As runners, we have a tendency to deal with pain much differently than others. Our mindset is usually “It will just go away over time” or “I’ll just run through the pain and deal with it later.” Neither of these sets up for doing what we love for as long as we want to. There are several factors that can lead to pain, including increasing intensity too soon and fast, running form and stride length, cadence, type of shoe wear, and even warm-up and recovery. So how do we know when to seek help to get back on track for running and doing what we love?
Here are some factors that we as physical therapists take into consideration when pain arises to keep you running!
Is it just soreness or the onset of a possible injury? Below is a chart that helps us to figure out if you should keep running or modify in the meantime. Let’s dive in!
1. Severity
Severity of the problem can be seen as to what degree our pain impacts our function, or ability to perform everyday tasks. On the green side of the chart, we can see that severity is basically zero, that there is no impact on running or activities of daily living. On the other side of the spectrum, our injury significantly impacts the ability to go throughout our daily lives and leaves us feeling like we cannot run at all.
2. The 3 T’s
Time to Onset: This marker depicts how long into your run it takes for pain to appear. This can be anywhere from only at the end of an intense run, or 5 minutes into a short or slower run.
Time of Tolerance: How long can you tolerate the pain during your run once it appears? This can be present throughout your run as mild symptoms occur, or could cause you to stop your run completely?
Time to Recover: How long does it take the symptoms to go away? After some stretching or a cool down at the end of the run, or possibly lingering for 2 days or more.
As you can see, there are a few different aspects to pain to consider. Just because one of the T’s of your injury is in the red zone, does not necessarily mean the others are dependent on that. Depending on the type of injury (muscle soreness, tendon, joint-related, etc.) some instances may fall in the green zone (negligible), while another T may be yellow (moderate) or red (severe).
3. Pain Scale
I am sure you have had Doctors or therapists ask, “Rate your pain from 0-10.” This question can be difficult to answer because there are many factors that develop our perception of pain and how we experience it. However, it does help determine how serious it affects us. For example: 0-3 is considered minimal and does not alter our running at all. We may barely notice it. 4-6 is more moderate and may require some alteration to running intensity or duration in order to decrease our symptoms. 7-10 is considered intense enough to alter form and compensation patterns, as well as affect other activities outside of running.
The type and quality of pain also informs our course of action or treatment plan. Is your pain dull and achy? Is it sharp and shooting? Maybe pins and needles? Oftentimes, our bodies perceive the type of pain as more threatening than others, such as sharp and stabbing. This could lead us to believe it presents more intensely or can become more problematic.
When to Seek Help
So now that we have a good background on the various aspects and presence of pain during a run, how do you know when to keep running and when to seek help?
If you notice a problem beginning to arise, it is never a bad idea to seek a consultation on if this could turn into a long-term issue. However, there is something to be said to knowing how your own body responds to certain stimuli and after a run. Noticing symptoms that are relatively abnormal or uncommon to what to usually feel, getting it checked out may be warranted. The last thing you want is to be sidelined from the thing you love to do.
Quick Tips
Want to prevent the onset of pain or sideline pain before it sidelines you? Here are some quick tips to reduce the likelihood of injury.
1. Dynamic stretching before a run - There is something to be said to prepare our bodies for the task we want them to accomplish. A dynamic warm up aids blood flow and tissue elasticity to prepare us for our run rather than just taking off immediately out the door.
2. Increasing step cadence - The ideal cadence for runners is 180 steps/min or greater, independent of the pace you’re running at. This decreases the amount of force through your body with each step. Important considering running consists of thousands of steps! If your cadence is significantly less than this, try increasing gradually rather than all at once.
3. Increase running mileage or intensity by 10% per week - Increasing mileage too soon before your body is ready for it and adapted can cause things such as shin splints and tendon strains. One good rule of thumb is to increase total weekly mileage by 10% in order to reduce this stress (ex: 15 miles in one week * .1 = 1.5 mile increase to 16.5 the next week)
As you can see, there are many things that can keep us from running and doing what we love, however there are also many ways to combat this! Need some advice for getting to the finish line pain free, or wishing to go through a running assessment to see where you can improve? See if we can help, come visit the Fit Run Shop - in cooperation with Big Peach Running Co!
Thanks for reading,
Andrew Maddox PT, DPT
Originally interested in the world of architecture, Andrew loves getting to know people personally and helping them to achieve their goals by using that engineering mentality of human movement. He loves to celebrate all the accomplishments of his patients and takes your experiences and viewpoints into consideration with every decision made to help you become your best, pain-free self. Andrew lives in Stone Mountain Village with his wife, Stephanie. They have 2 dogs: Chipper (Lab mix) and Benji (Corgi/Blue Heeler). They all enjoy a long walk in the park, camping, sporting events, and visiting coffee shops in the Atlanta area. You can catch Andrew running with the Dunwoody Road Runners group to combine his passion with creating community.