One of the main questions I get asked as a Doctor of Physical Therapy and running coach is, “Is it ok for me to run??” Some people will take the easy way out and say “Oh, just take a few weeks off.” But any runner knows that’s an entirely unsatisfactory answer, especially when given in a dismissive tone. True, sometimes we DO need some time off, but it should be the LAST resort, not the first option.
Here I’ll go through some “red flags” that can help us determine if we need to avoid running for at least today. Nothing is ever absolute, but if any of these are present, you’d need a very powerful reason to run through the pain…
In Part II, I’ll discuss some training factors we can work with to help mitigate the need for excessive time off.
Sharp, unrelenting pain - This pain is intense and doesn’t go away, not even when you’re at rest. If it’s that bad, then you probably shouldn’t be running today.
Does it hurt when you start running and get progressively worse with running - Rarely does anything good come from trying to push through this situation. If it gets better when we run, then we’re having a different conversation (stay tuned for part II)
Do you feel pain with landing AND feel point tenderness in your shin or pubic area - Pain when landing can describe MANY things, so that alone should not automatically take you away from running. But if you’re also experiencing pain that you can specifically pinpoint in one of these two “hot spots,” you’ll want to get imaging to rule out a stress fracture or bone stress injury
Does it noticeably change your stride - I recommend a common sense approach for this: if your stride looks painful (meaning the pain is so intense that you can’t even fake your way around it), then we probably shouldn’t be running through the pain.
Do you think about it constantly - Think mind-body connection. If the pain is at the forefront of your thoughts and you can’t get your mind off it, your body is telling you something.
Have you felt this pain before and unsuccessfully tried to run through it - Use your experience as a guide. Any experienced runner has taken a chance on running through what they consider to be a minor pain. Often it will resolve on its own. But other times we lose our “bet” with our body and the minor pain isn’t so minor. Don’t make the same mistake again (however, the reverse of this isn’t always true…just because you won the bet previously doesn’t give you an automatic free pass…)
Do you need a supramaximal dose of pain medication to get through a run – If the pain is that bad, there’s something needing attention. Taking that much pain medication just isn’t a good thing.
Look out for Part II where we discuss factors that we can modify to help us work around certain aches and pains…
Allan Phillips, PT, DPT is owner of Ventana Physiotherapy