As runners, we’re constantly debating which aches we can tough out and run through, and which pains are red flags. After all, some soreness is to be expected whenever you’re pushing your body farther or faster than you’ve gone before. “When injury is more of a nagging or dull ache it can be difficult to distinguish between this pain and normal soreness,” says Adam St. Pierre, a Boulder-based ultrarunner, exercise physiologist and founder of Boulder, Co-based ASTP Coaching. The trouble is that if you guess wrong and try to run through an injury, say if you’re training for a race, you might end up changing your gait to avoid the pain, which can cause overuse injuries in other areas of the body. “Trying to run through injury can also result in furthering of the the original injury,” he says. But it’s also easy to make the opposite error. Running without set goals or races in sight may lead runners to rest for too long or fail to make necessary changes.
Here are some tips to help you determine whether you’re reaping the sore rewards of a tough workout, or whether you need to run to the doctor.
When you experience pain at rest, and it intensifies with any weight-bearing activity like walking or running, it’s time to see a doctor. Pain that improves with movement is normal and shouldn't be a red flag for runners. When running if you notice and increase in pain after getting warmed up it may be an issue. Pay attention to patterns in your pain that develop over the course of your run or after resting. Symptoms that worsen after the first mile might be of concern.
If you experience a dull general achiness in your muscles, that’s a normal sign that you have challenge your body in the previous day’s workout. And it’s no cause for worry. But a sharp, shooting sensation is typically a sign that you have an injury. In most cases, a sharp onset of pain is a bad sign that usually follows a twist or a fall.
With a sharp or acute onset of pain medical attention is likely necessary, says St. Pierre. Often an acute injury needs to settle down for a day (or a few days) before a medical provider can provide an accurate diagnosis. If a a sharp or acute pain is still present after 24 to 48 hours, make an appointment with a physical therapist, sports medicine doctor or other provider. Make your appointment as soon as possible after the injury, as many times the doctors are booked with limited scheduling flexibility. If the pain goes away, you can always cancel!
Most minor irritations can improve with three days of rest, icing along with stretches. But if the pain lasts more than two to three days, it’s most likely the result of injury and not normal soreness. Normal running pains should not hurt throughout normal daily activities for more than three days. Aches that change how you move for longer than three days should be considered
Generally, if pain is focused in an area or comes on very quickly then it likely will need medical attention. For instance, if your left knee hurts, but there is little or no pain elsewhere, that’s a sign that you may need medical attention for acute injury.
If you have obvious signs of trauma, like bruising and swelling, especially in the knees or ankles, see a doctor for evaluation. If the pain interferes with routine activities like walking, standing, sitting, and climbing or descending stairs, seek medical attention. Often to their detriment, runners have a high pain tolerance and will push themselves to "work through it" with little willingness to get the pain checked out.