What is the Running Readiness Scale and can it be used to determine running injury risk?

Running injuries are all multi-factorial which means they are often due to a variety of reasons ultimately causing an imbalance between the workload being placed on the body and the body’s ability to withstand and adapt to it. This overload can be due to training errors, non-optimization of lifestyle or ecosystem factors (sleep, protein intake, hydration, etc), and/or specific deficits in strength, mobility, movement control, power, and the running gait itself.

Because of the multi-factorial aspect of running injuries, it is difficult to determine the likelihood of sustaining a running injury. I was surprised when this study demonstrated the Running Readiness Scale (RRS) was able to determine injury risk in a population of runners across a training cycle.

What is the Running Readiness Scale (RRS)?

The Running Readiness Scale (RSS) is a series of 5 tests which are graded on a pass or fail basis and then added together for a total composite score. The tests include a Bilateral Jump Test, Wall Slide Test, Step Up Test, Single Leg Squat Test, and a Prone Plank Test. Many of these tests are used individually, with some modifications, in my typical physical therapy or coaching evaluations for runners. Over the last few years, this test has been studied and utilized as a 5-part composite score to be taken collectively opposed to grading only based on the individual test performance.

I'm providing FREE Running Readiness Scale screens to the first 20 runners in Augusta, GA to sign up

If you’re a runner in Augusta, GA and want to determine your injury risk with this Running Readiness Scale, please read through the rets of this post, fill out the form at the end of the page, and I’ll contact you within 24 hours.

Is there any research on the RRS?

Yes! Because I am an evidence-based clinical provider (and please do not assume the average physician or therapist is just because they underwent schooling that is evidence-based), I always start my decision making process for using new assessments based on the actual clinical utility determined by research. Far too often, providers will use proposed tests and treatment methods with little to no research to support them. This should not be common practice but unfortunately it is. I have provided brief summaries, links, and citations to the three current research studies that have evaluated and/or utilized the RRS. An additional Delphi review article, Clinical and exercise professional opinion of return-to-running readiness after childbirth: an international Delphi study and consensus statement, also recommended the Running Readiness Scale although it was not evaluated in that particular article.

(Luedke, 2025) The Running Readiness Scale and Injury in Collegiate Track & Field and Cross Country Athletes

The Running Readiness Scale (RRS) was utilized on 113 NCAA Division III track and XC athletes prior to their respective track or cross country season. Those who scored 3, or less, on the RRS composite score were 5 times more likely to develop a running-related injury compared to those who scored a 4 or 5. Failed scores on the individual Double Leg Hop Test and the Wall Sit Tests also indicated increased injury risk. (Luedke, 2015)

(Harrison, 2023) The Running Readiness Scale as an Assessment of Kinematics Related to Knee Injury in Novice Female Runners

The Running Readiness Scale (RRS) was performed on 56 novice female runners to determine if the peak joint angles for the hip and knee were similar between the results seen on the RRS movement-based tests and during the running gait cycle. Several joint angles often seen with running related injuries, such as hip adduction, knee abduction, and contralateral pelvic drop were correlated with joint angles and scores on this test. Those who scored higher on the RRS demonstrated decreased knee abduction while running (which has been shown to be correlated with injuries, although inconsistently, in research) (Harrison, 2019)

(Payne, 2019) An Examination of Step Frequency and the Running Readiness Scale as Predictors of Running-Related Injury in Collegiate CrossCountry Athletes

The Running Readiness Scare (RRS) was performed on 16 cross country athletes before their cross country season. 6, of the 16, cross country runners became injured during the subsequent XC season. Individual scores on the RRS were not significantly different between those who were injured and noninjured. However, this study did not compare the composite score of the RRS among those who were injured and non-injured. (Payne, 2019)

How is the RRS used?

The RRS is used in two primary ways:

To improve decision making regarding returning to running following an injury, period of inactivity, or pregnancy (as included in the decision making process of this Delphi study regarding return to running criteria for postpartum runners).

Many runners resume running far too quickly following injuries, pregnancy, or long periods of inactivity and these tests can serve as part of the criteria to determine if a runner is recovered and/or strong enough to resume running training.

To determine running injury risk prior to a racing season.

The capacity for this scale to collectively determine injury risk has been evaluated in one study which demonstrated those scoring 3, or less, were significantly more likely to be injured compared to those scoring 4 or 5. This study was performed on much more competitive track and cross country runners and these results may not be fully applicable to recreational runners. However, generally speaking if a test identifies injury risk in a more fit population, it is generally able to perform similarly with recreational athletes but the opposite is not true. Far more often, research will assess recreational runners which makes the applicability to more competitive runners far less likely.

How shouldn’t the RRS be used?

The RRS should not be used in the following ways:

To identify deficits related to injury risk or a particular injury.

This scale operates much more as a screen than a particular test or outcome measurement. Screens are used to identify risk so that more individualized testing can be performed. For example, high blood pressure can be measured with a blood pressure cuff (sphygmomanometer) but further testing is required to determine root causes of this high blood pressure reading. Similarly, a person may fail the single leg squat test and that can be used to inform decision making but ultimately requires more thorough testing to determine why the test was failed.

To use the Single Leg Squat Test as an example, we can identify whether a runner can pass or fail the test but we cannot identify if this is due to mobility restrictions of the hip/knee/ankle/foot, strength deficits, or movement control deficits. In this scenario, I would advise someone to get more fully evaluated to assess the reason why the test was failed as many runners can demonstrate similar looking issues for vastly different reasons.

The RRS should not be used as the sole method for exercise prescription.

I say the sole reason as the test positions themselves are very suitable exercises in their own right and it certainly isn’t wrong to use them. Single Leg Squats and Step Ups/Downs are staples to many running rehabilitation programs as an example. But, similar to the aforementioned point about these tests not being able to identify very specific deficits, they also cannot be used to treat them either.

As an example, if someone demonstrates a failing score on the Step Up Test, repeatedly performing step ups as an exercise will improve this test performance. But if the failed test is due disproportionately more to quad weakness, using only the step up exercise to improve it will likely result in continued compensations with the quad weakness being addressed suboptimally. Contrastingly, another runner may have strong quads but fail the Step Up Test due more to lateral hip weakness which limits an optimal position for the hips, and therefore knees, to exert optimal force. These two runners would require very different treatment strategies to improve The Step Up Test.

How is the RRS scored?

Each test on the RRS is performed for 1-minute with the following grading criteria for each test listed below. For the sake of the composite score for this test, these are the considerations used to determine a passing or failing score. In a clinical setting, other aspects of the test performance would also be utilized such as performance disparities between legs (even if both are scoring the same), perceived effort, comfort during the tests, and other movement deviations not included within the grading criteria.

In general, the Wall Sit Test and Plank test are scored for time to complete, and the remaining movement based tests are scored based on the ability to perform while maintaining the cadence of the metronome and while maintaining a level hip/pelvic position and minimizing inward knee movement (called knee valgus/abduction or hip adduction).

How do I sign up for my FREE Running Readiness Scale screenings?

If you’re a local runner, in or near Augusta, GA, I’ll be offering approximately 20 FREE Running Readiness Scale Screenings to help you determine injury risk before beginning a training program. This also helps me gather normative data as I further implement this new outcome measure into my assessments for my physical therapy and coaching clients. If you’re interested in receiving this free screening, please read the following FAQ’s below and complete this brief form linked here which asks for contact information, includes a waiver and consent for assessment, and requires stating an understand of what is, and what is not, included in this free screening.

What does my free Running Readiness Score screening include?

  1. Supervised performance of each of the 5 tests used on the RRS
  2. Scoring for each test, based on pass and fail criteria for timed performance and kinematic (joint and body positioning) performance
  3. Composite scoring, between 0-5, for the RRS overall to determine injury risk
  4. Video recording of the movement based tests included on the RRS (Double Leg Hop Test, Single Leg Squat Test, and Step-Up Test)
  5. Evidence-based guidelines for strength training for runners. This will not be individualized or based on the scoring for this screen as additional testing would need to be required to perform this optimally.

What is not included with my free Running Readiness Score screening?

  1. Further breakdown of these individual screens into more isolated testing to determine a more conclusive reason for why the test was not passed. An example would be individual strength assessments of the quads, hip abductors, and glutes which are commonly weak in runners and may result in failing scores on these tests.
  2. Exercise prescription, outside of the general guidelines which will be provided, to improve performance on these tests. As previously stated, the underlying reason for why a particular test was failed may be different between runners. However, there is merit in completing the tests themselves as exercises.
  3. Coaching or follow-up regarding the RRS performance. I’ll be happy to respond to follow-up questions regarding the performance or scoring of this test but formal follow-up or coaching is not included.

Free Running Readiness Scale screening for the first 20 runners in Augusta, GA to sign up.

Fill out this form below if you’re interested in receiving this Running Readiness Scale screening or are interested in any of my other services for runners which includes Physical Therapy, private running coaching, strength assessments for runners, and strength and injury prevention program design.

No purchase of my services is necessary, or expected, to receive one of these 20 free Running Readiness Assessments.