Disc herniation and sport: when can you start running again?

Receiving a diagnosis of disc herniation is often a moment of real worry, especially for people who take part in sport regularly. Among the most common questions is the one about running: will it still be possible to run? How long do you have to wait? Is there a risk of making things worse?

The answer does not depend solely on the presence of the herniation, but above all on how the symptoms evolve, on the recovery of function and on the spine's ability to tolerate load progressively.

In recent years scientific understanding has profoundly changed how this problem is approached. Today the aim is not to avoid movement, but to recover it gradually through a personalised programme.

Approaching physiotherapy for a disc herniation the right way makes it possible, in many cases, to return to running safely and with greater awareness.

Many people immediately associate a disc herniation with having to stop all physical activity.

In reality the situation is far more complex.

There are people with clearly visible herniations on imaging who have no symptoms at all, while others experience pain even with less significant changes.

This is why the rehabilitation programme is not built on the MRI alone, but above all on the clinical assessment of the person.

A very widespread belief is that running is automatically harmful for anyone with a disc herniation.

The scientific evidence does not support this idea.

When recovery is adequate and the return to activity is progressive, running can be reintroduced without necessarily representing a danger.

What matters most is checking whether the spine is genuinely ready to handle the impact and the loads that running demands.

Many athletes wait solely for the pain to disappear.

In reality recovery calls for a much broader assessment.

Before increasing the level of activity, several aspects are taken into account:

• quality of movement
• mobility of the spine
• muscle strength
• trunk control
• tolerance to load

Physiotherapy for a disc herniation is precisely what helps rebuild these capacities step by step.

No two patients are identical.

The herniation can affect different levels of the spine and cause widely varying symptoms.

Among the most frequent are:

• low back pain
• pain radiating into the leg
• tingling
• loss of strength
• stiffness

This is why the return to sport cannot be decided using standard timescales that are the same for everyone.

In the past, long periods of rest were often advised.

Today we know that, except in particular situations, prolonged immobility can slow recovery down.

Movement, when properly dosed, helps maintain function and allows tissue to adapt progressively to load.

This clearly does not mean ignoring pain.

It means learning to manage movement in the most appropriate way.

During a run, every stride generates forces that are distributed along the whole kinetic chain.

To handle them safely, the system needs adequate muscular control.

Particular attention is given to:

• the trunk muscles
• the glutes
• the lower limbs
• pelvic control

Good stabilising capacity distributes load better while running.

The way you run can change the forces that reach the spine.

An inefficient technique can unnecessarily increase the work demanded of certain body segments.

During the assessment, aspects such as these may be observed:

• foot contact
• pelvic control
• trunk oscillation
• stride frequency
• overall coordination

The aim is not to impose a perfect running style, but to identify the elements that can be improved.

The return to running does not happen overnight.

The programme generally involves a progression that may include:

• restoring mobility
• muscle strengthening
• motor control exercises
• brisk walking
• alternating walking and running
• gradually increasing running time

Each stage is adapted to the individual patient's response.

There are situations in which it is preferable to postpone the return to running.

For example when the following persist:

• intense pain
• significant loss of strength
• worsening of symptoms during movement
• significant functional limitations
• poor tolerance to exercise

In these cases rehabilitation continues until more favourable conditions are reached.

One of the most frequent mistakes is resuming training at the same volumes as before the injury.

The body, on the other hand, needs to adapt progressively.

This is why the following are monitored:

• training frequency
• duration of the run
• intensity
• recovery between sessions
• how the body responds the next day

A well-built progression reduces the risk of overload.

One of the most overlooked aspects concerns how training sessions are distributed.

Sudden increases in volume or intensity can exceed the tissue's capacity to adapt.

A more balanced plan, by contrast, supports recovery and reduces the risk of relapse.

This applies both to competitive athletes and to those who swim at amateur level.

The aim of physiotherapy is not only to reduce pain.

A functional assessment identifies the factors that can influence recovery.

A physiotherapy programme for a disc herniation may include:

• therapeutic exercise
• restoring mobility
• muscle strengthening
• work on motor control
• progression of load

Every element is adapted to the person's characteristics and sporting goals.

At TI-FISIO in Mendrisio the programme is built starting from the patient's specific situation.

The assessment considers:

• symptoms
• quality of movement
• functional capacity
• strength
• motor control

This information makes it possible to plan a gradual return to running, respecting the biological timescales of recovery and the athlete's needs.

A disc herniation does not necessarily represent the end of sporting activity.

With a personalised programme it is often possible to progressively regain the ability to run.

What really makes the difference is not how quickly you get back to training, but the quality of the recovery.

Approaching physiotherapy for a disc herniation means building more solid foundations through the recovery of mobility, strength and movement control.

In this way running becomes an activity to enjoy with confidence again, reducing the risk of relapse and improving the spine's ability to manage load over time.

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info@ti-fisio.ch

Via Ceresio 42, Pregassona.

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