Trail running: returning after an injury

Risks and order of return

Technical descents, roots and rocks multiply ankle and knee risks; elevation comes back last, after pace and duration.

Trail running: start on wide, even paths before technical trails. Downhills load the knees and ankles heavily: add them last, walking at first.

Bringing the movement back in four stages

1. 1

   Brisk walking and alternating walking with a gentle jog, on a flat, soft path.

2. 2

   Slow running on a smooth trail, no roots or stones.

3. 3

   Varied trails, gentle hills, slightly technical terrain.

4. 4

   Technical descents, elevation gain, speed and competition.

Common injuries in this sport

• Ankle sprainResume on the flat first, then on smooth trail, before roots and rocks; keep single-leg balance in the programme.
• Achilles tendonSteep climbs and descents load the tendon heavily: add them last.
• Iliotibial bandLong descents often trigger the pain: limit them and resume on flat ground first.

Preparation exercises

• Single-leg balance

  Stand 30 seconds on one foot, knee slightly bent. Then with eyes closed, then on a cushion or unstable surface.

  To start: 3 holds of 30 seconds per leg, every day.

  Variations, mistakes and progression

  Easier

  One hand on a chair, or the tip of the free foot on the floor.

  Harder

  Eyes closed, then on a cushion, then throwing a ball against a wall.

  Common mistakes

  • Knee straight and locked.
  • Looking at your feet instead of a point ahead.

  Moving on

  When you can hold 30 seconds without putting the other foot down, as on the healthy side.

• Ankle eversion with band

  Seated, band around the forefoot, turn the foot outwards slowly then return over 3 seconds.

  To start: 3 sets of 15, slowly, once a day.

  Variations, mistakes and progression

  Easier

  No band, or a very light band.

  Harder

  Stronger band, then standing side steps with a band around the ankles.

  Common mistakes

  • Turning the leg instead of the ankle.
  • Letting the band snap back.

  Moving on

  When 3 × 20 is easy with the strongest band.

• Chair squat

  Sit down onto a chair then stand up slowly, range limited to what is pain-free, knees in line with the feet.

  To start: 3 sets of 10, 3 seconds down, every other day.

  Variations, mistakes and progression

  Easier

  Higher chair, hands on your thighs to help.

  Harder

  Lower chair, without touching the seat, then holding a weight against your chest.

  Common mistakes

  • Knees caving in.
  • Dropping onto the chair.

  Moving on

  When 3 × 12 is easy on a low chair, with no discomfort the next day.

• Low step-up

  Step up onto a 10 to 20 cm step with the affected leg, come down slowly, pelvis steady.

  To start: 3 sets of 10 per leg, slow on the way down, every other day.

  Variations, mistakes and progression

  Easier

  10 cm step, one hand on the rail.

  Harder

  Higher step (20 to 30 cm), then with weights in your hands.

  Common mistakes

  • Pushing off with the leg on the floor.
  • Knee drifting inwards.

  Moving on

  When 3 × 12 on a 20 cm step is clean and causes no discomfort the next day.

• Single-leg heel raises

  advanced

  Same movement on one foot, lowering over 3 seconds, a light hand on a wall if needed. Add a loaded backpack very gradually.

  To start: 3 sets of 8 to 10 per leg, 3 seconds down, every other day.

  Variations, mistakes and progression

  Easier

  Rise on both feet and lower on one.

  Harder

  On a step with the heel over the edge, then with a loaded backpack.

  Common mistakes

  • Leaning too much on the wall.
  • Bending the knee to cheat on height.

  Moving on

  When you can do 20 to 25 raises in a row on the injured leg, roughly as many as on the other.

• Controlled step-down

  Standing on a step on one leg: slowly bend the knee to tap the floor in front with the heel of the other foot, over 3 seconds, then come back up. Knee in line with the foot.

  To start: 3 sets of 8 per leg, 3 seconds down, every other day.

  Variations, mistakes and progression

  Easier

  Lower step (10 cm), one hand on the rail.

  Harder

  Higher step (20 to 25 cm), then with a loaded backpack.

  Common mistakes

  • Knee drifting inwards.
  • Dropping down instead of braking.

  Moving on

  When 3 × 10 on a 20 cm step is clean and causes no discomfort the next day: bring back your sport’s downhill sections.

The doses are starting points. Stay at 2 out of 10 discomfort at most, during and the next day; otherwise switch to the easier version or go back to the previous exercise.

Equipment and set-up

• Trail shoes with good grip, and poles on climbs only when the terrain calls for it.
• Start on smooth trails and avoid wet or unstable ground.
• Carry water, a phone and warm clothing: a slow return is safer with backup gear.