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Comprehensive Return to Competitive Distance Running: A Clinical Commentary

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Abstract

Running injuries are very common, and there are well-established protocols for clinicians to manage specific musculoskeletal conditions in runners. However, competitive and elite runners may experience different injuries than the average recreational runner, due to differences in training load, biomechanics, and running experience. Additionally, injury-specific rehabilitation protocols do not consider the broader goal of return to competitive running, including the unique psychosocial and cardiorespiratory fitness needs of elite athletes. This review aims to suggest a guideline for running-specific progression as part of a comprehensive rehabilitation program for injured competitive runners. Tools to evaluate an athlete’s psychosocial preparedness to return to competition are presented. Recommendations are also provided for monitoring cardiorespiratory fitness of injured runners, including the nuances of interpreting these data. Finally, a six-phase training paradigm is proposed to guide clinicians as they help competitive runners transition from the early stages of injury through a full return to competition.

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Acknowledgements

The authors would like to acknowledge that graphics from FlatIcon (www.flaticon.com) were used in Figures 2–5 of this paper.

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Authors and Affiliations

  1. Department of Physical Therapy, One University Parkway, High Point University, High Point, NC, 27268, USA

    Eric J. Hegedus, Kevin R. Ford & James M. Smoliga

  2. Physical Therapy Program, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA, 02111, USA

    Eric J. Hegedus

  3. Department of Exercise Science, One University Parkway, High Point University, High Point, NC, 27268, USA

    Lindsey Ickes & Franziska Jakobs

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  1. Eric J. Hegedus
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Correspondence to Eric J. Hegedus.

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Eric Hegedus, Lindsey Ickes, Franziska Jacobs, Kevin Ford, and James Smoliga declare that they have no conflicts of interest relevant to the content of this review.

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All authors contributed to writing the first draft of the manuscript. All authors read and approved the final manuscript.

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Hegedus, E.J., Ickes, L., Jakobs, F. et al. Comprehensive Return to Competitive Distance Running: A Clinical Commentary. Sports Med 51, 2507–2523 (2021). https://doi.org/10.1007/s40279-021-01547-1

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