Should I Run Today?
This is a topic that so many runners find ever so frustrating and fear hearing the words “you need to stop running” coming from a health professional. So how do we answer this question?
1) Knowing the difference between an acceptable discomfort and a bad pain.
2) Determining when it’s OK to run? When do you need to rest? Or modify training?
We always aim to keep runners running when possible, as keeping you running, keeps up your load tolerance of all your tissues, keeps you consistent, which in turn keeps you strong physically and mentally. Sometimes you can continue to run through some niggles and ‘good pains’, it’s the nature of the sport: but if we listened to every niggle, we wouldn’t run much at all! So while it’s a fine line, with experience you can get to know how hard you can push your body.
However there are some pains you CAN’T or SHOULDN’T run through. So firstly, how do we determine what a good pain is and what a bad pain is? And then secondly, how do we know whether we should keep to the training plan, modify your training, alter your training – ie swimming or as a last resort, have a rest day!
Is the pain Good or Bad?
Can your pain fit in the following description to be classified as an acceptable pain.
Self rated as a 1-2/10 stiffness kind of pain.
It generally warms up, with running or throughout the day.
The pain doesn’t last long after exercise.
It’s not obviously swollen.
It doesn’t make you limp.
You hardly feel it with activities throughout the day.
The trend is it seems to be improving.
Bad Pain:
Stronger/sharper pain or a constant unrelenting tiring, never ceasing dull ache kind of pain.
Generally impairs normal movement, slows you down, makes you limp.
Pain lasts for a long time after exercise.
Symptoms aren’t getting better with time, potentially they are getting worse.
Pain that is present at rest, at night and can be constant.
Treatment and pain medication are failing to alleviate symptoms.
Any pain associated with an old injury.
Any pain that gets worse with running.
Often visibly swollen.
Any pain that fits the pattern above and you suspect to be bony in origin or an early stage irritated tendon/plantarfascia or unresponsive shin pain…(get diagnosed as for these you may need to stop running for a small period to get better again)
Bad pain fails the below battery with any pain greater than 2/10 with testing or inability to complete. While good pain should be fine with positive responses to the following battery of questions/tests:
You can you walk for 30 mins without pain.
You are comfy with most daily activities.
No pain or minimal pain with single leg stance for 10 seconds.
No pain or minimal pain with 10 single leg squats.
No pain or minimal pain with jogging on the spot for 1min.
No pain or minimal pain with 10-15 jumps or bounds
No pain or minimal pain with 10-15 hops or 30 seconds of hopping.
No pain or minimal pain with a 4-5 min treadmill run tolerance test
What running or training can I do?
Everyone is an individual, there is no recipe to this reasoning process. Start by asking yourself: what is your running goal?
Is it good pain or bad pain?
Then reason through a risk vs benefit analysis
Is there a race coming up and how invested are you? (ie have you paid for flights overseas?)
How prepared are you – have you genuinely done the training up to this point?
Are you able to run at a level
What are the risks/consequences of taking some time off? Will the injury get worse if you were to cross train or rest?
Will you be able to maintain your fitness with cross training?
Where in your training program are you?
What running can you do? Start with performing a small run tolerance test. Try a run slightly lighter run to your normal level and monitor your response during, after and next day? If the pain is still a 1-2/10 the morning after, this running load forms the basis of your return to run program. If it declines, then we need to reduce your load further and perhaps add in some strength or rehabilitation training to get you back to full strength.
Sometimes it might be the type of run you are doing. For example a chronic Achilles tendon pain may get stirred up and sore for 3 days straight with hill reps and short, fast speed work around the track. However, copes well with long slow runs or fartlek sessions. This runner gets ‘bad pain’ with hill repetitions and speed work at the moment but ‘good pain’ with long easy runs and 20 minute tempo sessions. So we now know how to structure their training for the coming weeks. When progressing a runner back from injury/pain, it’s important to do it as gradually as you can and change just one variable at a time. This might look like ensuring the duration/time on the feet runs are up to an appropriate level before adding intensity, a change in terrain, footwear, hills etc…
If it is ‘bad pain’ irritability is generally high, and flares are probable with a poor program, so you will need to change your running schedule (you will need to add a combination of the following; some-rest, cross training, or some modified/reduced running training). Cross training that doesn’t cause pain is acceptable however don’t suddenly do 5hrs as this will use valuable energy that normally goes into recovery. If there is still little to no improvement in pain and you are unsure what to do, a proper diagnosis and treatment plan from would be an appropriate next step before the issue worsens and you are missing more training.
Zoe Lorenzo
Hub runner
Director/ Specialising in Paediatric and Women's Health Physiotherapy
Bsc (Physiotherapy) M(Paediatric Physio)
www.moveforlifephysio.com.au
131 Lower Dandenong Road Mentone 3194
p: 9584 2000
