If you’re anything like most experienced runners, you’ve probably run through your share of pain. Basically, unless an appendage actually falls off of your body during a run, you keep going.
You’ve heard it a million times…pain is your body’s way of telling you something is wrong. However, that “something is wrong” can mean anything from “hey, dude, your tibia is about to snap in half ” to “ohhhh, I wish I hadn’t had that 3rd martini last night at dinner…”
All runners experience pain at one point or another, especially when increasing mileage or speed. Marathon, ultra, and elite runners are mentally tough, and have fine-tuned their ability to turn pain signals into “background noise”. This can occasionally be a problem because they don’t always recognize a significant injury when it begins to sneak up on them.
Recreational and new runners have the opposite problem: they often run to my clinic at the slightest hint of pain because they haven’t yet trained their bodies to deal with the significant discomfort that often comes with getting faster.
If you’re increasing your intensity or mileage, pain is normal. That’s what I call “adaptation pain”. So how do you know the difference between injury pain and suck it up pain?
Here are a few guidelines-
- Medial shin pain (on the inside front of the shin) needs to be very closely monitored.
- These types of shin splints are common issues in runners with weak calves or abductors and those that get stuck in prolonged pronation. However, there is an extremely fine line between inflammation of the Tibialis Posterior muscle that causes posterior “shin splints” and that of inflammation around the actual bone, which is referred to as a stress reaction and is a precursor to stress fracture.
- Lateral shin pain (on the outside front of your shin)
- Not as scary from a stress fracture perspective, and is most common in new runners or those who tend to over-stride. While running through this kind of pain is less risky, it may significantly prolong the injury.
- Pain that really feels like pain as opposed to discomfort, tightness, decreased range of motion, or diffuse achiness should get immediate attention.
- Instability, locking, clicking, catching, swelling, or pain in a joint of any kind (hip, knee, ankle, shoulder, big toe, et al) should always be evaluated before running through them. This is imperative to rule out joint pathology and make sure no damage to ligaments has occurred. However, if you just experience some clicking in you knee or hip with certain movements it is often due to a tight tendon snapping across a bone and is nothing to be concerned about, especially in the absence of pain.
- Symptoms that occur at rest should always be evaluated. This is especially true if you have noticed that symptoms have progressed from only occurring while running to lasting through the night. If this is the case, it’s time to take a couple of days off and figure out what’s going on.
And finally, DO NOT run through Achilles pain! The Achilles tendon has poor vascular supply and can have a very slow recovery if not managed properly. You have a much better chance of avoiding a significant break from running if you get treatment right away.
Basically, there are 3 levels of pain:
- Debilitating Pain
- Stepping barefoot on a Lego kinda pain (as a mom, I know this pain first hand)
If your pain is at number 2 or 3, it’s time to come see us, otherwise, suck it up, keep running and see how things go.