Have you ever wondered what you should do if you have pain during or after a run?
This is a topic we hear about often. Have you ever been in a situation where you’re running and feeling pain and wondering, is this real pain or is this normal soreness? Are you icing after every single run? Are you wondering, am I doing any long term damage?
These questions may be scary, but that curiosity regarding your physical health as a runner should not be ignored! In this article we will be discussing four serious running injuries to never push through! Let’s get started.
If you are more of the visual and auditory learner just click the YouTube video below outlining everything that is in this article!
The first injury we’re going to discuss involves Neurological symptoms. If you experience any symptoms consistent with a nerve injury such as numbness or tingling, or any burning sensation, you’re going to need to STOP running. This is especially the case for any radiating symptoms, meaning you feel the sensation down your whole leg. A classic example of this is sciatic nerve pain, where you’re getting that numbness and tingling in your buttock area, down your leg and possibly radiating into your foot. If you’re feeling any of this radiating pain in your legs or even in your arms (yes, it’s possible to have neurological symptoms in your arms during running, who knew?) you should absolutely take a break from running and consult a physician. These symptoms are more than likely nerve related and running will only exacerbate your symptoms and make the nerve injury worse. By continuing to run, you can potentially cause long term nerve damage. Nerves that are compressed for a long period of time begin to break down which may cause permanent damage and weakness in your muscles. This may lead you to not being able to run at all. We talked about that classic example of sciatica, but we also want to recognize something called Exertional Compartment Syndrome. This is not the same as Acute Compartment Syndrome, where there’s swelling and pressure builds up in the leg (This is a medical emergency and you need to go to the Emergency Room ASAP). Exertional Compartment Syndrome is seen more in an individual who goes out for a run and feels okay when they start, but after the first couple miles they start to feel numbness and tingling in their foot and pain and pressure in their lower leg. If you are experiencing this, you should NOT be running!
So point #1- if you are experiencing any neurological symptoms, you should stop running and get to the root of those symptoms.
The second topic we’re going to discuss includes any suspected bone injury. Signs and symptoms of this include any sharp or stabbing deep bone pain, localized swelling in the area right over the bone, common over the crest of the tibia in your lower leg. This topic really focuses on our stress fractures. We see this most commonly in our distance runners who are doing repetitive motions or in someone who ramps up too quickly in their training after taking a lot of time off. If you’re ramping up the intensity of your running too quickly, it sets your bones up for injury because your bones haven’t been dealing with the stress and the loading during your time off. If you don’t train your bones in a progressive fashion to handle the repetitive stresses associated with running, the bone will do the opposite of strengthening and start to have stress reactions and stress fractures. Let’s talk about what happens if you run through this. First of all, it’s not going to get better. The bone won’t have the opportunity to heal and it will only weaken and get worse. Think about this: if you have bone pain and you continue to run through your pain then your bone will be much weaker than it should be. Let’s say you trip down two steps on the stairs, a common thing that should not cause any damage, right? Well, sure. Right- if that bone was strong and healthy. Wrong- if that bone is weak and has stress reaction damage to it. You trip down those two steps and now you have a broken tibia and you need surgery. That’s no fun and now you really can’t run. Moral of the story? Make sure that if you have signs and symptoms of a bone injury you recognize it and you don’t try to push through this pain. You need to stop running! Most likely, you’ll need to be non-weight bearing for 6-8 weeks, either on crutches or in an immobilizing walking boot to allow the bone to heal!
Point #2- Sharp or Stabbing pain in your bones should not be ignored!
The third thing that you should not run through are shin splints! Shin splints, also known as Medial Tibial Stress Syndrome, is very common in novice runners who are just starting out as a runner. Shin splints are an overuse type injury where you’re taking on too much load too quickly and therefore setting yourself up for a stress reaction injury (see the connection from above?). If you continue to run through them, they most likely aren’t going to get better. While shin splints are significant, they may not stop you completely from running but will lead you to decrease your load. So instead of 20 miles a week, maybe you’re dropping down to 5 to 10 miles a week. It’s recommended to reduce your running capacity by 50% to allow the body to adapt to running so you can run without any pain as you move forward!
Point #3- Shin Splints are common and they won’t end your running career, but you have to be mindful and take the initiative to reduce your load so your bones can get used to the repetitive stresses associated with running.
The final running related injury that you do not want to run through is any type of sharp pain that actually causes you to stop running. Meaning, you’re running and you feel a sharp pain that requires you to physically stop your run or you completely change your gait (how your running) and have to compensate by not putting any weight on one leg and continuing to run in a compensated pattern. This is indicating that you’ve got something going on and you’re only going to cause more injuries by pushing through this severe pain. Let’s talk about another example. You have shin splints so you compensate and because you compensate, you’re not putting as much weight on that leg meaning you’re not firing your glute and then you start to develop hamstring pain. See that snowball effect? Pushing through that initial sharp pain will only lead to more injuries and a longer recovery time. It really goes back to those classic hamstring, achilles tendon, plantar fascia soft tissue injuries that started because of a completely different injury. With significant pain causing any type of compensation, stop running and give your SPARK Physical Therapist a call.
Point #4- Do not force yourself to run through severe pain!
While these injuries may seem overwhelming, your health and physical longevity should be a priority! Although it may not seem like anything, acknowledge your pain and be aware of any changes that you experience! Let’s be healthy, strong and the best version of ourselves as runners and as individuals!
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Are you a runner that is trying to stay healthy but can’t train because pain is stopping you from meeting your goals?
Are you worried that an injury will limit you from doing what you love like working out and training?
Have you wondered what it will cost you in the long run if you continue to train through pain?
Have you seen other medical providers in the past that just tell you to stop your activity?
We have a unique treatment approach that focuses on solving these problems with our clients. We combine manual hands-on techniques with guided supervised exercises to help you get stronger, pain-free and perform at your peak level to get you back on the road doing what you love. Our goal is to help keep you active and on the road, while recovering from injury by guiding you in ways to modify your training, rather than eliminating running!
The SPARK Physical Therapy Commitment
No long waits or multiple trips to providers’ offices every week. We see you either onsite at a partnering gym or in the comfort of your home when it is convenient with your schedule.
One on one for a full hour with your doctor of physical therapy, every visit. We provide you with a customized plan specifically designed for you, based off your unique injury and goals.
Full transparency in what you pay. You will never get a bill from us a couple of months after your visit.
Access and availability to you! Have a question about your pain or exercise program? Get an answer from your therapist directly.
If you’re in the Wallingford, CT area and are a runner that has been dealing with injuries we can help. We’d love to chat for a few minutes and see if you are a good fit for what we do. Fill in the contact request and we’ll set up a free 10-minute phone consultation with a doctor of physical therapy
Thank you for taking the time to read,
– Duane Scotti, PT, DPT, PhD, OCS
A special thanks goes out to Allie Eldridge, SPT for her contributions to this article
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“I developed IT band syndrome during my first marathon training cycle last year and ended up in physical therapy for about 3 months. I was told not to run if I had any pain at all. I lost so much time “recovering” that I ended up deferring my registration to the next year. I spent the next summer training for the same marathon when about 6 weeks out, that familiar IT band pain returned. I could barely finish a mile. I didn’t want to go back to my physical therapist because I knew what he was going to tell me. Stop running. I was so frustrated and started to feel like marathons weren’t for me. I stumbled upon the healthy runner podcast and learned that I don’t have to stop running in order to recover from injury! I was skeptical about an online physical therapy session. But I reached out to Dr. Scotti and he was able to give me the tools to mitigate my pain within the first session! I was able to complete my training cycle and made it to the finish line of my first marathon with his help! I highly recommend!”
“I’d been dealing with Proximal Hamstring Tendinopathy (PHT) for about 4 years and had been doing PT, but still had lingering pains. I just figured I’d have to suck it up and deal with it because that was as good as I was going to get. But then, I came across a podcast of Duane being interviewed by Jason Fitzgerald on PHT and how he overcame the injury, and my curiosity was piqued. I met with him virtually and he has been a GODSEND! I’m able to sit as I type this! I can bend over and get in and out of cars without pain! And, I’m RUNNING again!!! It is amazing to be able to do things that I haven’t been able to do without pain since 2016!!! Thank you so much Duane for being an incredible PT!!”
“I suffered from IT band syndrome for four years before seeing Dr. Scotti in April 2020. Before then, I couldn’t run more than about 10 minutes without stabbing pain near my left knee. I’d seen various orthopedists, physical therapists, and chiropractors looking for some relief. My career needed me to run a mile and a half within a certain amount of time, and it was impossible to do so with the knee pain. I saw Dr. Scotti and he immediately got to work! That first visit, he helped me understand the anatomy and underlying cause of my knee pain (aka IT Band syndrome). Once I understood what was happening, the course of treatment made so much sense. Not only did he have online videos of all the recommended exercises to treat the problem, his “healthy runner” Facebook group, Podcast, and YouTube videos held a wealth of information and supplemented my plan. I soon understood that running wasn’t just a casual hobby – it’s a sport and one that deserves dedication and focus. Without his dedication to the sport and his community, I wouldn’t have realized this! Over the next few months, I had many ups and downs – victories and failures – and even some tears! Two steps forward and one step back. Dr. Scotti always checked in between appointments and tweaked my plan if needed. By August, I was regularly running 3-4 miles with barely any pain! If I did get pain, it was because my dedication and focus were lacking – and I quickly picked it back up and overcame. I’m so thankful I took another chance at having my knee looked at and trusted someone else. I run regularly now and am really enjoying it. I can’t thank Dr. Scotti enough and would highly recommend him to anyone having trouble.”