be successful, you are exposing them to injury, and making your job a lot harder (it is much easier on you as the coach or clinician to simply add small progressions as they can handle it rather than try to coach them through very complex movements with little to no experience performing them).

Before our athletes begin their return to running progressions, they first have to earn their right to begin them by demonstrating that they have a base level of strength, stability and movement quality. This includes:

• Full Pain Free Range of Motion
• Normal walking gait
• Symmetrical and optimal rolling patterns in all 4 quadrants
• A 2/3 or higher on the Active Straight Leg Raise as defined by the FMS
• A 2/3 or higher on the Trunk Stability Pushup as defined by the FMS
• A 2/3 or higher on Rotary Stability as defined by the FMS
• Demonstrate a proper loaded hip hinge
• Perform within 10% of the uninvolved limb in a single leg press for a 3 rep max

Many of our athletes can perform these items very quickly and easily based on their high proficiency in these areas prior to their injury. The reason most are proficient is because we screen repeatedly and work on them as part of our training programs.

Once we ensure proficiency in these areas, we feel comfortable moving towards running progressions. But, before we begin running, we must remember that most of our athletes were injured while decelerating in one manner or another. Either they landed poorly, attempted to stop and cut, or tried to decelerate a body part for proper foot or hand placement, any of which lead to their injury. So, if we don’t address deceleration and body control, then we are setting them up to fail again.

Further, we must address deceleration first because most athletes struggle with slowing down much more after an injury than they do accelerating their body. To use a knee injury as an example, typically athletes returning after a knee injury struggle with quad control. When someone decelerates from a linear sprint, there is a huge eccentric force applied to the quads. So, if they don’t know how to contract eccentrically to decelerate the body under control (via quad control), then they will get hurt. At that point, any chance of running at a high rate of speed will fail very quickly.

We take our athletes through 3 different deceleration progressions prior to running. This is important because the body is always working in 3 planes of movement, so we must address all 3 areas:

• Linear Deceleration Progression
• Lateral Deceleration Progression
• Vertical Deceleration Progression

Before we move into the specifics of each progression, it should be noted that the progressions listed here are involved and specific.  It isn’t overly important that you follow these progressions. Rather, its important that you have a well thought out progression and approach each area in a systematic manner. I would be arrogant of me to tell you what is best for your athletes in your facility is when we have different athletes with different backgrounds with different facilities and we are trained differently and have varying experiences. Use your clinical experience to develop your own if you don’t like mine.

Linear Deceleration Progression

• Lunge release
• Drop lunge
• Box step offs
• Single leg box step offs
• 3-step deceleration
• 3-step band deceleration
• 5 yard deceleration run and return

Lateral Deceleration Progression

• Lateral lunge release
• Lateral drop lunge
• 45° drop lunge
• Rotational drop lunge
• 2-step wheel drill
• Single leg lateral jumps
• Single leg lateral box step offs
• 3-step lateral shuffle deceleration
• 3-step lateral shuffle band deceleration

Vertical Deceleration Progression

• Drop squats
• Jump, jump, squat
• Medicine ball jump, jump, squat
• Kettlebell swings
• Kettlebell eccentric loaded swings (power bombs)
• Box step offs
• Single leg box step offs
• Box jumps – emphasize landing
• Single leg jump, jump, squat

Running Mechanics

Now that our athlete is learning how to decelerate efficiently, we can turn our eyes to the actual task of running. Part of this is ensuring that they have the neurological efficiency and motor patterns to run well. We accomplish that with running drills:

• Arm swings
• A-March
• A-Skip
• High knees
• Butt kicks
• Leg cycles
• Harness drill

These drills should be performed for multiple sets and reps for as many sessions as needed until we can ensure that they possess a basic level of competency with the skill of running. These drills should also be used to increase work capacity for the athlete. Most athletes who are working through this progression have not been very active for a while, so building some work capacity is important to ensure that fatigue doesn’t become a limiting factor in their running progression. Don’t underestimate the metabolic component to this.

After you feel comfortable with their mechanics, it is finally time to run. This initial session should start with running drills to promote the optimal patterns that you are looking for, as well as ensure that they are fully warmed up before actually running.

Initially, keep the volume low with only 4-6 runs at 30-50 yards. Over the next few sessions you can increase the volume as they succeed with the progression. Keep in mind that movement quality is what is most important. Only increase the volume when they demonstrate high quality movements with the previous volume. The progression we use to introduce running looks something like this:

• Form run @ 80% of full sprint
• Acceleration run
• Ins-outs
• Sprints

This progression typically takes several training sessions to work through. I usually only perform form runs in the first few sessions and add more to them as they earn the right to add to the previous session.

As they continue to improve their strength, power and work capacity, they will be able to progress into more complex movements such as agility training and plyometrics (sometimes these are concurrent with this progression).

By following this progression, you can easily progress someone through return to running progression in a safe manner that makes sense and reduces pain and injury risk.

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