In Part I we covered some factors that if present would suggest we shouldn’t be running today. In this Part II, we’ll discuss some factors that may offer at least a glimmer of hope. If any of these conditions are present, it doesn’t automatically mean we’re in the clear but it does give us something to work with.
Do your symptoms get better during or after running? Many of you have probably experienced the situation in which you feel pain while walking around or even at rest, but once you start running your symptoms seem to get better. Persistent pain under any situation necessitates caution but the fact you see improvements while moving is a favorable sign. Although this is reason for optimism, we shouldn’t get too greedy because sometimes our bodies can suppress pain signals to get through the physical exertion. Still, any temporary diminishing of pain can help guide us toward a full resolution if we can identify WHY running is making us feel better.
Can you run ten minutes with minimal to no symptoms? Ten minutes is long enough to get an honest assessment of our symptoms but not so long that we’re causing any harm if we later find out that we aren’t ready to progress. Also, if you can get through ten minutes or longer of running without symptoms, any reappearance of symptoms later in the run would suggest a training issue related to form or conditioning, not a persistent injury that threatens our ability to run at all.
Do you sometimes forget you were in pain? One of my favorite indications of progress. You go to do something that has been causing pain and afterward you have this realization of “wow…that doesn’t hurt anymore.” Maybe you’ve been having back pain and have dealt with the reality of pain while bending forward. Then one day you reach down to tie your shoes and surprisingly don’t feel pain anymore. Subconscious action is often more reliable for pain perception since it lacks the implicit bias of our conscious mind.
Does the pain migrate? If your pain migrates, that leads us to believe we’re dealing with a case of irritation rather than diagnosable structural injury. Think of a fracture at one extreme where your pain is typically centered on the spot of the break. That pain doesn’t migrate. You might experience other secondary pains, but pain remains at the site of the break until healing occurs. Migrating pain, on the other hand, is often a sign of the body trying to work through things subconsciously rather than a structure that we risk damaging if we don’t take the needed rest.
Do changes to training variables lead to changes in symptoms? Maybe it’s different shoes. Or maybe trails or grass help relieve the pain you’ve been experiencing on the road or track. Perhaps your easy runs feel good but running faster provokes symptoms. They might not be permanent at this point, but first things first. HOW to manipulate these variables is a whole discussion unto itself but for now, recognize that having control over these variables also gives us control of our symptoms.
Allan Phillips, PT, DPT is owner of Ventana Physiotherapy