My strain Recovery Philosophy · Ruth Performance Lab

Dec '25 (edited) • Program Design

My strain Recovery Philosophy

My Strain Recovery Philosophy

Context:

and I recently had a conversation about our approach to recovery after strain injury. We talked at length about the principles underlying the approach I used during my grade-2 hamstring tear this summer from sprinting. These are the same things I’m focusing on with my quad tear now.

Main Pillars:

1. Blood flow early and often:

- BFR is the best lever I’ve found for speeding return to training and reducing atrophy.

- If BFR isn’t available, cyclical work can still be used to get a “flush” effect started.

- BFR can be started as soon as DAY-1 post injury as long as there is not pressure directly on the injured tissue

2. Train around the injury, aggressively

- Keep training the athlete as an athlete. This is important for both mental and physical recovery.

- Maintain hypertrophy around the injury training any and every muscle group you have safe access to.

- Maintain general capacity while the injured tissue catches up.

(note: I like to use a “train the systems” approach during the early phase of rehab. Maintaining blood volume with Sauna, building respiratory muscle endurance with Breathe Way Better, keeping aerobic fitness on the non-involved ergs)

3. Contralateral training is a MUST

- Train the healthy side hard in the same pattern you’re trying to restore (but don’t overtrain it!).

- Training the healthy side keeps neural patterns active which makes the return-to-play process MUCH faster.

- Keep “touching” the injured side with the safest version of that same pattern. (note that in many cases this will be handled by the PT, but is still a must)

4. Visualization integrated into training & rehab

- Visualization is “free volume” for the brain.

- No tissue cost + positive transfer to movement patterns.

- Can be integrated during rest periods of rehab work.

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General takeaways

1. The fastest recoveries I’ve seen happen when we keep the athlete training, not when they take time completely off.

2. BFR plus early isometrics plus contralateral loading has been the highest impact combination for speeding return to play.

3. Rehab works better when it feels like training. Small chunks, done consistently, then normal training around it. Use super-sets, couplets, triplets of: ISO / Dynamic / Conditioning.

4. Progress is best judged by markers: gait, tolerable isometric positions, eccentric tolerance, and improving ROM, not by days or weeks post injury.

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How I integrate these principles into a training session:

Example Session: (Hamstring Grade-2 || early, phase-0)

A. 5min BFR IPC (100% pressure, cuff applied proximal to pain site)

B. 5min Continuous Reverse sled drag (light loading, pain free ROM’s only)

C. Contralateral Block-1

3 Rounds

15-20sec Step-up ISO Hold (Injured leg, edge of pain free ROM)

6-8 DB Step-ups @30x1 (Healthy leg, mod-heavy loading)

1km Bike-erg @ zone-2 (adjust seat for pain-free ROM)

D. Contralateral Block-2