The Essential Return-to-Run Checklist

As a physical therapist, I’m often asked, “How long will it take to heal?” or “When can I get back to running, tennis, or my sport?” It’s one of the most common questions, and my go-to answer is always, “It depends.” There’s no simple timeline, as recovery is influenced by a variety of factors. The healing process varies depending on the nature of the injury, the type of tissue involved, and the effort put into recovery. Let’s dive into what influences recovery times and how tissue heals.

Factors That Impact Healing Time

While there are general timelines for healing, how long an injury will take to recover depends on several key factors:

• Sleep and Nutrition: Proper rest and diet are essential for supporting tissue healing.
• Underlying Health Issues: Conditions like low energy availability, autoimmune disorders, or imbalances in lab values can slow recovery.
• Activity Modification: Following prescribed activity restrictions and avoiding re-injury is crucial for speeding up healing.

Once these factors are addressed, the healing process for the injured tissue generally follows a predictable path. While the recovery time can vary, certain tissues have a more reliable healing timeline.

Healing Times by Tissue Type

Different tissues—bones, muscles, tendons, ligaments, cartilage, and nerves—heal at different rates. The reason for this variation lies in blood flow. Tissues like bones and muscles have a good blood supply, enabling them to heal faster. Tendons and ligaments, on the other hand, have less blood flow, which makes their healing process slower.

Healing is generally broken down into three stages, each dictating how much load the injured area can handle and when it’s safe to return to physical activity.

Phases of Healing

1. Inflammatory Phase

The inflammatory phase begins immediately after an injury and can last from hours to days. During this phase, blood vessels dilate to increase blood flow to the injured area, which brings cells that help clean up the damaged tissue. You’ll often notice redness and warmth as a result. Swelling is also common, which can inhibit muscle function. The tissues are at their weakest during this phase, and it’s important to protect them from excessive strain. While inflammation is a necessary part of the healing process, it can be problematic if it lingers longer than expected—usually beyond a week.

2. Proliferation Phase

This phase focuses on tissue repair and can last anywhere from several days to several months. During this time, new cells, blood vessels, and the extracellular matrix begin to fill the injury site. Collagen—the building block of connective tissue—is laid down in a disorganized manner, providing a framework for new tissue. At this stage, the tissue can start to handle some load, but it’s still relatively weak. The collagen fibers need time to mature and align in a way that supports the healing tissue.

3. Remodeling Phase

The remodeling phase is where the real strengthening occurs. This phase can last from months to even years after the initial injury. As the tissue adapts to stress, the collagen fibers realign according to the forces they experience, which improves the tissue’s ability to handle load. For example, tendons will realign based on the lines of tension, and bone density will increase under weight-bearing conditions. During this phase, excess scar tissue is broken down, and the tissue begins to regain its strength and flexibility. Gradual, progressive loading is crucial during this phase to restore function and ensure full recovery.

The Role of Physical Therapy in Recovery

While the healing process can feel slow and frustrating, having a physical therapist guide you through proper rehabilitation and exercise progression is key to a successful recovery. A well-planned physical therapy program can help you return to your sport safely and prevent future injuries.

Understanding the stages of healing and the factors that influence recovery time can give you a better idea of what to expect. Patience and adherence to the recovery plan are essential, but with the right approach, you’ll be back to your activities stronger than before.

Thanks for reading!

For a long time, endurance athletes, particularly runners, have been advised to stay away from the weight room. The fear of bulking up, losing speed, or simply not knowing where to start with strength training has kept many runners from lifting weights. However, recent research and the success of elite athletes who incorporate strength training into their routines are changing this outdated mindset.

Despite the growing evidence in favor of strength training for runners, many still avoid the weight room. A study published last year found that only 62.5% of competitive distance runners used resistance training. In contrast, exercises like stretching and core stability were much more common, with 86.2% and 70.2% of runners performing them, respectively. While these exercises are valuable, they only represent part of a complete training program. Strength training is equally essential for improving overall performance.

So, why are runners hesitant to add weights to their routines? Let’s address some of the most common concerns.

Will Strength Training Make Me Bulk Up?

One of the most frequent worries among runners is that strength training will lead to excessive muscle gain, which could slow them down. However, studies have shown that strength training does not alter body composition significantly. Runners who incorporate strength training into their routines do not put on excess muscle mass. You can rest assured that you won’t get bulky from a well-designed strength training program.

Will Strength Training Slow Me Down?

Another concern runners often have is that strength training might reduce their speed. This fear stems from the idea that strength training is too different from running and could hurt performance. The truth is, strength training has been shown to improve time trial results, increase anaerobic speed, and enhance running efficiency. Far from slowing you down, it can actually make you faster.

Will Strength Training Reduce My Risk of Injury?

Injury prevention is a major concern for any runner, and strength training can play a crucial role in reducing injury risk. A quality strength training program that is performed safely can help strengthen muscles, improve stability, and reduce the likelihood of injury. At worst, strength training will leave you stronger and just as injury-prone as before. But, for most, it can help reduce the risk of common running injuries and improve overall durability.

How Do I Get Started?

If you’re thinking, “This sounds great, but I’ve never touched a barbell before,” you’re not alone. The idea of starting strength training can feel intimidating, especially if you’re new to it. The key is to start slow and get the proper guidance. A well-structured, personalized training program designed by a professional will set you up for success. While generic programs can be found in magazines, they aren’t tailored to your unique needs. As a Certified Strength and Conditioning Specialist, I can help you create a program that addresses your specific goals, medical history, and injury risks.

Once you’ve mastered the basics, you might want to take your strength training to the next level. If you need more advanced guidance, consider working with experienced coaches at a specialized facility.

Incorporating strength training into your routine can greatly improve your running performance and overall health. So, why not give it a try?