Target Muscle/s: Rehab for lower leg injury
Sets & Reps: Progression from 5 to 20
Tempo: Progress from slow with pauses to fast continuous
Frequency: Twice a week (or as per rehab plan)
Many runners returning from injury assume that the moment they can walk without pain they are ready to return to running. Unfortunately, this is not always the case. The forces your body is exposed to when running are far higher than those generated when walking. Within the walking gait, every step you take includes a moment at which both feet are in contact with the ground, referred to as the double support phase. Because of this, you never actually ‘take off’ the ground and do not generate much landing force. With running, however, there is no double support phase as both feet are never on the ground at the same time. Instead, there is a moment when both feet are off the ground, referred to as the double float phase. This increases the landing forces considerably in comparison to walking, and the faster you run the higher these landing forces become. Rehabilitation from lower leg injury therefore often involves ‘closing the gap’ between walking and running, in other words a week or two of exercises designed to gradually increase landing forces so that when you eventually do return to running your body is prepared for the demands. The ‘Jump, Skip Hop’ progression does just this: jumping (taking off two legs and landing on two legs) creates more of a landing force demand than walking but not as much as running. Skipping (jumping from one leg to the other) increases the landing forces a little more. Hopping (jumping from one leg to the same leg) closes the gap even more by creating landing forces more similar to those required during running. In all three of these versions you can also increase the demand by increasing the distance of the jump, skip or hop, as well as reducing the rest time between them.
By jumping, the forces are spread across two feet. This provides an excellent starting point for exposing the recovering leg to a slightly increased force demand. Start with a short distance, then if there is no pain progress to a slightly longer distance. Although only forward movement is shown, the same progression should be carried our jumping sideways, backwards and at diagonals.
Once your body can handle jumping long distances in all directions, it is time to progress to skipping. i.e. jumping off one leg and landing on the other. You can expose the recovering leg to increased forces during either ‘take off’ or ‘landing’. Again, start with a short distance and if there is no pain progress to a slightly longer distance. Remember to perform sideways and diagonal versions too.
Once your body can handle skipping long distances in all directions, it is time to progress to hopping. This means both jumping off the leg you are rehabbing and landing on it, thus increasing the forces even more. As previously, start with a short distance, then if there is no pain progress to a slightly longer distance. Remember to experiment with directions too.
Running As Rehab
Once you are able to hop in all directions without experiencing pain, you should be ready to progress to running into your rehab. Note, this does not mean going out and suddenly doing 5k. Running a mile takes 1600-2000 hops (depending on pace) so even a mile will need gradually working up to. You are still ‘closing the gap’ to full recovery so may need to start with intervals e.g. run 30 seconds, walk a minute. Take your time closing that gap and you will eventually reach full recovery.
Matt Phillips is a Running Injury Specialist & Video Gait Analyst at StrideUK & Studio57clinic in Sussex. Website: www.sportinjurymatt.co.uk