EP8.45 Earning the Right to Run Fast: A data-driven, criteria-based return-to-run testing protocol in a collegiate athlete with FAI - A Prospective Case Report

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ID: 330936
2026
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Abstract
Abstract Background There is limited evidence-based criteria to return-to-run for athletes with FAI¹. With ground reaction forces reaching upwards of 4x bodyweight (BW) in <0.250s, quadriceps and triceps surae provide 75% of the total vertical support impulse during high speed running (HSR) while hip muscle forces during swing phase reach 10x BW2. This underscores the need for athletes’ kinetic chains to safely withstand these forces. The purpose of this case report is to describe a criteria-based return-to-run testing protocol used in the conservative management of a track and field athlete. Case Description A collegiate 400m/800m athlete presented with an 8-month history of right-sided FAI and labrum tear limiting competition, pursuing conservative treatment. Clinical examination consisted of adductor squeeze (pain visual analogue scale (VAS)) and hip range of motion. Similar force plate return-to-run criteria from ACL research was used and included 3x BW ankle ISO push, 5.5x BW knee ISO push, single leg drop jump (SLDJ) contact time <0.3s. Benchmarks were based on normative data for the athlete's age, gender and sport. Intervention A periodized 4-phase rehabilitation program was implemented, focusing on hip motor control, lower body strengthening, plyometrics and gradual return to running. Serial objective testing guided programming and progressions using previously mentioned key performance indicators. Results Clinical examination revealed pain with adductor squeeze (VAS 5/10), decreased hip internal rotation (15°), and decreased quadriceps flexibility (prone knee bend 95°). Force plate testing revealed deficits in ankle ISO push (<3x BW), knee ISO push (<5.5x BW) and SLDJ contact time (>0.4s). At 12 weeks, improvements were observed in adduction squeeze VAS (0/10), hip internal rotation (25°) and prone knee bend (120°). At 16 weeks, the athlete progressed to running drills but not HSR due to unmet strength and reactive strength return-to-run thresholds. Conclusion This case report demonstrates that after symptom resolution, unlike time-based protocols, a criteria-based approach can identify deficits that would have been missed and could result in failure of returning to HSR or persistent pain with activities. Future research should aim to identify metrics leading to successful return to HSR. References 1. Loudon, J. K., & Reiman, M. P. (2012). Lower extremity kinematics in running athletes with and without a history of medial shin pain. International journal of sports physical therapy, 7(4), 356. 2. Dorn, T. W., Schache, A. G., & Pandy, M. G. (2012). Muscular strategy shift in human running: dependence of running speed on hip and ankle muscle performance. Journal of Experimental Biology, 215(11), 1944-1956.
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Authors Matthew Kelly
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.425
URL
https://doi.org/10.1093/jhps/hnag043.425
Keywords Keywords not found

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