Have you recently suffered a foot or ankle injury, or undergone surgery that’s put your running on hold? Many patients are eager to get back to the activity they love but are unsure of how and when it’s safe to return.
In this article, a consultant orthopaedic surgeon who specialises in foot and ankle conditions shares expert advice on how to recover properly and return to running safely, step by step.
Understanding your recovery timeline
Recovery depends on the nature and severity of the injury or surgical procedure, as well as your general health and fitness. While mild sprains or early tendonitis may resolve in a matter of weeks, more complex surgeries, like ankle ligament reconstructions or fracture repairs, often require several months of structured rehabilitation.
Avoid rushing the process
Pushing too hard too soon can delay healing or even cause re-injury. Persistent pain, swelling, or instability are signs that you may need to pause or modify your activity.
Your step-by-step guide to returning to running
The recovery process can be broken down into the following stages.
1. Early phase: Protection and mobility
Rest and protection are crucial in the first few days post-injury or surgery. However, at this stage it is important to have two goals. The first is restoring and maintain movement. The second is too control swelling. Starting with gentle movement and progressing as you can, will help maintain joint flexibility and prevent stiffness. It is also very important to reduce swelling with rest, ice, compression, and elevation. Also at this time you can do exercises to maintain core strength which do not put pressure on your injured ankle.
2. Mid-phase: Strengthening and stability
As healing progresses, the focus shifts to rebuilding strength in the foot, ankle, and surrounding muscles. Balance and proprioceptive exercises (single-leg stands or wobble board training) help retrain your body’s ability to stabilise and react quickly during movement. At this stage working on double heel lifts is a good way of starting to strengthen the healing tissue without over straining the injury. At this stage you will find non-weightbearing exercise such as cycling on a Wattbike to be helpful and you will gradually find you can do more. Most patients flutter kicking during swimming causes pain but you may find that with a noodle or by switching strokes that there are ways of returning to swimming.
3. Final phase: Gradual return to impact
Once you can walk briskly without pain or limping, tolerate low-impact activities, and perform basic strength exercises, you can begin a gradual return to running. At this stage you should be able to perform a single heel rise on the injured side. If you are not able to do a single heel rise you stand a high chance of re-injuring yourself. This is a sign you need input from a specialist if you have not already had help. When you can perform a single heel rise, start with a walk-jog programme on flat, predictable surfaces, increasing duration slowly over several weeks.
Top tips for a safe return to running
- Follow a structured plan: use walk-run intervals and gradually increase duration and intensity.
- Wear appropriate footwear and check to make sure your old trainers weren’t part of the cause of your injury: Use supportive running shoes that suit your gait and offer cushioning. Look for a wide, stiff sole with a gentle rocker with looks of cushioning and in built arch suppot. There have been fantastic improvement in trainers over the past 10 years. Patients and physiotherapist note that I frequently wear and recommend Hoka trainers but Brooks, On Cloud, Asiics and most of the major trainer brands make good alternatives.
- Cross-train wisely: activities like swimming, elliptical training, or cycling can maintain cardiovascular fitness without overloading healing tissues.
- Make sure your Core is strong: a strong core helps to reduce all impact landing on your injured ankles
- Make sure your calves and hamstrings are flexible: tight calves will increase the pressure on the anterior ankle joint and can lead to impingement
- Monitor your symptoms: mild soreness after activity is expected, but sharp or worsening pain is not. If in doubt, scale back.
When to seek specialist advice
If progress is slower than expected, or if pain returns with activity, it's important to consult a foot and ankle specialist. In some cases, further investigations such as imaging, custom orthotics, or advanced treatment options may be required to support a full recovery.
With the right guidance and support, most patients can get back to running safely and confidently. If you're unsure where to start or feel stuck in your recovery, consulting a specialist can make all the difference.
