The Pains of Being a Runner: When to Run Through it and When to Stop
Whether you run 12 miles a week or 70, if you run consistently you’re going to feel some aches and pains. It’s part of being a runner, and after running regularly for a few months, you’re probably accustomed to the feeling of being a little sore. Often these small aches and pains go away on their own and aren’t anything to fret over.
However, injuries are on a large spectrum, where one end is that little twinge in your knee and the other is a torn ACL. Paying attention to red flags and knowing when it’s time to see a professional is the best thing you can do to take care of your body and not make things worse. On my second day of my RRCA Run Coaching training, we went over the 7 main runner breakdowns and when to: Stop, Proceed with Caution, and Go Run!
Here’s what I learned:
What: A doctor will call it patellofemoral pain syndrome, but you probably know it as “runner’s knee“. What can happen is the cartilage under your patella (knee cap) gets irritated and causes a general knee pain. Knee injuries account for roughly 40% of running injuries so it’s far from uncommon to experience some type of knee related issues.
Stop: Pain on either inside or outside of the knee as soon as you start walking, and it doesn’t lessen throughout the day.
Proceed with Caution: Twinges and small pains early on, then disappear, but return later in the day. Acts up after sitting too long.
Go Run: Pain free after prolonged sitting (i.e. road trip or movie) or after long or hilly run.
What: Your Achilles tendon is what connects the calf muscles to the back of your heel. When it’s under a lot of stress (running too much too soon, long runs, speed work, etc.) the tendon tightens and gets irritated.
Stop: Intense pain and swelling just above the heel, at any time (not just on the run). Standing on your toes is painful.
Proceed with Caution: Achy pain round the heel and the end of a run, but ice will make it go away.
Go Run: No pain when you pinch the tendon at the heel, working your way up to the calf end.
What: Your hamstrings play a major role in running, allowing you to bend your knees, extend your legs and drive you up hills and sprint to the finish. They are long and located on the back of your thighs (and are probably always feeling a little tight!) If the tightness, or weakness, is preventing you from running your best, start paying attention.
Stop: Any sharp, sudden or intense pain, especially if you hear a pop (yikes, but it happens). The back of your legs are bruised.
Proceed with Caution: Chronic achy feeling or tightness that makes you slow your pace or alter your gait.
Go Run: Long sitting, hill repeats and speed work do not produce pain.
What: When the tendons and ligaments that run along the sole of your feet, from heel to toe, get small tears from the force of running and become inflamed. It will feel like a bruise or dull ache on your heel and/or along the arch of your foot and is worse in the morning.
Stop: The pain does not decrease after rest and throughout the day.
Proceed with Caution: Pain is present first thing in the morning but seems to fade through the day and after you’ve warmed up on your run.
Go Run: Walking barefoot causes no pain and you do not feel it in the morning.
What: When the muscles along your tibia (shin bone) get small tears in them from the stress of running, you’ll feel an ache along your shin bones referred to as shinsplints. Often they spur from the old shoes or running in the wrong type for your foot, but can also pop up when you take on too much mileage too soon.
Stop: Tenderness down your leg and pain when just walking. Hoping on the affected leg especially hurts.
Proceed with Caution: Tight or achy pain only when running, that dissipates after and does not hurt to hop on.
Go Run: No pain when running, even when you aren’t icing and/or taping the shins.
Iliotibial Band Syndrome (IT band or ITBS)
What: Your IT band runs along the thigh, starting at the hip and connecting at the knee. When your knee flexes and extends when running, it rubs on the back of your femur and can cause irritation if you do too much mileage or a lot of speed or hill work.
Stop: Pain is on the outside of your knee, but radiates along the entire leg even just walking down stairs or a decline.
Proceed with Caution: Minor aches and twinges that arise in the first mile of your run, but go away when you slow down or walk.
Go Run: No pain on the outer knee or thing, even after running a hilly route.
What: Typical fractures are the result of a sudden trauma like a fall, but stress fractures happen gradually and develop from cumulative strain on the bone. Common points on runners are the shin, feet, or heels. This is probably the most serious and primarily come from overtraining.
Stop: Pain intensifies during your run, but just being on your feet is not comfortable.
Proceed with Caution: There’s no in between here! If you’re feeling pain in these spots that do not sound like the other injuries, it’s time for a pro.
Go Run: No pain during your run, or afterwards. Being on your feet all day is not an issue.
Your first defense is running smart. That means:
- Warm up before you head out with dynamic stretching and slowly building to your desired pace.
- Strength train
- Avoid overtraining
- Do not ignore lingering pain (or race on it!)
- Adhere to the 10% rule; don’t increase your weekly mileage more than 10% from the week before
- Run on softer surfaces (grass over pavement, gravel over concrete)
- Hydrate and refuel properly
If you find yourself in the Stop zone, it’s time to visit a physical therapist to asses what’s going on. Many clinics offer a free screening, so if you have a nagging issue that isn’t getting better, stop in and let them tell you it’s OK to keep going before you find yourself sidelined.
The smart running techniques along with recovery methods like icing and foam rolling will ideally keep you running pain free, but paying attention to your aches and pains and recognizing when they get worse is the best way to be proactive.