Whether you’ve had ACL surgery on your knee, an operation to fix an Achilles tendon rupture, a hip replacement, or any other major surgery, you’ll be wondering when you can get back to running again, with all the associated joy it brings you.
But Dr Emma Ross – sports scientist at The Well HQ – warns that recovering from major surgery is more likely to take months rather than weeks, as “running is high-impact, repetitive and quite stressful for the body”. Though it will of course depend on the type of operation you’ve had, along with how it went, plus your age and fitness level.
Here's how to set realistic expectations and reduce your risk of joint injury in the future.
Speak to your doctor about your recovery
“It's important to ask about the specifics of your surgery and how the healing process should look,” says Dr Ross. This includes asking when you can start moving and putting weight on the injury. Some parts of the body heal far more quickly than others and being as informed as possible about the implications of your surgery will help you to manage your recovery expectations and map out a plan to deal with it.
Be patient in the first healing phase
As a runner who is used to being fit and strong, it’s easy to imagine you’ll bounce back quickly and be up and running in no time. But, says Dr Ross, there is a natural healing process for the tissues in our bodies that can’t be avoided.
“Being patient is boring, but it's so important,” she says.
“Even though you're not physically doing anything, your body is working really hard when it's healing from surgery.” Dr Ross says it’s a good time to look at your life holistically and make sure you’re eating well – including lots of anti-inflammatory foods (such as fruits, vegetables and nuts) and protein for repair – and sleeping well. “Sleep can be hard after surgery, so be diligent about winding down and perhaps try using meditation or breath work to help you relax before bed,” she says.
Use visualisation and mirroring techniques
There is good evidence around the benefits of visualisation, says Dr Ross. “For example, if your knee is injured and you visualise doing a leg extension with your injured knee – and sit there for a few minutes actually picturing that movement – it keeps your neural pathways primed for when you’re ready to use them again.”
And, she adds, there is also good research about what you can do with the non-injured side of your body to help the injured side, which is essentially mirror work. “If you do weights, leg raises or other strength work on the non-injured leg, it will preserve some, though obviously not all, of the neural connections on the injured leg,” says Dr Ross.
Work on getting strong
After that initial phase of tenderness and healing, you’ll want to make sure your body is strong and stable before you consider an impact exercise such as running. Working with a physio and later a personal trainer is a smart move, says Dr Ross, as it ensures you’ll use good form and get stronger without overloading other parts of your body.
Along with doing strength work, you can start walking, which is lower impact than running but still weight bearing, she says, though make sure you build up the distance and time you spend walking gradually.
Carve out time for cross training
Swimming, rowing, and static cycling can provide excellent cross-training benefits – depending on where your injury is – boosting your cardio fitness and building up your strength and range of motion. “Any mode of exercise where you can increase blood flow to that area is super helpful,” says Dr Ross. “Blood flow will bring in the nutrients from your diet and flush out the waste products from the injury site, aiding your recovery.”
Don’t rush the running phase
Even if your cross training has been going well, don’t presume you can go straight into full-on running. “Couch to 5K is a great programme as it incorporates walking and running in a well-paced way,” says Dr Ross.
“When you’ve been injured and start running again it will feel euphoric and it’s tempting to go further and faster than you should but following a set programme helps keep that urge in check.”
Building up your running strength and fitness on gentle terrain and soft surfaces, such as grass verges or playing fields, is sensible too, she says, as is making sure you do a good dynamic warm-up.
Let pain be your guide
In a world where we’re increasingly self-monitoring with data, it’s easy to forget to listen to how your body is actually feeling, says Dr Ross. “Pain is a really good indicator. If the day after training, the pain around your injury site is more than three out of ten, you shouldn’t progress to the next stage of training, and it might be wise to consider going back a step,” she says.
Swelling is always an indication that recovery is still ongoing too, she says, and you want to be able to move the injured area with a full range of motion – move the same part on your non-injured side to check how it should feel. “Recovery is not linear,” says Dr Ross. “You might take a step forward and then have to take your foot off the gas for a week.”
Ward off future injuries
Moving forwards, keep strength and resistance work as a regular part of your training programme, says Dr Ross. “Instead of looking at it as time away from running, think about it as time that helps us run,” she says. “10 minutes of really good conditioning work three times a week can reduce your risk of joint injury by 45%.”
Written by Sam Haddad. Sam is a freelance journalist based in Brighton, she's been writing about sport and the outdoors for over 20 years.