In my experience, I’ve found many runner’s to have a high pain threshold, which can be a help when you’re a runner. However, deciding whether to run through pain is a dark art and filled with many pitfalls!
So, in this blog, I’d like to help you avoid unnecessary injuries and share with you some insider information built up over a lifetime of clinical practice treating runners, offering you some clarity and debunking these myths related to running through pain:
Pain is weakness leaving the body!
Pain is a sensation and all sensations are pleasurable, so enjoy the pain!
No pain no gain!
So, “should I run through pain?” Well, in a nutshell it depends on what type of pain you’re experiencing. Broadly speaking there are 2 types of pain related to running and it’s crucial to be able to distinguish between the main 2 types.
1. Delayed onset of muscle soreness, also known as DOMS for short, which is a normal part of any successful exercise training programme. It’s often described as “heavy legs” and in runners is mostly felt as a broad, dull, heavy, ache in the large propulsion muscles of the leg i.e. gluteals, quadriceps or claves.
DOMS is often experienced the day after a run, when you’ve increased the mileage or done a hard hill or speed session, when you are doing day-to-day tasks that work those muscles, such as getting out of a chair or walking downstairs. It’s entirely normal and desired for the training effect.
Physiologically, one way to describe what’s happening within the muscle in DOMS is that during the harder exercise session, you get microscopic tears within the exercised muscle. The body is then in a phase where it’s laying down new muscle fibres, increasing muscle cross sectional area (getting larger) and increasing strength and endurance, hence the desired “training effect”. It normally peaks day two after the exercise session and then subsides. Read more about DOMS here.
2. Pain as a result of injury This type of pain is undesirable as any part of a training programme. Unless there is a definite memorable traumatic incident whilst out running either a slip, trip or fall (which you would be able to remember), all other running injuries can be classified as overuse injuries.
By their very nature, overuse injuries, will start gradually and mostly occur when there is a perfect storm of intrinsic and extrinsic factors.
Intrinsic (Internal) Injury Factors
These are factor internal to your body, namely:
- A recent increase in body weight
- Your running technique
- Poor or altered foot & lower limb biomechanics
- Long term muscle imbalance
- Muscle strength & control
- Muscle flexibility
Extrinsic (External) Injury Factors
These are factors that are external to your body and focus generally around your training parameters, namely:
- Running volume – frequency, duration or distance
- Running intensity and speed
- Running terrain – hilly or flat, road or off-road
- Inadequate warm-up
- Running footwear
When we assess runners at goPhysio we will often find a unique mix of these factors. When combined together, they lower their body’s loading capacity or ability to cope with the demands that are being placed on their body. This results in the body complaining, often with a sharper, more niggling pain, where injury has occurred. An important part of our job as physiotherapist’s is to prioritise which factors, if addressed, will give the quickest, best outcome i.e. return to running symptom free long term.
However, if you continue to mindlessly run on this type of sharper pain without addressing the predisposing factors, it will likely worsen in severity and frequency, being felt earlier into a run and to a greater severity, eventually limiting your ability to run.
At this stage, what is usually happening physiologically, is the DOMS described above has developed into pain from injury. The micro-trauma, if left unaddressed, becomes inflammation, pain and eventually an injury.
So, if you think you’re experiencing these worsening, sharper symptoms over 2-3 runs in a week to 10 day period, stop and seek an expert physiotherapy assessment to identify, modify and remove all the predisposing factors getting you back to pain free running quickly!
Happy Running and don’t enjoy the pain!
By Paul Baker, Clinical Director of goPhysio