One of the most frequently asked questions from my clients is “how do I prevent running injuries?”. The answer is not always straightforward, especially for athletes who are very tolerant of pain or even for newer runners who are building strength and experiencing the usual aches, pains and soreness of that process.
Beyond looking for injury prevention Pilates exercises, the bigger underlying question from these clients is, “which pain should I ignore and which pain I should address?”. The most important part of injury prevention is learning to listen to and understand the different types of pain or discomfort that will inevitably come up, and to then respond appropriately.
As runners, we have a unique relationship with pain. Running hurts, and then it doesn’t. We push through, get stronger, and overcome discomfort to find joy. So pain isn’t always a bad thing, but sometimes it really is a warning sign we shouldn’t ignore. How do we know the difference between ‘good pain’ and ‘bad pain’? In other words, what is the difference between manageable discomfort that makes us stronger and the warning signs of serious damage and injury?
If a client is concerned about an ache, pain or niggle, I usually ask, “are you hurting or are you hurt?”. The former is temporary and usually ends when your run/race/event is over (or a few days later). Examples of manageable discomfort are muscle soreness, joint stiffness/achiness, and tender feet. Giving the body some TLC such as massage, rest, heat or ice, stretching and a healthy diet will usually clear these things up. The latter is more disruptive to your life and movement. Signs of being hurt are when the pain is unilateral (on one side), when it’s intense in the morning or before you’re warmed up (for more than a few days after a big effort), or when you start needing painkillers for day-to-day activities.
Learning to tell the difference can be a very subtle and personal learning curve that often takes a couple injuries to fully understand. The most important part of the process is to listen to your body. Instead of ignoring or blocking out pain, recognise that your body trying to get your attention. Sometimes your body is saying “Ouch!! Really? This is f*#@ing hard, but ok…”. Other times your body may really be saying “Aaah! Stop! S.O.S.! Send HELP!”. Your body will always tell you what it needs and what it can tolerate, but listening can be the hard part. Building a relationship of patience and respect with your body is the foundation for knowing when you can safely push yourself further than ever and when you need to ease back and care for yourself.
But I may not actually be the best person to give advice on the matter. My first year of running long distances I went buck wild. I raced half a dozen ultramarathons and had three major injuries: a stress fracture, a knee strain, and Achilles tendinitis. I didn’t even know I had injured myself at the time of any of them, because a heady cocktail of adrenaline, unbridled enthusiasm, stubbornness and a sturdy pain tolerance let me hammer through just about anything. I was very lucky though, because about six weeks off running took care of each of these injuries. I probably learned more about pain and injuries during that time than any other. My desperation to get back out onto the trails drove me to learn everything and anything I could about rehabbing those injuries, as well as why they had occurred and how I could prevent them from happening again.
Perhaps the most valuable lesson I took from that time was how to look more closely at different kinds of pain. I started learning when I can “lean in” to the pain, and when I needed to ease back and address it. Examples of pain I can lean in to are the achiness of my legs and hips in the final miles of an ultra, the final cries of a toenail on its way out after a long, steep descent, or the burning of lactic acid during a finish line sprint. Pain I knew I shouldn’t ignore was any that was totally unfamiliar, such as a sharp or jabbing pain in a place I hadn’t felt it before. The pain of old injuries popping up to say hello usually needed attention as well, but rarely came back full-blown. Over time, I learned what something serious feels like, versus something that will resolve itself in a day or two.
At times when we’re particularly stressed out or worn down, injury can be more likely. When life is more even-keeled, we have deeper reserves and can usually tolerate a lot more discomfort. While running will relax and refresh the mind during times that we’re spread thin or stressed out, we still need to respect the fact that we’re on limited reserves of energy and resilience. But when we’re happy and healthy, it’s all systems go!
Proper rest and recovery are also a very important part of the picture. Recovery isn’t just non-running time, but rather doing all that we can to generously give back to our bodies after having asked a lot of them. Think delicious food, lots of sleep, a cold IPA, hot pools, massage and Pilates or yoga. Relaxing and recovering fully after a hard effort can sometimes be the difference between a temporary niggle that resolves itself and a full blown injury.
The grey area between hurting and being hurt, between ‘good pain’ and ‘bad pain’, can be difficult to navigate, and I certainly don’t have a map. We each have such unique bodies, histories and relationships to pain that we all respond differently to challenges. At times, ‘toughening up’ and moving straight through pain is what helps us get stronger and reach goals. At other times, the opposite is true. There is rarely a black and white answer about how we ought to respond. The best we can do is embrace adventure, celebrate the moment, care for ourselves, and respect all the amazing things the body can do.