13 Aug Return To Running After Knee Surgery
One of the more frequent questions asked in the physical therapy clinic after a knee surgery is, “Will I be able to run again?” The more important question to be asked is, “Should I return to running and what program do I need to follow to prevent against future injury.”
It is estimated that there are 15-35 million active recreational runners in the United States. Clinically, physical therapists treat many runners who have undergone a meniscectomy or an ACL reconstruction (ACLR). The Academy of Orthopedic Surgeons estimate there are 850,000 meniscectomies performed each year and the incidence of ACL injuries is on the rise in young athletes. It is therefore necessary to provide professional care reliant on evidence-based practice in order to safely return to running for recreation or sport.
Research has cited degeneration of the articular cartilage and osteoarthritis (OA) as common side effects of undergoing a meniscectomy or ACL-R. For a meniscectomy, there are several risk factors for increased risk of OA development including: lateral meniscal tears, insidious tears, female gender, age over 40, BMI higher than 30, and more than 1/3 total meniscus torn. After an ACL-R, research reveals that there is increased tibial motion during running based activities, especially with rapid changing of direction or stopping. Therefore it is essential to properly restore dynamic control of the entire lower extremity, especially hip control, in order to minimize the stress to the articular cartilage. Frequently, people all receive the same post surgical rehabilitation protocol for similar operations. For many people this treatment will correlate to a full return to their prior functional level. However, this approach will fall short of the mark for those who desire to return to running. Based on the evidence provided, runners need to be screened, educated and specifically trained to safely return to their sport.
Typically, after an ACL replacement, people begin a running progression program at 10-12 weeks after their operation and after an uncomplicated meniscectomy, a return to running program begins at 6-10 weeks.
People who run need an individualized rehabilitation plan to meet their unique goals. At OPTM our team of physical therapists are educated and trained to educate runners on return to their sport following surgery and other lower extremity pathologies. Our team of specialists will provide sound evidence-based advice, as well as a comprehensive biomechanical assessment to help our running patients meet their goal of returning to the sport they love.
Return to running Progression:
- Mandatory 2 day rest between workouts for 2 weeks
- Advance 1 level per week
- Running pace patient specific 95.0-6.0 mph)