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- Pain is unpleasant.
But we do actually feel it for a reason.
It's to protect our bodies.
That doesn't mean, however,
that as soon as you feel any form of discomfort,
you need to stop whatever it is you're doing.
Instead, you need to listen to that pain,
respect it, and then make a rational decision.
- Yeah, and if you've been running for some time now,
you may well have experienced some pain
whilst running or some discomfort.
Sometimes that pain will have stopped you from running,
or prevented you from doing your next session,
and other times, may well have been able run through it.
So understanding good pain and bad pain
does take a little bit of experience.
Also learning from the advice of professionals
and also understanding how your body works.
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- If you're new to running then sometimes
it can all feel a little painful and hard work
but unless that pain is in a really specific area
it's probably just your body adapting to this new sport.
Having tired, achy, or heavy legs, again,
is another symptom of training.
And even that burning lung sensation that can be described
as a pain is just part of working hard
and sometimes you even learn to embrace that feeling.
- Yeah, and a level up from discomfort we have pain.
And this can kind of be divided into two categories.
You've got that sharp, intense type of pain.
And then you've got that dull, continuous type of pain.
And the type of pain you experience can be
some kind of indicator as to what that pain is
and whether you can continue to run.
Some are quite obvious.
If it's so intense and it's so painful, well,
you're probably going to struggle to walk on it let alone run.
So, running's not going to happen but it's that pain
that's in the middle that's really hard to gauge.
- We're not pretending to be experts in this field
and we certainly don't know your body
so this video is very much a guide
but to get us started and on the right track
we're going to go speak to an expert in this field,
who is a therapist, Claire Wheller.
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So, if you've got pain when you're running
it's not preventing you from running,
should you, should you actually stop?
- When you've got pain it's a good idea
to look at it in a grade from zero to 10
and see if it changes while you're running,
whether it disappears.
So, we often look at it as mild pain,
which is often one to three.
And this means that as you're running the pain
disappears after your warm-up and everything else.
And that's very safe to run through that
because it goes,
and then you do the recovery afterwards.
Moderate pain is more a sort of, four to six level
and what happens here is it's a threshold pain
so it doesn't actually increase
and you don't limp and you don't change your gait cycle
but you do have to be aware of it.
And sometimes with that you need to maybe cross-train,
leave it for a couple of days,
and then go back to your running.
- Okay.
- If the pain still persists with that
then you do need to go and seek help.
Severe pain, sharp pain that causes limping
and changes to your biomechanics then
definitely you shouldn't be running through that
and go and see a chartered sports physiotherapist.
- Okay, great, that's nice to know.
And how do you differentiate, yourself as a runner,
between whether it's joint pain,
whether it's bone pain, or whether it's muscle pain?
How should we, sort of, learn to interpret that?
- Muscle pain and bone pain.
Muscle pain is less intense than bone pain.
It tends to be more when you've pulled the muscle.
It's more superficial.
It hurts when you contract the muscle
and it can be swelling around the area.
Bone pain is more of a deep, sharper pain.
It can then go on to being into a dull ache
which often happens with stress fractures
and can lead to night pain.
And joint pain is more stiffness
or if you've actually pulled a cartilage
then you get a clicking or locking in that area.
And you can often see swelling around your joint.
- Okay, so from those signs are there
any signs in particular,
other than the level of pain,
of when you should go and see a professional?
- If your pain, if you're trying to train,
continue training, for a good week
and the pain does not disappear then
definitely you should do.
If you then end up getting a hot spot over an area
and it's very tender on the bone then
definitely you do need to go and see a doctor
or a chartered physiotherapist
'cause it can often be a stress fracture.
So, anything that's causing you limping
or not allowing you to train efficiently
then definitely you need to cover yourself.
So, they might be looking at how you're running
biomechanically, helping with exercises,
and making sure that you're not causing any problems
to other parts of your body as well,
not just the area that's been effected.
- Okay, and when it comes to muscle pain,
how does one differentiate between, sort of,
something that's been a really severe cramp
to just a bit of overworking DOMS or a tear?
You know, there's all sort of muscle pains
but how can we know the difference?
- Yeah, good question.
With a muscle cramp, it's often
an involuntary, forceful muscle contraction
that takes the time to relax
and it's often because you haven't
got the fluids in you, or your electrolytes aren't right.
You can simply stretch it off
and it will go after a time and there's not a problem there.
If you've caused damage then
you try to contract the muscle
then it really hurts then there's weakness in the muscle.
When it's DOMS you tend to have that
feeling of going down stairs
and you can feel your muscles ache
and then it comes on sort of 24-48 hours.
With a muscle tear, you feel it straight away.
- Okay. Cool, that's nice to hear.
And then finally, you mentioned night pain.
What's the significance of night pain
and when might you get that and what does it mean?
- If you're getting night pain and a dull ache,
it often can mean a stress fracture.
You definitely need to go and get it checked out.
Because otherwise you'll be causing more damage.
These are small little cracks in the bone
which then cause a hot spot and make you unable to run
and can put you out for a lot longer
than the six weeks which often a fracture takes to heal.
And also, night pain is one of those things
that the doctors do need to check out.
- And finally, Claire, when are you
coming back afterwards and you start to train again,
how do you know if it's that injury reoccurring
or if it's just a pain of, kind of,
getting used to running again?
- Yeah, that's a good question.
It's important when you're going back to after an injury
I often find with a lot of my runners
and sports people that actually it's not the injury,
it's because a lot of the other muscles have switched off
because swelling causes muscles to switch off
and you're just changing your biomechanics
and the connective tissue around the area has tightened
so it's getting used to warming it up, releasing it through.
If you're still getting quite significant symptoms
exactly as your injury then you definitely need to
contact your physio and check
but a lot of the times it's often
because other areas have tightened.
Which, then you need to get used to
getting back into training.
So, your easy runs end up being
your hard runs to start off with.
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- Claire's talked about different types of pain
and what they might indicate.
There are some areas that are more susceptible
to pain from running than others.
But I don't want you to go away from this
and worry about every niggle and ache.
But it is a good idea to be aware of the
common problem areas that might
cause you pain so at least you know
what you might be dealing with.
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- Well a lot of foot problems come
from a poor choice of shoes or socks.
Now, rubs, blisters, or pressure points can be
excruciating at the time but normally by removing the issue
or the problem that's causing them
they quite quickly go away.
The more worrying problems are bone and tendon related.
So if you feel a deeper pain on weight bearing
then we would really advise you seek professional advice.
After all, when you're running,
the impact that's going through the foot can be quite a lot.
There are 26 bones to hold together your ligaments
and tendons can be put under a lot of strain.
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- Connected to your foot you can expect some similar
problems but a common injury here is a twisted ankle
and you'll have immediate pain from that
but listen to the severity of the pain.
If you can still walk on it, do so,
but make sure it's very gentle.
If the pain doesn't ease then get home
as quickly as you can, try to put your foot up,
and put some ice on it to reduce the swelling.
And then reassess in a few hours time.
If you do think you've done some serious damage,
like a tendon or ligament or worse,
then make sure you go and see a doctor or a physio.
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- And then we have the shins
which is a regular problem area for runners.
Particularly for those that might increase their
mileage a little bit too quick.
Now, the shins are prone to what we call stress reactions.
And if those are left untreated,
it can lead to stress fractures.
Now, if you do experience some pain whilst you're running
and that increases throughout your run
and then you even experience some pain during the evening,
we really recommend that you rest
and you get it checked out.
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- The Achilles tendon, the soleus, and the gastrocnemius
all interconnected at the back of the calf.
Well, overloading or going too hard
without enough of a warm up can lead to
a strain in this area, or even worse, a tear.
So, if you do have any pain
then it doesn't ease in a few days
then respect it as you could end up with a tear
and training through that is only going to make it worse.
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- Well, the knee itself is actually
a fairly straightforward joint
but it does take a lot of repetitive force from running.
Now, a lot of knee pain or discomfort
actually comes from muscle imbalance,
weakness, or even tightness.
So, try to look at the bigger picture of how you move.
This includes runner's knee
which you can tend to feel across or over the kneecap.
But if you do feel a sharper or deeper pain,
this can be something a little bit more serious.
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- The thigh muscles are pretty large,
and therefore generate a lot of force
on every stride of running.
As a result, it does mean you need to do a thorough warm up,
especially if you've got a speed session planned.
It's important to you understand the difference
between the pain you might have the day after doing
a tough session in the gym and then something more severe.
Now, muscle pain usually
responds well to some gentle movement.
Now, if you've been unfortunate enough to
fall off your bike and maybe have a hematoma on your muscle.
Yes, that's unsightly
and it's probably going to be pretty sore to the touch.
But doing some very gentle movement through that area
is going to help to break that hematoma down
by increasing the circulation to the area.
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- Whilst injuries around the hip do have
a tendency to take a little bit longer to heal themselves.
Weak glutes or tight hip flexors contribute to this.
If it's a sharp sensation, or a catching feeling,
then we would often recommend seeking
some professional advise on this.
If it's a dull or deeper aching sensation
this could be a sign of a stress fracture
which hips can be prone to, due to overloading.
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- The majority of pain when running is in the legs
but obviously it's a full body movement
so you can expect problems in other areas, too.
Your lower back takes a lot of shock absorbing,
especially if you're running on the hard and downhill.
So, maybe expect some pain there.
And further up the side stitch,
which can be so painful it actually makes you stop.
But you won't likely to be able to do any damage
by pushing through a stitch pain.
But one pain you do certainly need to listen to
is if you get a sudden, sharp, stabbing type feeling
in your chest area then go and seek some help.
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- Once you're having pain of the mild variety
and you're confident that by continuing to run
you're not really causing any further or harmful damage
then there are a few changes you can make
that will potentially ease it.
- Yeah, something as simple as
if it feels like it's a bit of tightness
then just stop and have a mild stretch
and run again and see how it reacts.
If it does react well do a little bit more stretching.
And then even just changing up the actual terrain
you're running on can make a real difference
as it's starting to challenge your joints
and your muscles in a different way.
So, as simple as going from road
to grass could even make a difference.
And then look at the actual incline or decline,
because sometimes if you're running uphill
it might be more painful than downhill, and vice versa.
And if you do discover a way that's more comfortable
then you can maybe even go on a treadmill
and stick it on the right gradient for you.
- Well, talking of terrain you may not actually
even realize, if you're running on camp or off camp,
if you're doing the same loop over and over
in the same direction, same side of the road,
or perhaps running an athletic track in the same direction,
this could potentially lead to problems.
So, try mixing things up, going the opposite way around,
or even retracing your same footsteps to even things out.
- Yeah, and if you're in a race
and you've got some pain
but it's not so bad that you actually need to stop,
there's not that much you can do
but you can actually mix your cadence up a little bit.
So try increasing that which sometimes can help.
Or if you have to then just back off the pace.
And then there's something else,
which hopefully you do anyway,
but do check the soles of your trainers
because that could have unusual wear
which could be causing you pain.
But also if you're still having problems,
think about trying to actually change the
type of shoe that you run in.
- Once you finish your run,
the pain may well quickly subside
but you can still treat the effected area
to prevent any discomfort for your next run
or maybe even eliminate the discomfort all together.
And now the fail-safe is RICE:
Rest, Ice, Compression, Elevation.
And this going to decrease the inflammation the area.
Also, it's going to help the circulation to the area.
But just make sure that you're not
putting the ice directly onto your skin
and for more than 20 minutes at a time.
- Yeah, and that's what we mentioned at the start.
Pain is there for a reason
so please don't ignore it even if you can run through it.
Just listen to your body
and if it persists then it's probably
a good idea to go and see a physio and a doctor.
And remember that the sooner you address a problem
then you're more likely to be back
running pain free all that bit quicker.
- Yeah, and if you have enjoyed today's video
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- If you want to know a little bit more
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or the run foot strike is broken down,
there's a video on that just here.