Running with an Injury: Beyond the Rest
Running with an injury or after being injured is simple. It can be done if you follow these steps outlined. Rest is part of the process, but not the whole process. When you know what to stop doing, and what to do instead you’ll be able to keep running.
In this article:
Start off on the right foot
So you’re injured and want to run… whether it be get back to running after a break or keep running through the pain you need to start off on the right foot with your training. If you don’t, you’ll wind up hurt again or hurting worse.
Balance out the stress running adds to your body
The best way to prevent running injuries is to balance out your training plan. When you’re running, either running straight through or doing the run walk method, your body is getting stressed. That’s normal and a must in order to make any progress. But, if you stress it out too much that’s when injuries happen.
Other people’s recommendations
You’ve seen different recommendations on how to avoid running injuries and that list looks like this:
Stretch before you run
Stretch after you run
Strengthen your muscles
Get new shoes
Foam roll
Get a massage
Rest more
Eat more protein
Fuel better
And those recommendations are all true. And they’re all wrong. At the same time. See it’s about balancing all of those things to fit your needs.
What to do:
Immediately after the injury comes on
Should you rest?
If you’ve got a running injury and you went to your doctor they probably told you to rest for a few weeks and ease back into it.
This is terrible advice.
And it’s terrible because it doesn’t tell you anything.
How long should you rest?
When do you know you’re ready to run again?
How easy is easing back into it?
None of those questions are answered with that advice.
Should you rest when you have a running injury?
Yes. And No.
Since I became a physical therapist in 2012 I’ve told my patients for years to rest from the things that cause them pain. Because pain is your body’s way of telling you something isn’t right. But, complete-laid-up-in-bed-rest isn’t it.
I believe in active rest for running injuries.
This means avoid the really painful things and keep doing the other non-painful things.
This could mean completely staying away from running. (That’s rare).
It more likely means back off on the running: either back off the pace or distance you’re currently running.
80%+ of running injuries are caused by repetitive stress… this means doing too much too fast.
Things injured runners must stop doing
When you’re first injured back off the training: cool it on the amount you’re running and how fast you’re running.
Stop doing long distances.
Stop going so fast.
Instead, you should
Run shorter distances temporarily.
Run slower.
Things injured runners can keep doing
Continue all activities that aren’t painful.
This could include:
Walking
Elliptical
Ice skating
Roller skating
Swimming
Riding a bike
Strength workouts
Stretching
Light jogging short distances
Continue with a balance of rest and activity.
Continue doing those activities listed above, and continue to incorporate rest days. An injured runner should include at least 2 rest days each week. These are rest days from cardio and strength exercises, you can still do light stretching to keep your muscles loose on rest days.
When to push through
How much pain should you push through as an injured runner?
If you’re an injured runner with pain use the 0-10 pain scale to help you decide if you should push through running pain.
Before you go out for a run think about your pain level.
Running with pain less than a 4/10
If you start off with pain that’s less than a 4 on that 0-10 scale and you consider that pain level tolerable go ahead and go for a run.
Running with pain more than a 4/10
If you start off with pain that’s more than a 4 on that 0-10 scale or you don’t consider your pain level tolerable, switch to another activity that doesn’t create that same pain.
Pain that goes away as you run
If your pain goes away, or gets better when you run: keep on keeping on. This type of pain in runners is usually because you haven’t warmed up enough, or have started out too fast.
Incorporate a good warm up before you run and build up pace as you go. Don’t go 0-60 right out the gate, build up to the pace you want.
A good warm up helps get your body ready for activity by making your blood vessels dilate in your muscles and helps lubricate your joints to prepare them for movement.
A good warm up increases your heart rate by at least 20% from resting. Things you’ll feel when you’re warmed up: a faster heart beat, a little flush in the face, and slightly more breathy when you’re talking.
Pain that gets worse when you run
If your pain gets worse as you run you may need to stop. When deciding, go back to the 0-10 scale. If you started at a tolerable amount, or something that’s under that 4/10 on the scale and your pain gets worse as you run you can keep going if the pain goes up by only 2 points on that scale. If it’s getting higher than 2 points on the scale, and it’s not tolerable, consider switching to another activity.
Symptom relief
Right when an injury happens you need to work to handle any pain and swelling. And of course when I say injury, I mean as soon as you have any pain or see swelling. Even if you didn’t have a deliberate injury, if you have pain or swelling something is going on on the inside. And to be honest most running injuries happen because of overtraining, and not because of a specific, pin-point injury.
So how do you handle pain from a running injury?
Any amount of pain should be taken care of ASAP when training for a race. Some of my favorite ways to get rid of pain are:
Ice
Heat
Heat & ice
Ice baths
Hot epsom salt baths
TENS units
Gentle movement
When using ice, heat, hot epsom salt baths the key is to use the right one, for the right amount of time, and often enough.
The #1 mistake women with running injuries make when it comes to using ice, heat or hot epsom salt baths is that they don’t do it long enough (frequently enough)... meaning they give up too soon.
So here are the keys for ice, heat and hot epsom salt baths:
When using a pack (ice pack/hot pad) use for 20 minutes at a time
Do it every day for 10-14 days
Use ice & heat multiple times a day in those 10-14 days (hot epsom salt bath can be 1x/day)
For many of my clients those first 10-14 days I’m recommending they use ice or heat 3-5x/day to get the pain and swelling down.
None of those techniques work when you do them just once, they need to be done soon and often when you have a new pain.
If you’re using heat & ice combo use them in that order: heat first, then ice. When you do it this way you get a wave effect to bring in blood flow which brings in nutrients to the area and then you stop the blood flow with the ice and the blood with the nutrients stay there for a little longer to do their thing.
TENS units can help override pain signals and can be used in combination with ice and/or heat. Make sure to not wear a TENS unit while you’re doing an activity that you need the feedback to let you know you have pain (ie: don’t go for a run with a TENS unit on because the TENS takes away the pain).
Gentle movement to keep the muscles and joints loose is helpful. The goal of this is to keep things moving, so no forceful movements or extended length of holds. IE: instead of doing a quad stretch on the knee and holding for 30 seconds, just bend and straighten the knee in the position of your preferred quad stretch.
When to see a doctor for running injury
It’s important to know when to go see a doctor and when you can toughen it out at home. In general if something is going to go away on it’s own it will in the first 10-14 days. If it doesn’t go away with home remedies like those listed under the pain and swelling section it means your injury needs more than you can give it: go see a professional. Check out the post about going to the ER.
If you can’t put weight on your injury or it’s getting worse go see a healthcare professional, don’t wait 2 weeks. And if it’s not getting better in 2 weeks, go see a healthcare professional.
Take that information and get back to running. Run modified, cross train and recover. Balance out how much activity you’re doing with how much recovery you’re doing. The right balance makes it so you can keep running.
