Readers Roundtable: When Do You Train Through Pain?

imageNear the end of my treadmill tempo last week, I noticed a little soreness in my knee. I blew it off and did my cool-down according to plan. The next morning, my knee was definitely sore. Thus, I faced a conundrum all to familiar to all of us: do I attempt my easy run through the minor discomfort, cross train, or take a day off? Do I assume injury and head straight for a medical professional, go with my own instincts for self-treatment with my foam roller, ice, or other tools, or ignore it?

In the past, I often trained right through pain and while it was annoying for weeks or months, I could get away with it and never injured myself worse. But now, after more setbacks than I care to count and finding myself on the other side of 40, what I did in the past isn’t necessarily the best gauge for what to do in my present. So, as I floundered my way through this dilemma, I wondered what you would do.

So tell us:

What do you do when something hurts? When do you train through the pain and when do you admit defeat? When do you consult a medical professional? How has your approach to pain changed through the years?ย 

Salty Running boss and mother of 3 little ones with PRs of 3:10:15 (26.2), 1:25:59 (13.1) and 18:15 (5k). I love to write about running culture, mental training, and fitting in a serious running habit with the rest of a busy life.

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  1. In college I think I tended to spend a lot of time in the Athletic Trainers room. Ice baths, hot baths, stim, getting stretched out, whatever the case be. I think a part of me thought it was a great tool I had (it was) but used it more than need be and at times it was an excuse to get out of something. (honesty here, hello hindsight)

    Now I think I tend to be more rational before running off to the doctor or something. I try and remember the difference between aches and pains. Aches are the post-workout feelings, and pains are the things you have to be more careful of. If something is affecting my form, and actual pain- I will stop and take a rest day and go from there. Maybe it means a few days off, with extra stretching, compression and PT exercises. Maybe I just needed a day to rest. My first thing is always to look at what I can do, or maybe what I AM doing to cause it (hello, maybe shoes need to be rotated out or I haven’t been drinking enough water etc.). Try and find the cause, and adjust as needed. If it persists without any relief, or gets worse, I will discuss with a professional or someone I know who has had similar issues.

  2. I’m training through the most pain ever right now. My left knee, back and shoulder hurt. When I run, fatigue is generally not the issue.
    I have the Boston Marathon rapidly approaching so I don’t have the option to take some time off. Usually when something hurts I go and exercise anther part of my body.
    What have I done to address my current issues? I switched to brand new shoes. I ice my knee almost every night and I try to get into my hot tub at least once a week. The tub is outside so I can only use it when temps are reasonable.
    I also take the maximum dosage of ibuprofen at least once a day, sometimes twice. I foam roll when I remember to.
    I’m avoiding my PT because I don’t think there is anything that she can do. I don’t have time for strengthening exercises to have any impact. If she told me not to run, well you know what I would do. ๐Ÿ˜‰
    It is frustrating.

    1. Oh boy, knee back AND shoulder! I wonder if a good full body massage would help? Things can get so tight with the cold weather, and training. Hot tub helps, but I think seeing someone who can really loosen things up might work wonders! I try and get one every 6-8 weeks (I would more, but you know..$$), or at the very least a few weeks out from the marathon to make sure everything is in good order. Best of luck with the rest of your Boston training!

  3. I’m the same age as Salty (I think we may even have the same bday) and I have always been a very durable runner. Within a week of turning 40 last year I tweaked my knee with just a slight movement and I ended up having to take almost two months off. That’s made me extremely wary of any aches and niggles. I ran 20 on Saturday and then worked in the yard all day and felt great. But as soon as I stopped late that afternoon, my ankle swelled and I couldn’t put any pressure on it. WTF? Never experienced that before. Anyway, I opted to take yesterday off and instead I iced and loaded up on ibuprofen. As much as I love to pile on the miles and run hard, I’m choosing to err on the side of caution now that I’m a masters runner.

  4. This is a great question. For starters, I distinguish sharp, potentially serious injury pain that usually crops up during a hard workout (potential torn muscle, shin splints, stress fracture) from annoying niggles and soreness. Potentially serious injuries should not be run on for fear of causing widespread damage that can take a long time to heal.

    In the other category are the soreness and niggles that often crop up during hard training and aren’t bad enough to keep one from running but are in the zone of not completely healthy and could turn into something worse. I usually put tender knee and slightly aggravated plantar fascia in this category. When those crop up, I always run easier and decrease the mileage I had planned for the day and treat extra sleep as a doctor’s prescription (nap plus 8+ hours in bed, even if I have to cancel other things to get it). If my morning stress score on my watch is in the green zone, I will keep training even if I feel a bit sore and creaky at the beginning of the run. But I won’t push myself hard or increase training stress until I don’t hurt any more. If I simply pull back and treat my body well, it usually bounces back fairly quickly.

    I cross train and strength train rather than run if pain causes me to alter my gait, because I know that could turn a niggle into a serious injury.

    Hope you feel better soon!

  5. I used to be really stoic about training through pain. I would run no matter what, even if I could barely walk before or after, and even though my injuries usually got worse and worse until they got to the point where I had trouble walking and functioning. I never questioned whether or not this was a rational thing to do. I just thought to myself, “Well, running is hard, it’s hard on the body, and I need to accept a certain amount of pain if I want to succeed.”

    Now, lots of significant running injuries under my belt, I know that was a completely stupid attitude. I would never advise anyone to run through significant pain – and I’m a doctor so I think I have at least a modicum of credibility here. I think if something feels a little off and you want to try a short very easy run to see how it does, that’s one thing. But anything that gets worse as you run, or flares up a lot after running, or is significant enough to affect your walking, needs to be given the rest/recovery it deserves. A few days of rest never matter as much in the grand scheme of things as months off because you ignored your body’s warning signals.

    Here’s my post on the subject from a while back with some tips about how to navigate “The Niggle Conundrum.” :

  6. When I was new runner (and first-time athlete) any pain or discomfort added to all the articles about the big, bad running injuries made me crazy and positive that I had them all too. Training is wear and tear on my body and now I can differentiate between normal hard-work soreness and pain that means it’s time to put a little more post-run care into the area in the evenings with a massage, chiropractor adjustment, or just ice and a little stretching (my sore areas tend to be the bottoms of my feet, so I roll them on a frozen water bottle at night and stretch my calves to loosen up the whole chain of calves-Achilles-plantar fascia). My other sore spot tends to be hips, but then I do some stretching and foam-rolling or massage and it takes care of itself after a few days of extra care. Knock on wood, I’ve been a bit of a unicorn– never had a big injury that required extended time off.

  7. As I get older, I can’t get away with things I used to be able to get away with. It’s frustrating, but liberating in a way – I don’t have to feel so guilty about taking a day off or whatever. I’ve had to come to terms with my perfectionist tendencies and get over it. This time, I backed off, worked on it on my own for a few days and then when it wasn’t following a pattern I was comfortable managing on my own I went to my ART guy (Dr. Leo at Ohio Sports Chiropractic for you NEO readers!) Turns out I probably strained some tendons tripping on a toy on the way to my treadmill, which is obnoxious, but I’ll be up and running again this week. Woo! But if I hammered through it, who knows how it would have turned out!

  8. I hear what most of the crew is saying but sometimes it is hard to distinguish what is aches of hard training and real injury, especially when the real injury is in the early stages.

    I am the worst at taking this advice but stretching and strength training consistently seems to help mitigate both for me. Being over 40 as well, I have had to stop wearing (and walking long distances in) my 3-4 inch heels consistently (contributing to plantar fasciitis). That was the best solution than any other stretching or exercises for me. I ice more regularly as many commenters have said and it does help too. Lately I have added Epson salt baths to the rotation too. I don’t know if they work but its a good mental break and treat from all the training.

    I haven’t trained more than 60 mpw for any marathon because I am not sure my body or my life could handle it. I have been fortunate to avoid serious injury (knocking on wood as I type) but I feel it is a high probability with ANY significant training/competition — running, cycling, field sports, etc. Running gets a bad rap but pro players on all sports are injured frequently, and it wasn’t because they were running. It’s because they push their body to the extreme (or just have bad luck like the rest of us). I do train through the niggles because that is all they are and I feel better working them out. I think I just increase the stretching, icing more when they get to be a nuisance or take an extra rest day because it will make me stronger and missing 1 day to recover when things don’t feel right is better than a few months or a blown up race.

  9. What a timely post – I’m in the process of making an appointment with a PT today because I’ve got some chronic niggles that I’m not sure I’m dealing with correctly. My self-remedies (foam roll, the stick, biofreeze, ice) aren’t making things worse and I haven’t missed any workouts this training cycle, so yay, but I feel like it’s time to seek professional help to see just where my issues are coming from.

    (And I had to stop wearing heels, too…so sad.)

  10. Niggles is a funny word.
    I feel like I live in constant fear of injury! My first few years of running were full of injuries, and the last two times I’ve started training for marathons, I’ve had to drop within a month due to major injury (stress fracture, severe tendonitis). So far, I’m 6 weeks through my marathon training and very few aches or pains. Every time I run though, whenever I feel the faintest hint of anything I start to obsess if that’s the beginning of an injury! I am doing my very best to foam roll regularly and to make sure I’m taking in some protein after I run- My muscles always seem to bounce back better when I am consistent with those two things. I am terrible about stretching, but try to do so when I’m feeling tight.

  11. Be found that if the pain gets less after a warm up, I’m ok to train, although it’s best to cut out speedwork until the pain is pretty much gone. Any pain that worsens through a run means I stop and take at least a day off before trying again.

    Amd I’m so glad to read that others quit wearing heels too! I’m just a shade over 5′ tall, and I still don’t wear heels — my feet and calves can’t stand them since I started running.

    1. Yeah, I’ve had good results following the advice that if it still hurts after you’ve warmed up, it’s going to need serious attention. Most “niggles” will fade after a few minutes of running, a real injury won’t.

  12. I’m just now finally coming back from having to take 6 months off due to sesamoiditis–which I’m sure I made much worse by running through it for way too long. I’m trying so hard to be more careful/less stupid about these things this time around (my New Years resolution was to banish the words, “Well, but it doesn’t hurt THAT much” from my vocabulary), but it’s so hard to tell when something really needs to be worried about vs when I’m just paranoid!

  13. I think I’ve FINALLY learned to discern between pain that needs attention and discomfort that is ok to push through. If anything makes me change my stride — I stop running, walk home, and take one or two days off. If it gets better with a bit of walking and massage, I’ll stop the workout, jog home, and reevaluate the next day.
    …unless I’m in a race. Then I’ll push it til my legs fall off ๐Ÿ˜‰