The Niggle Conundrum: Can I Run Through It?

Garlic

Rebecca has written 55 posts on Salty Running.

Mom of three kiddos and a black lab, running enthusiast, doctor, trainer and coach with a love of the science and sport of running and all things related. Founder of Moms Run Strong (www.momsrunstrong.com). I live in Brookline, MA and when I'm not in my minivan I can be found out on the roads, track or trails or on the floor with my foam roller.

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Arsenal of the oft-injured runner

A few weeks ago, Salty, Allspice and I had a conversation about whether or not Allspice should continue running through a niggle she had developed.  This led us to ponder the classic runner’s dilemma – it hurts, but can I run through it?  Because most of us who love to run would give up any material good we own rather than miss a few days of training, many times we do wind up running through pain.  Sometimes we’re okay – the issue resolves even though we didn’t take a break – but sometimes we are decidedly not okay.  If only we had a clear set of rules to tell us when the pendulum will swing one way versus the other!

I wish I could give you that clear set of rules, but I can’t.  Between us Salty Bloggers, we all have a very different set of personal rules for dealing with pain. How your body handles a burgeoning injury is dependent on so many things: your own perception of pain or limitation, your current level of fitness, your genetics, your age – the list goes on.  But what I can do is give you some insights I have gained over the course of my own running experience, and invite you all to contribute your own wise words to the conversation.  Healthy and consistent running means fast running, so let’s all help each other get there!

Changing our attitude towards pain: In his authoritative text on functional movement, Movement, physical therapist Gray Cook writes,

“…pain is simply the brain’s interpretation of a neurological signal normally associated with trauma, dysfunction, instant and continuing damage.”

He then goes on to write, “Exercise and activity in the presence of pain present more risk than reward,” and describes a number of studies in which pain has been shown to alter muscle activity, motor control, and even motor planning.  Why, then, do we so often view pain as an inconvenience or an annoyance, and try to cover it up with painkillers, ice, wraps or braces?  I myself have been guilty of this on countless occasions; I used to pop three Motrin before every single run to neutralize any protest my body might have had to the training I wanted to do.  I felt angry, like my body had betrayed me, whenever I started to develop a sore spot that hampered my plans.  But I was doing myself a disservice by feeling this way.  My body was trying to warn me, but I didn’t pay attention or feel grateful for that danger signal.  And let me tell you, this never, ever led to improvements in my running, only full-blown injury, frustration, and more pain.

en: Photo of a Band-Aid manufactured by Johnso...

Pills, ice and gritting our teeth are just superficial ways to cope and won’t get rid of the problem. (Photo credit: Wikipedia)

When a niggle first develops: Muscle soreness is an inevitable part of pushing our limits in training and competing.  The symmetrical, bilateral stiffness or soreness in your prime mover muscles (glutes, quads, hamstrings) after a hard workout or race is a natural part of gaining fitness and improving.   It’s when things don’t feel the same on both sides that you need to start to pay attention.  Particularly in the feet and lower legs, areas with poorer circulation, asymmetrical soreness needs to be noted.  Back pain during or after running is not normal.  If you start to feel something while you are running, stop and check it out, particularly if it becomes increasingly uncomfortable as you go on.  Take a short break, palpate it, massage it and/or stretch.  Try to restart; if the pain is still there, pack it in and go home.  Yes, this will ruin your tempo run pace, and might be inconvenient if you are out on your long run, but no single workout will make or break your progress as a runner.  If you are a devoted runner chances are you have an extremely strong will, but just because you can continue to run through something does not mean that you should.  Your body might be letting you know enough is enough, and if you don’t heed the warning you are at risk of breaking down.  I would argue it just isn’t worth it to take that risk.

Things to help you determine if it’s okay to run: Frequently when an injury is first developing and is still in a very mild state, all you need is a day or two of rest and you can resume training.  You may feel that your fitness is slipping away by taking that time, but in the grand scheme these few days of rest are just a drop in the bucket.  Loss of fitness happens from weeks or months of missed training, not a couple of days or even a week.  You will still be well on track for your goals by letting your niggle sort itself out.  Pain-free walking is usually a good indicator you are ready to try a run.  You can hop on the affected foot/leg before you go out; if this causes pain, give the injury a little more time before challenging it.  If not, a test run is appropriate.  I like ten minutes of easy running, then a brief break to stretch and check yourself out, and then another ten minutes of easy running if you feel okay.  Sometimes there can be a little residual soreness when you start up – this should resolve completely within the first few minutes.  If not, the affected area is still vulnerable and likely needs more rest.

The risk of running before it’s ready: Months of being sidelined while your running fitness truly does slip away.  As anyone who’s been out for months knows, you can cross-train your butt off but unless you have easy access to an Alter-G or a Hydroworx treadmill, nothing will maintain your running-specific fitness when you can’t run and you will have to build back up once you are finally healthy again.  There are many expletives to describe this situation.  Don’t put yourself there.

Easing back into training: Be sure to give yourself enough time to recover from the test run.  I recommend at least a full 24 hours before you try another run, as sometimes an injury response can be delayed.  I also think it’s wise to spend a few days running easy; get the blood flowing to the affected area and make sure things really do feel well.  You might be sore in the area after you run – this is normal, but make sure it subsides and you are pain-free again before your next run.  Let your body tell you how much your injury can handle.  Accept the fact that you may have to table your quality workouts for the next week or so, and even readjust your training schedule a bit.  Don’t taint your training with the worry that your niggle just won’t hold up – it will be too hard to reap the gains you are hoping for if you aren’t feeling healthy and solid.

Finding the root cause: So in response to all of this, you might say “Wait a second, Garlic.  Niggles come up in training all the time, and if I babied every sore spot in the way you’re recommending I’d never make any progress with my training at all!”  But why should we accept that training has to be fraught with injuries?  For so many years I did accept this – I thought to be a good runner I had to live in pain all the time, that this was just part of it.  But I question this now.  Maybe you are getting injured all the time because your movement patterns aren’t what they should be.  Maybe you lack running-specific strength, skill or power and just need guidance to develop these traits so you can run healthier and better.  Maybe you have an anatomic abnormality that can be addressed and managed by a healthcare professional.  Figure out what you need to do to run pain-free as much as you possibly can so our sport can be about joy in movement, as it should be.

How do you handle a niggle and keep it from turning into a sidelining injury?  Do you think you’re more conservative or aggressive in your approach to pain? Do you believe that we need to run in pain sometimes to progress as runners? 

4 Responses to “The Niggle Conundrum: Can I Run Through It?”

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  1. Allspice Allspice says:

    This is a great post! I completely agree that running shouldn’t be a painful activity, but it’s so hard to know the difference between ‘red flag’ pain and everyday niggles. I especially love the part about finding the root cause, which is so important to prevent the injury cycle from happening again and again.

    • Garlic says:

      Thanks Allspice! I agree…the difference between an everyday niggle and a red flag is so subtle, and also (as we have talked about), to muddy things further your ability to tolerate niggles changes with your level of fitness. We run along a fine line all the time between doing what we need to for performance gains vs. doing more than we can handle and breaking down. Tough to navigate, for sure!

  2. Gail says:

    I just had an experience where what I thought was a niggle was actually something much larger, and the experience worked out beautifully because we found the root cause! I had been having pain in my left foot that I thought was a pinched nerve, or at worst the beginnings of tendinitis. Coincidentally, I had an appointment with two medical experts in running to have my form analyzed, and when I described the pain, they told me that it was almost definitely the beginning of a stress fracture. I pulled out of a half marathon I had planned to run a few days later (such a painful mental decision) based on their advice, and am now listening MUCH more to my body. I also learned why, anatomically, I am prone to stress fractures in this area of my foot, and knowing the root cause will allow me to adjust my form for it and hopefully prevent them in the future (along with a healthy dose of paying attention to the niggles!).

    • Garlic says:

      Good for you for listening to your body and saving yourself from a bad injury! It’s so tough mentally to pull out of a race right before it’s supposed to happen – all that training! – but it seems like a lot of positive things came from the experience, and I’m very glad for you about that.

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