Physio Recovery and Return to Training

What it feels like

• Heel or arch pain, often worse with first steps in the morning.
• Tender arch, pain after long standing or lots of walking.

Acute, 7 to 14 days

• Reduce impact volume, swap to cycling or rowing if needed.
• Foot mobility: toe spreads, towel scrunches, gentle ball roll 60 to 120 seconds.
• Isometric calf raise hold on both legs: 4 holds of 30 to 45 seconds.
• Supportive shoes temporarily can help. Avoid barefoot hard floors early.

Rebuild, 3 to 8 weeks

• Calf raises, standing and seated: 3 to 4 sets of 8 to 12, 3 times per week.
• Short foot drill: create a subtle arch, hold 10 seconds, 8 reps.
• Toe strength: towel scrunches 2 sets of 20, or banded toe flexion.

Return

• Walk progression first, then walk jog on flat.
• Add volume before speed, then hills last.

Check: if pain keeps worsening, or if there is nerve type burning and tingling, consider professional review.

What it feels like

• Stiff tendon in the morning, sore after running, sometimes thickened.
• Insertion pain can be sensitive to deep stretching over a step.

Acute

• Reduce sprinting, jumping, and hills temporarily.
• Isometric calf raise holds: 3 to 5 holds of 30 to 45 seconds, once or twice daily.
• Keep walking comfortable, avoid limping and avoid sudden spikes in steps.

Rebuild

• Heavy slow calf raises, straight knee and bent knee, 3 to 4 sets of 6 to 10, 3 times per week.
• Lower slowly 3 to 5 seconds, pause at top 1 second.
• Progress load first, then range, then speed.

Return

• Walk jog, then strides, then controlled hops before full sprints.
• Use a 24 hour check, symptoms should not worsen the next morning.

Avoid: sudden return to hill sprints and high volume intervals.

What it feels like

• Pain behind or around the kneecap, worse on stairs, squats, or long sitting.

Acute

• Reduce deep knee bending temporarily, keep range comfortable.
• Spanish squat holds or wall sits: 4 holds of 30 to 45 seconds.
• Cycling with higher cadence often feels better than low cadence grinding.

Rebuild

• Step ups, tempo split squats, leg press in a pain free range, 3 to 4 sets of 8 to 12.
• Hip work: side lying abduction, clams, band walks, 3 sets of 12 to 15.
• Keep knees tracking over toes, avoid collapsing inward.

Return

• Gradual running volume, avoid sudden downhill exposure.
• Add speed last, keep stride shorter and cadence slightly higher.

Check: persistent swelling, locking, giving way, or sharp catching should be assessed.

Acute

• Reduce long runs and cambered surfaces temporarily.
• Glute bridge 3 sets of 12 to 15, then side plank 3 holds of 20 to 40 seconds.
• Increase run cadence about 5 to 7 percent to reduce load per step.

Rebuild

• Step downs, lateral lunges, single leg RDL pattern, 3 to 4 sets of 8 to 12.
• Keep pelvis level and knee tracking clean, slow lowering.

Return

• Add hills late, add volume before intensity.
• Watch 24 hour response, especially next morning stiffness.

Acute

• Walk pain free, avoid sprinting and fast lengthening work early.
• Isometric heel press into box or towel: 4 holds of 30 to 45 seconds.
• Gentle range only, no aggressive stretching when it is still sore.

Rebuild

• RDL pattern, hip thrust, slide leg curls, 3 to 4 sets of 8 to 12 with slow lowering.
• Nordic regressions if tolerated, partial range only at first.

Return

• Drills, then strides, then controlled sprints.
• Keep one to two hamstring strength sessions per week for several months.

Acute

• Relative rest from sprinting and jumping for 1 to 2 weeks.
• Normal walking as pain allows, avoid limping.
• Ankle pumps and gentle calf stretching, no sharp pain.

Rebuild

• Seated calf raises, then standing calf raises, 3 sets of 12 to 15 progressing to 3 to 4 sets of 8 to 12.
• Lower slowly 3 to 4 seconds, pause at the top 1 second.
• Progress to step deficits and loaded carries when settled.

Return

• Walk jog, then strides, then hops and skips before full sprints.
• Maintain 1 to 2 calf strength sessions weekly long term.

Avoid: explosive push offs too early, large painful dorsiflexion stretches if they provoke symptoms.

What it feels like

• Pain lifting the arm, discomfort sleeping on the shoulder, pain with overhead work.

Acute

• Avoid painful overhead pressing temporarily, keep arm below pain threshold.
• Isometric external rotation with a band: 4 holds of 20 to 30 seconds.
• Scapular setting drills, light band pull aparts, 2 sets of 15.

Rebuild

• Y T W raises, row to external rotation, 3 sets of 10 to 15.
• Pressing options: incline dumbbell press, landmine press, 3 sets of 8 to 12.
• Keep elbows slightly forward of the body, avoid flaring aggressively.

Return

• Gradually reintroduce overhead pressing and pull ups, keep last reps smooth.
• Increase range and load slowly, not in the same week.

Check: sudden weakness after a specific incident, or inability to raise the arm, should be assessed.

Acute

• Unload aggravating grips. Use neutral grip pulling if it is friendlier.
• Isometrics: wrist extension or flexion holds, 4 holds of 30 to 45 seconds with light load.
• Use straps as a temporary bridge for heavy pulls if needed.

Rebuild

• Eccentric wrist curls, 3 to 4 sets of 12 to 15.
• Pronation and supination with a hammer, 3 sets of 10 to 12.
• Grip variety, do not max grip strength while it is irritable.

Return

• Reload rows, pull ups, pressing gradually.
• Add sport specific striking volume slowly and track next day response.

Acute

• Reduce repetitive thumb abduction and extension.
• Consider brief thumb spica support if it reduces irritation.
• Pain free isometrics into band or strap, 4 holds of 20 to 30 seconds.

Rebuild

• Thumb abduction and extension eccentrics, 3 sets of 12 to 15 with light tubing.
• Forearm conditioning, radial and ulnar deviation, 3 sets of 10 to 12.

Check: numbness, tingling, or night symptoms may suggest another diagnosis and should be reviewed.

Acute

• Reduce sprinting and high knee drills temporarily.
• Isometric hip flexion, knee to hand press, 4 holds of 20 to 30 seconds.
• Gentle hip mobility within comfort.

Rebuild

• Marches with band, split squats, and Copenhagen knee supported holds.
• Glute strength to balance anterior load, bridges, RDL pattern.
• 3 sets of 8 to 12, keep tempo controlled.

Return

• Strides, then speed, avoid sudden volume spikes.

Acute

• Keep moving within comfort. Avoid long static sitting.
• Core: dead bug, bird dog, side plank, 3 sets of 6 to 10 each side or 20 to 40 seconds.
• Short frequent walks can help more than total rest.

Rebuild

• Hinge pattern: hip dominant RDL, glute bridge, 3 to 4 sets of 8 to 12 with slow lowering.
• Gradually reintroduce squats and deadlifts with submax loads and perfect form.

Return

• Normal training with sensible load progressions. Avoid maxing out for several weeks.
• Build capacity with volume first, then intensity.

Check: leg weakness, worsening numbness, or bowel and bladder changes need urgent review.

Acute

• Move little and often. Gentle rotations and nods within comfort, 5 reps each, several times daily.
• Reduce long static screen time. Use brief movement breaks every 30 to 60 minutes.

Rebuild

• Chin tuck holds: 6 to 10 holds of 5 seconds, keep it gentle.
• Scapular control: band pull aparts, face pull light, 2 to 3 sets of 12 to 15.
• Thoracic mobility: open books, reach and rotate, 2 sets of 6 each side.

Return

• Gradually reload upper body training. Keep head position neutral on pressing and pulling.

Check: arm weakness, progressive numbness, severe headache, fever, or trauma should be assessed.

General approach

• Strength helps joints. The key is controlled range and sensible volume.
• Use pain rules. Mild ache that settles is acceptable, sharp catching is not.

Rebuild

• Glute bridge or hip thrust, 3 sets of 10 to 15.
• Split squat to a comfortable depth, 3 sets of 8 to 12.
• Step ups, 3 sets of 8 to 12, keep knee and hip aligned.
• Hip abduction, side lying or band walk, 3 sets of 12 to 15.

Return

• Add walking volume gradually. Hills later if they flare symptoms.
• Keep one strength session focused on hips each week long term.

Check: persistent night pain, rapid loss of movement, or significant limp warrants review.

Acute

• Protection and optimal loading, ice, compression, elevation.
• Pain free ankle circles and alphabet, weight bear as tolerated.

Rebuild

• Balance: single leg stand, then eyes closed, then unstable surface if safe.
• Strength: calf raises and band inversion and eversion, 3 sets of 12 to 15.

Return

• Hops and change of direction drills, then sport drills.
• Continue balance work for 6 to 12 weeks to reduce recurrence.

Acute

• Reduce impact volume. Avoid back to back hard runs.
• Check footwear and surfaces. Hard camber can worsen symptoms.

Rebuild

• Soleus and calf loading as above, plus anterior tib raises, 3 sets of 12 to 15.
• Increase step rate by 5 to 7 percent while running to reduce load per stride.

Return

• Volume first, then speed, then hills last.
• Respect next day response. Do not chase pain through.

Check: focal sharp bone pain that worsens, or pain at rest, should be assessed for stress injury.