Running—it hurts so good. Right?
Not if you want to keep running for the long haul. You may have heard runners or other athletes talk about “pushing through the pain”—you may even have said it yourself. But whether you’re just beginning to run or are a seasoned marathoner, it’s important to know the difference between the soreness that’s expected when you are starting or ramping up a training program, compared to pain that could be an early sign of an injury.
“Typically, the normal aches and pains of running are going to end when you stop running—or will go away in the next day or two,” said Daniel Hannah, director of athletic training outreach at Augusta University Health. “There’s also a big difference between the soreness experienced by a novice compared to an experienced runner. Some may also experience delayed onset muscle soreness 48 or 72 hours following exercise—which will resolve better with more exercise.”
“We consider pain that is associated with injury rather than simple soreness if the pain is changing how you run—for example, if it causes you to limp—and if it doesn’t stop when you stop and it lingers for more than a few days,” added Emily Strobino, an athletic trainer at AU Health.
To help combat muscle soreness from starting or increasing an exercise regimen, Strobino recommends the 10 percent rule. “It’s really conservative, but it’s conservative for a reason, depending on a person’s age and conditioning,” she said. “As you train, increase your mileage, time or speed only by 10 percent to help decrease your risk of injury. And gradually change your terrain, too—don’t run 5 miles on pavement then 10 miles the next week on a trail.”
More than just soreness
Runners talk about pain a lot for a reason: As beneficial as the exercise is, the regimen is particularly tough on the body. While there are many common runner’s injuries—most typically caused by overuse or repeated stress to the body—Hannah and Strobino say these are three common injuries that runners should be aware of:
- Shin splints: Sometimes referred to as medial tibial stress syndrome, shin splints result in pain at the front of the lower leg. Most experts point to causes ranging from changes in intensity, gait or running surfaces to even the wrong type of shoes. While you could “run it off” and it could potentially improve on its own (especially if it’s due to a change in intensity of training), the worry is that shin splints left untreated could exacerbate to a stress fracture, said Strobino. How to treat/prevent: Proper stretching of the calves before and after running is key. Lean against a wall or other surface with your front leg bent and your back leg straight (you are stretching the back leg). Then slightly bend the knee of your back leg to ensure you’re stretching the full range of muscles in your calf. Switch legs.
- IT band friction syndrome: This lateral knee injury (outside part of the knee) is due to irritation of a band that runs from the hip to the knee. As you run and bend your knee, the band slips over and over against a bony prominence. A common mechanism for developing this condition is due to routinely running on the same side of the road. As a result of the crowning of the road, your body has to compensate, which results in an uneven distribution of forces on the body. How to treat/prevent: Start by switching up your route. Make sure to run on more level terrain, or if that’s not possible, at least change direction so that both sides of your body experience the uneven terrain equally. Foam rolling along the length of the band from your hip to your knee, can be helpful too.
- Achilles tendonitis: Also known as Achilles tendinopathy, this condition results in pain in the heel cord just above the point where it attaches to the heel, along with possible swelling. It can be caused by overuse, but also by the wrong shoe (see below). How to treat/prevent: Start by making sure to stretch the full range of the calf muscle, in the same way as you would for shin splints (see above). Calf raises done on an edge where you focus particularly on lowering back down are also helpful; try three sets of 15. During the day, placing a quarter-inch felt wedge or a heel cup under the heel may provide some pain relief. These are commonly available at pharmacies.
Is it your shoes?
Runners often overlook the importance of shoe care. It is suggested that your shoes be replaced every 300 to 500 miles or every six months. Improper shoe support may also contribute to the development of overuse injuries. Consider a consult with a running store to help determine the type of shoe support that corresponds best to your foot posture.
Maintain your form
No matter the injury, a few universal rules apply, say Hannah and Strobino. Icing during the acute phase of the injury is helpful, and ibuprofen can manage both pain and swelling. To maintain your level of conditioning, try changing up your exercise/training routine. For example, swimming still amps up your heart rate but is gentle on your joints, and yoga is helpful for maintaining flexibility.
Always perform a warm-up routine before running—old-school calisthenics such as jumping jacks are an appropriate warm-up activity—and make sure to stretch well after you run. If you’re easing back in after an injury, start with intervals: Walk for a minute, then run for a minute, and so on. Gradually increase the intervals.
“What we call active recovery is good for these conditions,” said Hannah. “Total rest and not doing anything is not going to get you that far and could make the problem worse when you do start running again.” However, if pain persists or does grow worse after trying these measures at home, make sure to schedule an appointment with a sports medicine physician or orthopedist pronto.”