the-addison

Running Assessments: What Is Your Physio Looking For?

Tue, 21 Apr 2026 06:18:28 GMT

A running assessment is often misunderstood. Some people think it is just someone watching how they run and commenting on their foot strike. In reality, a useful running assessment should be broader than that.

At our Marrickville clinic, running assessments are usually done to help understand why someone is getting sore, why a problem keeps recurring, or how to return to running more effectively after injury. For runners across the Inner West, the most useful question is usually not, 'What is the perfect running technique?' It is, 'What is it about my running, loading or capacity that may be contributing to this issue?'

It is not just about how you look on the treadmill

Video analysis can be useful, but it is only one part of the picture. A running assessment often also includes:

training history
recent volume and intensity changes
symptom behaviour
strength and control assessment
previous injuries
footwear and surface considerations

In many cases, the issue is not purely technique. It is a mismatch between load and capacity.

What your physio may be looking at

Cadence

Cadence can influence loading patterns, particularly in runners who are overstriding or spending too much time in a heavier braking pattern.

Stride characteristics

This includes where the foot lands relative to the body, how the runner manages impact, and whether any movement patterns appear to be increasing stress on a specific structure.

Pelvis and trunk control

Control through the trunk and pelvis can influence how load is distributed through the hip, knee and lower leg.

Lower limb loading

Depending on the injury, the physio may be watching for patterns that appear to increase stress at the calf, Achilles, patellofemoral joint, tibia, hamstring or hip.

What a running assessment should not do

It should not assume there is one perfect running style for everyone. It should also not make unnecessary changes just because something looks different.

Good running assessment is about relevance. If a movement pattern is not linked to symptoms, performance goals or injury risk in a meaningful way, it may not need changing.

Why strength still matters

Even if something useful is picked up in running form, the answer is often not just cueing. Capacity still matters. If the calf, hamstring, quads, glutes or trunk are not tolerating load well, changing form without improving strength usually has limited value.

Who may benefit from a running assessment?

It can be useful for:

runners with recurring injuries
people returning to running after injury
those increasing training load
runners preparing for an event who want a clearer plan

The key point

A good running assessment is not about chasing perfect form. It is about understanding your symptoms, your load and your capacity, then working out whether anything in your running pattern is meaningfully contributing to the problem.

If you are a runner in Marrickville, Enmore, Stanmore, Newtown or elsewhere in the Inner West and want a clearer idea of what is driving your symptoms, a proper running assessment can be useful.

Links: Exercise Prescription | Bone Stress | Hamstring Injuries | ACL Rehab

The Impact of the Relaxin Hormone Antenatally and Postnatally and How an MSK Physio Can Help

Tue, 21 Apr 2026 06:11:29 GMT

Pregnancy and the postnatal period involve significant physical change. One of the hormones often discussed in this context is relaxin. It is commonly associated with increased laxity and a feeling that the body is less stable, particularly through the pelvis, hips and lower back.

While relaxin is only one part of a much larger picture, it can help explain why some people feel physically different during pregnancy and after birth.

At our clinic in Marrickville, we see antenatal and postnatal patients from across the Inner West dealing with pain, reduced load tolerance and uncertainty around how to exercise safely. This is where a musculoskeletal physio can be helpful.

What does relaxin do?

Relaxin is a hormone involved in supporting pregnancy-related changes in the body. It is often discussed in relation to ligament laxity and changes in passive stability, particularly around the pelvis.

In practical terms, this can mean some people feel:

less stable through the pelvis
more sore through the lower back
more aware of hip, pubic or sacroiliac region discomfort
less tolerant of positions or loads that previously felt easy

Not everyone experiences these issues, and not every ache in pregnancy is due to relaxin, but it can be part of the broader load and stability picture.

Antenatal considerations

During pregnancy, people may notice discomfort with:

walking
rolling in bed
stairs
single leg tasks
exercise that previously felt straightforward

Common presentations include pelvic girdle pain, lower back pain, hip pain and rib discomfort. As pregnancy progresses, posture, breathing mechanics, abdominal wall demand and general movement patterns also change.

Postnatal considerations

Postnatally, the conversation often shifts to rebuilding tolerance. This may involve:

returning to walking comfortably
lifting and carrying a baby
regaining confidence with exercise
managing pelvic, lower back or abdominal symptoms

Even once pregnancy is over, people do not instantly return to full physical capacity. Load tolerance often needs to be rebuilt gradually.

How an MSK physio can help

A musculoskeletal physio can help by assessing the specific drivers of pain and reduced function, then building a plan that is realistic for the stage you are at.

This may include:

strength and control work
exercise modification
load management advice
guidance around returning to walking, gym or running
hands-on treatment where appropriate

For some patients, broader women's health or pelvic floor input is also appropriate.

The key point

Pregnancy and the postnatal period place different demands on the body. Relaxin may be one part of why the body feels less stable or more physically sensitive, but good management is rarely about simply 'being loose'. It is usually about understanding load, improving muscular support and building back confidence gradually.

If you are in Marrickville, Enmore, Newtown, Stanmore or elsewhere in the Inner West and are dealing with antenatal or postnatal musculoskeletal pain, our team can help guide safe, sensible progression.

Lin ks: Pregnancy Massage | Chronic Pain | Massage Therapy

Top 10 Benefits from Regular Soft Tissue Massage

Tue, 21 Apr 2026 06:04:33 GMT

Soft tissue massage is often seen as either a luxury or a quick fix. In reality, it usually sits somewhere in the middle. It is not magic, and it does not replace good rehab, but it can be a useful part of an overall treatment plan.

At our clinic in Marrickville, massage is commonly used alongside physiotherapy for people dealing with muscular tightness, training fatigue, stress-related tension and general physical overload. For many people in the Inner West, it is simply a useful way to feel and move better while supporting broader recovery.

Temporary pain relief

Massage can help modulate pain, particularly where muscles feel tight, overloaded or generally reactive. While it may not 'fix' the underlying issue on its own, it can reduce symptoms enough to help someone move more comfortably.

Reduction in muscular tension

Where someone feels generally bound up through the neck, shoulders, back, glutes or calves, massage can help reduce the sense of muscular tone and stiffness.

Improved sense of movement

People often feel freer after massage, even if objective flexibility changes are modest. Sometimes that improved sense of ease is enough to make exercise and daily activity feel more manageable.

Recovery support between training sessions

For active people, massage can be a useful recovery tool during heavier training periods, especially when combined with sleep, appropriate load management and sensible nutrition.

Stress reduction

Not all muscular tension is purely physical. Stress often shows up physically through the neck, jaw, shoulders and upper back. Massage can help reduce that load.

A useful adjunct to physiotherapy

Massage is often most useful when it supports a broader plan. For example, reducing symptoms enough to make strength work, movement retraining or return to exercise more manageable.

Better body awareness

Some people do not realise how much tension they are carrying until they actually stop and address it. Massage can help people become more aware of where they are holding tension and how their body is responding to stress and load.

Relief from desk-related tightness

People who sit for long periods often develop upper back, shoulder and neck tightness. While changing work habits still matters, massage can help settle some of the accumulated physical tension.

Improved short-term comfort for exercise and activity

For some people, massage helps them feel more comfortable getting back into walking, gym work or general activity after a flare-up.

It can simply help you feel better

Not every treatment benefit needs to be overcomplicated. Sometimes people book regular massage because it helps them feel less sore, less stiff and more settled. That is a valid reason.

The key point

Massage is best viewed as one useful tool, not the whole answer. It can help with pain, tension, recovery and general wellbeing, particularly when paired with good movement, strength work and load management.

If you are in Marrickville, Newtown, Enmore, Stanmore or elsewhere in the Inner West and are looking for regular soft tissue massage as part of your overall care, our team can help point you in the right direction.

Lin ks: Massage Therapy | Desk Neck Pain | Post-Op Rehab

How Can a Dietitian Benefit Your MSK Injury?

Tue, 21 Apr 2026 05:55:29 GMT

When people think about recovering from a musculoskeletal injury, they usually think about physiotherapy, exercise rehab and perhaps massage. They do not always think about nutrition. That is understandable, but it often means an important part of recovery gets overlooked.

A dietitian can play a meaningful role in injury management, particularly where healing, recovery, energy availability, body composition or bone health are relevant.

At our Marrickville clinic, we see a wide range of injuries across the Inner West, from runners with bone stress issues through to gym-goers managing tendon pain and people recovering from surgery. In many cases, rehab outcomes are not just shaped by the exercise plan. They are also shaped by how well the body is being fuelled.

Why nutrition matters in injury recovery

Injured tissue still needs raw materials to repair. Whether the issue involves muscle, tendon, bone or post-operative healing, the body needs enough energy and adequate nutrient intake to support the process.

If nutrition is poor, recovery may be affected by:

slower healing
lower training tolerance
poor recovery between sessions
loss of muscle mass
reduced bone support

Where a dietitian can help

1. Protein intake and tissue repair

Protein plays a key role in tissue repair and muscle maintenance. During injury, activity levels sometimes change, appetite can fluctuate, and people often end up under-consuming without realising it.

2. Energy availability

If someone is training, rehabbing and working, but not eating enough overall, recovery can stall. This is especially relevant in runners and highly active individuals, and links closely with RED-S and bone stress injuries.

3. Bone health support

For bone stress injuries, recurrent stress reactions, or low bone density concerns, nutrition becomes even more relevant. Calcium, vitamin D, total energy intake and broader dietary patterns may all matter.

4. Body composition during reduced activity

Injury can be a difficult period nutritionally. Some people become overly restrictive because they are moving less. Others struggle to manage appetite or routine. A dietitian can help keep things sensible and performance-focused rather than reactive.

Who may benefit most?

Dietitian support can be especially useful for:

runners with bone stress injuries
people with recurrent injuries
those recovering from surgery
highly active individuals with low energy availability
anyone whose recovery seems slower than expected

Why combined care works well

Physio and dietetics often work well together because they address different parts of the same problem. Physio helps guide loading, movement, strength and function. A dietitian helps make sure the body is appropriately fuelled to adapt to that work.

This is often particularly valuable in return-to-running and bone stress cases.

The key point

If you are dealing with an MSK injury, nutrition may not be the only answer, but it is often part of the answer.

If you are in Marrickville, Enmore, Stanmore, Newtown or elsewhere in the Inner West and want a more rounded approach to injury recovery, our team can help coordinate care between physiotherapy and dietetics where appropriate.

Lin ks: Dietitian | Red-S | Bone Stress Injury

RED-S and Bone Stress Injuries

Tue, 21 Apr 2026 05:48:50 GMT

When a runner or active person develops a bone stress injury, the focus often goes straight to the painful area. That makes sense, but it is not always the full picture. One of the more important underlying contributors can be RED-S, or Relative Energy Deficiency in Sport.

This matters because if RED-S is present and not addressed, bone stress injuries are more likely to occur and more likely to recur.

At our clinic in Marrickville, we see this most commonly in runners and highly active individuals across the Inner West who are training hard but not always meeting the energy demands of that training.

What is RED-S?

RED-S occurs when energy availability is too low to support both exercise and normal body function. In simple terms, the body is not getting enough fuel for everything it is being asked to do.This does not always mean someone is intentionally under-eating. It can simply mean that training load has increased and nutrition has not kept pace.

Why does it matter for bone health?

Low energy availability can affect:

bone health
hormonal function
recovery
immune function
performance

When bone health is compromised, the skeleton becomes less able to adapt to the repeated loads of running and sport. That increases the risk of bone stress injuries.

Common signs that may raise suspicion

Not every person with RED-S will present the same way, but common features can include:

recurrent bone stress injuries
persistent fatigue
poor recovery
drop in performance
low mood or irritability
menstrual irregularity in females
frequent soft tissue injuries

It is important to note that someone can look outwardly healthy and still have low energy availability.

Why runners are commonly affected

Running has a relatively high energy cost, particularly once volume increases. Add gym training, busy work schedules, poor recovery, or a drive to stay lean, and it becomes easier for a mismatch to develop between output and intake.

How it is managed

If RED-S is suspected, management should go beyond just the painful bone. It often involves:

temporary modification of training load
review of nutrition and overall intake
appropriate medical input where needed
physio support with load management and return to running
dietitian involvement

If there is a clear nutrition mismatch, dietitian input can be a particularly useful part of reducing ongoing injury risk.

The key point

If someone keeps developing bone stress issues, there is usually a reason. RED-S is one factor that should not be missed.

If you are a runner or active person in Marrickville, Newtown, Enmore, Stanmore or elsewhere in the Inner West and have had recurrent bone stress injuries, low energy availability may be part of the picture. Identifying it early can make a large difference to both recovery and future injury risk.

Links: Bone Stress Injuries | Dietitian | Sports Injuries

Hamstring Injuries: We Should Be Looking at More Than Just the Hamstring

Tue, 21 Apr 2026 05:42:14 GMT

Hamstring injuries are common in running and field-based sports, and they can be frustratingly recurrent. One reason for that is that hamstring rehab often becomes too narrow. People focus on the sore muscle itself but not enough on the broader factors that may have contributed to the injury.

At our physio clinic in Marrickville, we regularly see hamstring injuries in runners, footballers and active adults across the Inner West. One of the more important parts of assessment is working out whether the hamstring is the whole story, or just the structure that has become symptomatic.

The hamstring does not work in isolation

The hamstring sits within a broader system that includes:

the pelvis
the lumbar spine
the glutes
the calf complex
the ability to tolerate high-speed running

If there is an issue elsewhere in that chain, the hamstring can end up taking more load than it is ready for.

What else should be considered?

1. Lumbopelvic control

The pelvis and trunk provide a base for the hamstring to work from. Poor control here can change how force is transferred and may increase the demand on the hamstring during running and acceleration.

2. Glute strength and contribution

If the glutes are underperforming, the hamstrings often end up doing more work with hip extension. That does not mean the glutes are always 'off', but it can mean the posterior chain is not sharing load well.

3. Sprint exposure

A lot of hamstring injuries occur at high speed. If someone has not been exposed to enough high-speed running, then asks the hamstring to tolerate it suddenly, that is often where trouble starts.

4. Neural contribution

Sometimes posterior thigh pain is not purely a local hamstring issue. Lumbar referral or neural sensitivity can mimic or contribute to symptoms, particularly where there is a history of back pain, pins and needles, or symptoms that feel less like a classic strain.

What rehab should usually include

Good hamstring rehab often involves more than rest and basic curls. It may include:

progressive hamstring strength work
lengthened-position loading
single leg control work
glute and trunk strengthening
running progression
high-speed running exposure where appropriate

For a runner, this may also involve reviewing cadence, training progression and recent load spikes.

Why recurrence is common

Hamstring strains often settle enough for people to jog, gym and function reasonably normally. That does not mean they are ready for sprinting, kicking, fast accelerations or reactive movement. Returning too early or without enough high-speed exposure is one reason recurrence rates remain high.

The key point

If you injure your hamstring, it makes sense to treat the hamstring. But it generally does not make sense to stop there.

A broader assessment often gives a clearer picture of why it happened and what needs to improve to reduce the chance of it happening again.

Links: Running Assessment | ACL Rehab | Sports Injuries

Shoulder Pain: Are We Just Not Strong Enough?

Tue, 21 Apr 2026 05:32:47 GMT

Shoulder pain is common, whether it shows up in the gym, at work, during sport, or just with day to day tasks. A lot of people assume that if their shoulder hurts, something must be torn, pinched or worn out. Sometimes that is relevant. Often, though, the issue is more about load tolerance than structural damage.

In simple terms, the shoulder may not currently have the capacity to handle what you are asking it to do.

At our Marrickville physio clinic, we regularly see shoulder pain in active adults, gym-goers, overhead athletes and office workers across the Inner West. One of the more common patterns is not that the shoulder is incapable of loading. It is that it has become underprepared for the loading being asked of it.

Why strength matters

The shoulder relies heavily on muscular control. Unlike the hip, which has a deep socket and a lot of passive stability, the shoulder depends far more on the surrounding muscles to centre and control the joint.

These include:

the rotator cuff
the scapular muscles
the deltoid
the trunk and upper back muscles

If those structures are not strong enough, not well conditioned enough, or not handling load well, the shoulder can become irritable.

It is not always just weakness

That said, shoulder pain is not solved by randomly strengthening everything. It is usually a combination of factors such as:

reduced strength
poor tolerance to certain ranges
sudden increase in training or workload
loss of conditioning after time off
poor exposure to overhead positions

Common examples

Some common scenarios include:

a gym-goer who ramps up overhead pressing too quickly
a parent repeatedly lifting a child after not doing much upper body training
someone returning to tennis after months off
an office worker with a deconditioned upper back and poor tolerance to sustained postures

In each case, the problem is not necessarily that the shoulder should not be loaded. It may be that it needs to be loaded more appropriately.

What rehab often involves

Good shoulder rehab usually includes a combination of:

rotator cuff strengthening
scapular control work
graduated return to painful or demanding movements
review of training load or work demands
upper back and trunk contribution where needed

Importantly, avoiding all painful movement is usually not the long-term answer. The goal is generally to reload the shoulder in a sensible, progressive way.

Should you worry about scans?

Sometimes imaging is useful. But shoulder scans also often show age-related findings that are not necessarily the reason for pain. A scan result should be interpreted alongside your symptoms and physical assessment, not in isolation.

The key point

So, are we just not strong enough? Sometimes, partly yes. Not because the shoulder is weak in a simplistic sense, but because it may lack the specific strength and capacity needed for the tasks being asked of it.

If your shoulder keeps getting sore with gym work, sport, lifting, or day to day use, it is worth looking at whether the issue is less about damage and more about whether the shoulder is adequately prepared for that load.

Links : Sports Injuries | Neck Pain | Massage Therapy

3 Simple Things to Do When You're Getting Neck Pain Sitting at a Desk Too Long

Tue, 21 Apr 2026 05:25:58 GMT

Neck pain from desk work is common. It is also one of the more frustrating issues because it often builds gradually, feels worse by the end of the day, and then repeats itself the next morning.

The good news is that desk-related neck pain is usually not about one major structural problem. More often, it is a load tolerance issue. In other words, your neck, upper back and surrounding muscles are spending too long doing the same thing.

At our clinic in Marrickville, we regularly see people from office -based jobs around the Inner West dealing with neck pain, upper trapezius tightness, headaches and postural fatigue. Below are three simple things that are usually worth doing.

1. Stop chasing the perfect posture

A lot of people think their neck pain must be because they are sitting 'wrong'. Usually, that is too simplistic.

There is no perfect posture that you can hold all day without consequence. The bigger issue is usually that you have been in one position for too long.

What tends to help more:

changing positions regularly
standing for short periods
walking during calls
breaking up long sitting blocks

Even a quick movement break every 30 to 45 minutes can help reduce how stiff and loaded the area feels by the end of the day.

2. Restore some movement during the day

When the neck and upper back stay still for too long, they often become more sensitive. A few simple movements through the day can help.

Examples include:

gentle neck rotation
chin tuck variations
thoracic extension over the back of a chair
shoulder blade retraction

The goal is not to aggressively stretch everything out. It is just to move enough, often enough, to stop the area from becoming progressively more rigid and irritated.

3. Build your tolerance, not just your flexibility

Desk workers often try stretching, massage or heat, which can all feel good in the short term. The missing piece is usually capacity.

If the neck, upper back and shoulder girdle fatigue quickly, you are more likely to feel sore by the end of the day. That is where some simple strength work can help.

This might include:

rows
face pulls
deep neck flexor endurance work
mid-back strengthening

When to get assessed

Most desk-related neck pain is mechanical and manageable. That said, it is worth getting assessed if:

the pain is getting progressively worse
you are getting frequent headaches
you have pain into the arm
you are noticing numbness, tingling or weakness
your symptoms are not settling with simple changes

The key point

If your neck hurts when you sit at a desk too long, it usually does not mean something is badly damaged. More often, it means the area does not love prolonged static load.

Three useful starting points are:

move more often
restore some movement during the day
build strength and tolerance

If you are based in Marrickville, Enmore, Newtown, Stanmore or elsewhere in the Inner West and desk work is irritating your neck, our physio team can help work out what is driving it and give you a plan that is actually realistic to follow.

Links: Sports Injuries | Shoulder Pain | Massage Therapy

Bone Stress Injuries in Runners: The Continuum and What to Look Out For

Tue, 21 Apr 2026 05:16:34 GMT

Bone stress injuries are common in runners, but they rarely come out of nowhere. In most cases, they develop over time. That is why understanding the continuum matters. If picked up early, a bone stress injury may only require a relatively short period of load modification. If ignored, it can become a much more frustrating and prolonged issue.

At our Inner West clinic, we often see runners who thought they were just dealing with a sore shin, irritated foot, or something that would settle if they pushed through. Sometimes that works with other running aches. Bone stress injuries are not usually one of them.

What is a bone stress injury?

A bone stress injury sits on a spectrum. Bone is a living tissue that responds to load. When training load is appropriate, the body adapts. When load exceeds the body's ability to recover and remodel, the bone can start to become irritated.

The continuum is often described as moving from:

bone stress reaction
bone stress response
stress fracture

The earlier along that continuum you identify the issue, the easier it generally is to manage.

Common areas in runners

Some areas are more commonly affected than others. These include:

the tibia
the metatarsals
the femoral neck
the navicular
the pelvis

Some of these are considered higher risk than others, which is why early assessment matters.

What should runners look out for?

The early signs can be subtle. Common features include:

pain that comes on with running and eases with rest
a specific, localised pain rather than a vague ache
pain that becomes easier to provoke over time
pain with hopping or impact
tenderness over a small, defined area

As the issue progresses, symptoms may start earlier in a run, linger longer afterwards, or appear with walking and daily activity.

A general rule: if the pain is becoming more localised, more predictable, and more reactive to impact, it is worth taking seriously.

Why do bone stress injuries happen?

They are rarely due to one thing alone. Common contributors include:

sudden increase in training volume or intensity
change in running frequency
insufficient recovery
poor energy availability
reduced strength capacity
history of previous bone stress injury
change in surface, shoes or training environment

This is why a good assessment should look at more than just the painful area.

What should you do if you suspect one?

The main mistake is continuing to test it. Most runners want to know whether it is 'just tight' or whether it will warm up. Bone stress injuries often do not behave well when you keep probing them.

Early management usually involves:

modifying or pausing running load
reducing impact exposure
assessing strength and capacity
reviewing training history
considering nutrition and recovery factors

In some cases, imaging may be needed, especially where the site is higher risk or symptoms are progressing.

How physio can help

Physiotherapy is not just about telling you to stop running. The role is to work out why the issue developed, manage it appropriately, and help you return to running with a better plan.

This might include:

load modification and return-to-run planning
calf, hip and lower limb strengthening
review of running history and progression errors
screening for factors such as RED-S

The key point

Bone stress injuries are usually much easier to deal with when picked up early. If your running pain is becoming more localised, more impact-related, or less likely to settle, it is worth getting assessed before it progresses further.

If you are a runner in Marrickville, Newtown, Stanmore, Enmore or the wider Inner West and are worried about a possible bone stress injury, early assessment can make a large difference to how long you are out for.

Links: RED-S | Running Assessments | Dietitian

ACL Rehab and Physio: What a Typical 12 Month Period Looks Like

Tue, 21 Apr 2026 05:05:17 GMT

ACL injuries are one of the more significant injuries we see in sport and active populations. Whether you have had an ACL reconstruction, are preparing for surgery, or are trying to understand what rehab actually involves, it helps to have a realistic picture of the road ahead.

ACL rehab is not a quick process. In most cases, it is better thought of as a structured 9 to 12 month progression rather than a short block of treatment. For many people, the biggest challenge is not the surgery itself. It is the consistency required afterwards.

At our clinic in Marrickville, we regularly help people through different stages of ACL rehab and physiotherapy, from early post-operative management through to strength work, running progressions and return to sport testing. While every case is different, the outline below gives a good sense of what a typical 12 month period can look like.

Months 0 to 3: Settle the knee and restore the basics

The first phase is usually about getting the knee moving well again and settling pain and swelling. Early priorities often include:

reducing swelling
restoring full knee extension
improving knee flexion
regaining quadriceps activation
walking more normally
building confidence with basic daily tasks

For many people, this stage can feel slow. That is normal. Early rehab is not meant to look exciting. It is meant to lay a good foundation. If range of motion, swelling control and basic strength are not addressed early, they tend to create issues later.

Depending on the surgeon's protocol and any associated injuries, this phase may also include crutch use, brace use, and gradual progression of weight bearing.

Months 3 to 5: Build strength and control

Once the knee is settling and movement has improved, rehab becomes more strength focused. This is where people usually start to feel like they are doing more meaningful work, but it is still a relatively controlled phase.

Common priorities include:

quadriceps strength
hamstring strength
glute and calf strength
single leg balance and control
step work, split squat patterns and squat variations

A lot of ACL rehab success comes down to gradually rebuilding the capacity of the entire lower limb, not just the knee. That includes trunk control, pelvis control and confidence through single leg loading.

Months 5 to 7: Running and early power work

One of the most common questions people ask is, 'When can I run again?' The answer depends less on the date and more on whether the knee is ready.

Before returning to running, we are usually looking for:

good strength markers
minimal or no swelling response
acceptable single leg control
good tolerance to gym-based loading

Once those boxes are ticked, return to running usually starts as a graded progression rather than straight back into normal training. This phase often also introduces basic jumping, landing and power development.

Months 7 to 9: Change of direction and higher level loading

At this stage, rehab starts to look more athletic again. For field and court sports, this often means:

change of direction drills
deceleration work
single leg landing progressions
reactive movement drills
higher speed running exposures

This phase matters because many people can look good in straight line strength work but still lack the ability to tolerate unpredictable movement, speed and force.

Months 9 to 12: Return to sport preparation

The final phase is not just about feeling better. It is about being physically prepared for the demands of your sport or activity.

This often includes:

strength testing
hop testing
movement quality assessment
conditioning appropriate to your sport
graduated return to training and competition

This is also the point where many people need guidance around confidence. It is one thing to be medically cleared. It is another to trust the knee again in a fast, reactive environment.

Why ACL rehab should not be based on time alone

One of the more common mistakes in ACL rehab is assuming that if enough months have passed, the knee must be ready. In reality, two people at the same time point can look very different. One may be ready to progress, while the other still lacks strength, confidence or load tolerance.

That is why good ACL rehab should be based on objective progress markers, not just the calendar.

When to get help

If you are preparing for surgery, are early post-op, or feel like you have plateaued later in rehab, it is worth getting a proper plan in place. A structured approach can make a significant difference to how the knee functions long term.

If you are looking for ACL rehab and physio in Marrickville, Enmore, Newtown, Stanmore or the broader Inner West, our team can help guide the process from the early stage right through to return to running and sport.

Lin ks: Sports Injuries | Running Assessments | Hamstring Injuries