So, you graduated from physical therapy... now what?
Graduated traditional physical therapy recently?
Congrats!
Unfortunately, that does not necessarily mean you’re ready to train for that next race on the calendar this fall.
The demands on your body while training for a long distance race are significant. You want to be sure that your home exercise program at the end of physical therapy meets or exceeds those physical demands. Or else that nagging injury you just escaped from has a high chance of returning.
So how do you know if you’ve been discharged from physical therapy too early?
Here are some of the questions I always ask if someone reaches out to me after they’ve been released from traditional physical therapy:
Did you receive a video recorded analysis of your running form?
Did you utilize weights greater than 10 pounds during your exercises?
Did you receive a structured jump program?
Did you achieve 10 miles/week pain free before your final visit?
If your answer to any of these above questions is “no”, then you have not completed a full plan of care to prepare you for long distance training.
This is a story I hear all too often:
“I completed physical therapy two or three months ago, but as soon as I ramped up my mileage the pain returned. I do some of my exercises they gave me, but the list they gave me has about twenty exercises and I’m not sure which to do. I have a race in a few months and I’m not sure what I’m missing or why it’s still hurting.”
So why does this happen? Why does the pain return?
Don’t worry, you’re not alone.
You just need a plan that sets you up for success in long distance running.
Here are some reasons runners are released early from rehabilitation:
Your pain subsided with physical therapy and you were released soon after.
Although it's great your pain went away, that doesn’t necessarily mean you are “well” enough to just straight into training without guidance. That’s the problem with making goals in physical therapy solely based on pain relief. What you’re really hoping for when seeking care is a solution to the underlying issues that cause your pain. Or else, you risk that pain returning later.
Your physical therapist wasn’t specialized or experienced in the demands of long distance running.
Your rehabilitation needs to be tailored to the demands of long distance running. As a physical therapist, I left school with the education to treat stroke patients, infants, wounds (!), and more. In other words, I left school as a generalized physical therapist. It took me years to learn and gain experience working with runners. f you’re looking for long term resolutions for your running pains, working with a physical therapist who pursued further education in running will bring up key features of rehabilitation to make you successful in your next training program.
Your home exercise program for strengthening was not taken far enough.
If you learn to lift heavy and sweat during your home exercise program, you’re A LOT less likely to get injured again and your performance will increase. Did you know it takes 4-6 weeks to build true muscle strength? That’s if you’re performing exercises with the resistance and difficulty to make you strong. Just because your pain has subsided does not mean that your muscles have recovered to the point of supporting your long distance training goals. Let alone get faster, go further, and escape reinjury.
You were released before running enough.
How do you know you’re ready to get back to running if you … haven’t really gotten back to running? When I’m working with someone in my Return to Run Program, I am very careful not to progress their mileage until they’ve achieved at least 10 miles a week pain free. So if you have not officially gotten back into a weekly run routine (or one that’s typical for you) before leaving therapy, then there is more work to be done.
To be clear, I believe general physical therapists truly want the best for their patients and this does not mean they didn’t do fantastic work managing your pain up to a point.
However, if you’re looking to escape your pain and perform well in your next training cycle, you’ll need to achieve these goals with consistency:
Run at least 10 miles per week pain free
Strengthen with heavy resistance 2-3 times per week
Be able to hop on one leg for 3 sets of 30 seconds pain free
Stick with a personalized warm up for running that addresses your areas that need improvement (we all have them!)
Stay tuned for the next newsletter: “How to create an effective running warm up routine.”
Unsure of what these recommendations mean for you? Please reach out to ask me about them so I can support your lifelong running goals. Or ask me your questions at: erin@runwellclinic.com
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