Running injuries are a lot like international relations—usually, things aren’t all perfect or all terrible. It’s not a choice between perfect health and long-term injury, just like it’s not a choice between utopian peace and nuclear war. Often, things are somewhere in between.
Healthy runners are like good diplomats—negotiating strategically and knowing when to respond with love or aggression. Constantly injured runners are often like bad diplomats—ignoring clear signals and sending warships into hostile waters for no good reason.
Fortunately, unlike when dealing with those 400-pound Russian hackers, there are some general rules for navigating injury. Here is how to prevent mutually assured destruction of your body and soul from long-term injuries.
Fewer injuries = more woohoos. Photo by David Roche
As a General Rule …
… a few days off is no big deal. A few weeks off will set you back. A few months off and you’ll have to start back at Go without collecting $200.
With that in mind, it is better to take a few days off a bunch of times throughout the season than to make a minor injury a major one by pushing through it.
A less experienced runner might need 10 to 20 short breaks throughout the year as their body adapts to training. A more experienced runner might only need one or two. But the discipline to know when to hold ‘em and when to fold ‘em is one of the most important things a runner can learn.
These five rules should guide your decision whether to take a short break.
1. If you feel pain while walking, don’t run.
Whenever you have pain anywhere from the low back down to the toes in everyday life, running is not wise. Running involves far greater impact forces than everyday life—if it’s not good when bagging groceries, it’ll be really not good at mile three. Pay special attention to pain in the shins, knees, feet and hips.
2. If you feel pain start during a run, stop and take at least a day off.
You need to be a pro at the runner’s “walk of shame.” If you feel a serious pain, stop immediately and walk home.
Back in May, my wife Megan and I had a 20-mile trail run planned. It was a beautiful day, with birds tweeting more than presidential candidates (the good old days). Megan crushed the first climb, setting an all-time record. Then, she felt a twinge. We stopped and we walked the four miles back to the car.
Between us, we have had four walks of shame in 2016. As a result, we have had no major injuries (outside of pain from reading election-related tweets).
3. If it could be a bone stress (feet, shins, mid-thigh especially), take at least three days off. If it’s probably soft tissue (arch, calves, quads, hamstrings), let pain be your guide.
As a runner, you need to protect your bones as if your running life depends on it. Whenever you feel pain that is deep and close to any bone, especially if it feels like a dull “echo” or pulling, do not run for an extended period, even if it gets better in the short term.
Stress fractures usually don’t happen all at once. At first, the bone is just inflamed, kind of like a cake that pops up in the oven. Give it a few days to chill, and it will rebound most of the time. Keep on cooking and it will burn up and/or explode, progressing to a stress fracture.
Meanwhile, soft tissue pain is common for runners. The key is knowing when it could be more serious. In general, soreness in the middle, meaty section of muscles is fine to run easily through. Soreness or pain at connection points like the hips or butt/hamstring should be treated with the same precaution as a potential bone injury.
A few days without a sunrise is better than a few weeks without a sunrise. Photo by David Roche
4. If soreness gets worse while running, stop immediately.
Let’s face it, sometimes you have to run through small amounts of pain, or you’ll almost never run. If that small rivulet of discomfort becomes a raging current of distress (or even a bubbling brook of disquiet), do not run through it. Worsening pain could be the sign of a more serious issue.
Meanwhile, if the pain goes away while running, it could be a small bout of tendinitis or muscle soreness, which is fine to run through in moderation.
5. Diagnose, don’t guess.
If you look up your symptoms on WebMD, a small bout of shin tightness will become shinbola and a minor muscle ache will morph into mad quad disease. Ask your experienced runner friends for guidance, go based on past experience, but don’t rely on your own diagnostic skills.
Instead, get to a doctor if possible. I recommend all serious runners invest in a health plan that makes MRIs easy to get, even if it is way more expensive than an alternative plan. Usually, an MRI is the only way to unravel the mysteries of running injuries.
Absent an MRI and/or a doctor visit, you can do the “hop” test (jump on one foot—if you feel pain, don’t run) or other diagnostic tests for specific injuries (like the fulcrum test for femoral stress fractures). However, don’t invest too much energy in your ability to self-diagnose. I, for example, would have failed the hop test 75 percent of days since 2011, but that is just because I have the hips of the world’s worst salsa dancer (or world’s best bingo player).
Finally, if you are worried, take time off until you aren’t. Catch injuries early, and you’ll be running way more often.
David Roche is a two-time USATF trail national champion, the 2014 U.S. Sub-Ultra Trail Runner of the Year and a member of Nike Trail Elite and Team Clif Bar. He works with runners of all abilities through his coaching service, Some Work, All Play. Follow David’s daily training on Strava here, and follow him on Twitter here.