Dealing With Running Aches and Pains

I got some questions recently about running with aches and pains and what to do about it/them, if anything. That got me wondering how many of you are running with aches and pains of any kind. I don’t mean the type of pain which shows up for a minute or two during a run and then disappears (most of us have those pains from time to time), but instead the type which doesn’t get better during your run.

Running, or any exercise really, may cause you to feel some aches and pains. That’s part of improving your cardiovasuclar fitness and the training process. But, how do you know the difference between normal aches and true pain which can be the sign of something more serious?

Normal aches and pains include things like muscle soreness, blisters, chafing, minor twinges here and there in your muscles and joints and, after a particularly long or hard run, some difficulty getting moving or stiffness. These types of aches and pains will generally go away on their own either during a short break (after not running for a day and up to a few days) and Rest, Ice, Compression, Elevation (R.I.C.E.).  If these aches and pains persist for more than three to four days, they may be a sign of something requiring medical attention.

Some examples of aches and pains which are not typically “normal” running aches and pains and should be taken seriously are: 

  • sharp, stabbing pain, especially if it doesn’t let up if you stop or walk,
  • throbbing pain in your legs, particularly if it persists while resting,
  • shortness of breath after you’ve rested for a few minutes,
  • any sort of tightness or constricting feeling in your chest.
  • this list may not be complete as I’m not a medical authority.

I believe the key here is to decide which “normal” running aches and pains you can run through, which ones need R.I.C.E.  and which ones need medical attention, perhaps immediately.

I can’t provide much help with conditions which have progressed to the point where medical help is required as I’m not a licensed medical practitioner, but I may be able to help you with figuring out how to deal with “normal” running aches and mild or moderate pain which doesn’t cause you to alter your stride/gait. The key with these types of aches and pains is to diagnose what’s causing it and make the appropriate changes before a real injury occurs.

BTW – If you’re being treated for normal running pain by a medical practitioner, it’s also very important to figure out exactly what caused your injury and not just how to recover from the current injury.   I have seen this happen more than once as some medical practitioners seem more interested in fixing the current problem than preventing it from recurring.  For example, I’ve meet a number of people who have had stress fractures and while they recover well the fracture returns later on as they never figured out what caused it in the first place.

Most common running injuries are due to overuse, over training, improper shoes, or a bio-mechanical flaw (could be in your body structure or in your running motion. or both).  I believe that most running injuries can be prevented if the underlying issue(s) is/are address correctly and in time.

So, what’s the best way to prevent normal running aches and pains from becoming injuries?  Since most athletes are, or eventually become, driven and goal oriented people, they often subscribe to the “No Pain, No Gain” philosophy, which means they attempt to ignore pain.  While there are some aches and pains that may be OK to ignore (people vary in what they call pain and in how they rate pain intensity), moderate to significant pain is likely your body’s way of telling you to pay attention to some issue before it becomes a full blown injury.

For example, during a 17 miler, I stopped on a bridge for less than 60 seconds to check out the water level in the creek below.  When I started running again I had a pain in my left knee which I hadn’t felt before (never had knee pain of any kind).  As soon as I noticed that it wasn’t getting better I walked for about 30 seconds and it felt fine so I started running again.  The pain was still there for the first few steps and then it went away completely and hasn’t returned again.  What caused it?  I don’t know, but I’ve made a mental note of it for the future, and logged it in my running journal.

Some newer runners get side stitches and those are another form of pain which it is likely OK to continue the run with or after it’s gone.

Another type of ache/pain which may occur is Delayed Onset Muscle Soreness (DOMS).  With DOMS the soreness is felt most strongly 24 to 72 hours after the run/race and is usually brought on by increasing mileage and or effort/intensity too quickly.  While it is often experienced by new runners in a hurry to progress, even experienced marathoners may experience it.   Any measure that increases blood flow to the muscle, such as low-intensity workouts, massage, hot baths, or a sauna may help somewhat. The pain will normally go away on it’s own within 72 hours of starting.

Another type of pain is a blister on your foot, toe, heal, etc. or chafing on any part of your body.  While it’s painful to run with, it is not a pain which must cause you to stop running, and it can be treated either on the spot or later.  Of course, you need to be careful of infection with blisters especially, but that usually only occurs if it isn’t properly treated.  However, in some cases it might be wise to stop your run and get a blister or chafing taken care of so that you can continue your training in the following days with as little pain/discomfort as possible as they may cause you to change your running mechanics, which could result in causing an injury to another part of your body.  I do not stop running with blisters during most races.  During a “for fun” race or training run I may stop if I think that it may negatively impact future training sessions.

Since many runners get brief pain once in a while, like the short lived knee pain which I mentioned above, it is not a good plan to stop for the day at the first sign of pain.  If that were to happen, I believe that more phantom pains would begin occurring (a mental thing). No, we need to develop mental toughness right along with physical endurance and if we stop at the first sign of pain we’d likely never learn the mental toughness required for endurance running.

On the other hand, if we continuously ignore the warning signs, which pain really is, we will likely be continuously injured and in a frequent state of recovery.  What I suggest is to take one or more walk breaks after a pain has begun and then try running again after each break (it may take a couple of walk breaks to determine if it will go away). It the pain goes away continue the run.  If the pain continues at a low level, doesn’t get worse and doesn’t cause you to change your running mechanics it may be OK to finish your run if you’re almost done.  Here’s the key, whenever pain causes you to alter your running mechanics and doesn’t go way soon, end the run.

I once had the good fortune to meet a young woman who had begun training in the military and every time her long runs got to about 9 miles she would become injured.  She had experienced actual injuries, not phantom injuries and now it had become a fear that she never would be able to run anything more than a 5K and perhaps someday a 10K.  In her case the “No Pain, No Gain” philosophy had led to her downfall each time.   I’m glad to say that by modifying her training plan and paying attention to what her body was telling her, she has successfully completed a number of longer races, and stayed injury free.  In her case the pain which she was ignoring was a warning which lead to a physical injury and also to a emotional injury!

Another point I’d like to make is that the location where you’re feeling the pain may not be the actual cause of the problem, but only a symptom which has been caused by the real problem.  For example, Runner’s knee (also known as patellofemoral pain syndrome) is usually caused by weakness in the middle quadriceps muscles and tight hamstrings or IT bands. You may also be at risk if you over pronate (your feet roll inward excessively – pronation is normal and a good thing, it only become a problem when it is excessive). In this case the problem may be resolved by either changing to the proper type of running shoe for your body or getting good custom-fitted orthotics.

So what’s the take away?

  1. “Non Normal Running Pain” should be addressed immediately (see examples above)!
  2. Not all “normal” running related aches and pains are serious and some should not stop your training/racing. (write down the specifics of when it occurred, how it felt, and how long it lasted, etc. in case it returns).
  3. “Normal” running related aches and pains which are mild, don’t get worse during your run and don’t change your running mechanics (it’s best to ask someone to watch you run, if possible) may not necessarily cause you to stop your run, if you are nearly done. Rest and R.I.C.E are likely in order after your done though.
  4. “Normal” running related aches and pains which are moderate in intensity which doesn’t go away during your run should be followed by rest and R.I.C.E for a few days.  If the pain doesn’t go away then it should be looked at by a certified medical practitioner as soon as possible.
  5. “Normal” running related aches and pains which are severe and don’t go away quickly should be looked at by a certified medical practitioner right away.

While this is not a complete discussion of all possible aches and pains associated with running, I hope that it will provide some general information about a subject which we all experience at one time or another.

Please let me know if something isn’t clear or if you find something incorrect in my information. I look forward to hearing from you.

Happy Running!

Joe
Certified Endurance Running Coach
Executive Race Director, The New Jersey Marathon

Post Race Recovery Planning

Here are some of the questions I often get from runners in general after their races (my students know the answers to these questions prior to their races).

Q1) What should I be doing/not doing during the post race period to enhance my recovery!
Q2) When can I start running again, how often should I run and how far?
Q3) When can I start doing speed/hill workouts again?
Q4) How soon can I run my next race?

Unfortunately I can only give you generic guidelines as everyone is different and I don’t know anything about you.  Generic guidelines are sure not to be exactly right for anyone, but here goes! As with almost all of these questions there are many variables to consider, such as:

1) how long have you been running?
2) how much of a mileage base do you have?
3) which race did you just run?
4) how hard did you run it – are you a completer or are you competitive with others or with yourself?
5) have you run other races recently?
6) how old are you? etc.

BTW – “run” above also may apply to run/walk intervals as well, but the lingering effect of that technique is not usually as long lasting as a long run/race with 100% running.

Half Marathoners (25 miles per week peak mileage, running for less then 1 year).  I’d suggest to take off 1 day for each mile run – that’s about 2 weeks before starting any serious running. Get plenty of sleep, hydrate well at all times, eat a healthy diet with emphasis on quality protein, carbs and fiber and the good fats, AND cut down on the portions! You may feel tired and sore for the first few days (Delayed Onset Muscle Soreness – DOMS).  Avoid sick people as much as possible during this period.  You may also feel low/slightly depressed (that’s normal as your body has been trained to expect exercise regularly, and you don’t have a big, bad scary goal in front of you any longer!). If you don’t have DOMS, you feel good in a couple of days, please err on the side of caution. Once the soreness is gone, think about a fun run of a few miles, but don’t set a mileage or pace goal (20 minutes is a good place to start), and leave your distance and pace calculator at home or off!  If this run doesn’t feel like fun, take a couple of more days off and try it again.  When the joy of running has returned, add another fun run after a couple of days off.  Repeat until every one of these runs are easy and fun and you’re neither sore nor tired afterward.  This process should only take you a week or two.  However, if the joy of running doesn’t come back then look for a reason and make a change.  If you usually run alone, find a group or a buddy to run with, but only if you can run at your slow recovery pace with them (it’s not the time to show off by trying to run fast as they may not be in recovery mode). Choose a different route or run your favorite route backwards, etc. Pay attention to your mental state also.

Full Marathoners (35-40 miles per week peak mileage, running for less than 2 years). I’d suggest to take off 1 day for each mile run – that’s about 4 weeks before starting any serious running. Get plenty of sleep, hydrate well at all times, eat a healthy diet with emphasis on quality protein, carbs and fiber and the good fats, AND cut down on the size of the portion! You will likely have Delayed Onset Muscle Soreness – DOMS for a few days. Some people enjoy light yoga and/or a message can help and both is even better (be careful of deep tissue work yet – the second week could be time to keep the blood flowing into the the damaged areas). You have a high likelihood of becoming ill as your immune system may be significantly weakened.   Avoid group settings as much as possible and wash your hands often.  The most important thing is to be aware of the increased possibility and try to avoid situations which will expose you to the greatest risk. Once you can walk normally and are not tired, likely after the following weekend (for a Saturday or Sunday race), think about a fun run of a few miles, but don’t set a mileage or pace goal and leave your distance and pace calculator at home or off (20 minutes is about right).  If this doesn’t feel like fun, take a couple of more days off and try it again.  When the joy of running has returned, add another fun run after a couple of days off.  Repeat until every one of these runs are easy and fun and you’re neither sore nor tired afterward.  This process should only take you a couple of weeks, but could take longer.  If the joy of running doesn’t come back then look for a reason and make a change.  I.e., if you usually run alone, find a group or a buddy to run with, but only if you can run at your slow recovery pace with them (it’s not the time to show off by trying to run fast as they may not be in recovery mode). Choose a different route or run your favorite route backwards, etc.  Pay attention to your mental state also, as that could need attention also.

Experienced athletes:  Specific questions should be posted here and I’ll do my best to answer them. For more experienced people which I train, their recovery, after about a week for a marathoner, usually looks a lot like a reverse taper (the reverse of the last three weeks of their training plan). I hope that answers most of your questions, but if not please let me know.

Remember, I don’t know anything about you and therefore can only give generic guidelines. My experience, my professional ethics and my professional insurance will not allow me to provide specific coaching advise as it is not possible for me to know the best answer for you without having spent time observing your training over an extended period of time. However I can provide the range of possibilities which I have seen work for many different athletes, if that is helpful to you in formulating your plan.

So, how long before I can do speed/hill work again and when can I start training for my next race?  I’m glad that you may be thinking about this already, as that’s a good sign.  I would wait until the end of the 2 or 4 weeks to start anything like that. Can some people start up sooner, sure.  I’d err on the side of caution as you want the repair process to complete before you start the stresses again. Done improperly, you will eventually break down, as this stress is cumulative, and with it you may get injured in a seemingly instantaneous manner, when in fact the injury is the result of the cumulative effect of over training for a number of weeks/months. If you plan to generally follow my advise then start your intervals, tempo runs, hill repeats gently and add to them slowly while listening to your body.

I hope that’s not too much info at once.  In summary, don’t worry about temporary muscle soreness as it will go away, expect to get back into running slowly, don’t be surprised if you feel a bit down, watch out for the effects of a temporarily impaired immune system, and sleep, hydrate, eat in proportion to your reduced activity level.  You should be ready to get back into it within the guidelines.  BTW – you have attained a relatively high state of physical conditioning, and a few well chosen weeks of rest and easy running will not put your back at the beginning in training for your next race.

Congratulations and best wishes,

Joe

Weight Gain after your race, etc?

Let’s discuss weight gain after your race.  First, I’m not a doctor, just a certified endurance running coach, so please don’t bet your health on my comments below as I can’t see you and don’t know your medical history!

With that said, here is what my experience and training tell me about the weight gain after a long run or race (some experience this more than others): 1) it’s likely water retention which can be caused by a few different reasons (see below), and 2) do not go on a diet to get rid of the extra weight as it will likely go away on it’s own, and you need the proper diet in order to help your body repair itself after your long run/race in order to be better and stronger than before!

The water retention could be caused by being dehydrated (you didn’t drink enough during your race), and/or it could be your body retaining water to help it in it’s repair work, and it could also be made worse by overloading with carbs prior to race day. Carbs at the optimum time and in the proper quantity and quality are important for full marathoners for sure, but many half marathoners can store enough energy reserves via their normal healthy died to last their entire race.  Half marathoners do not usually “hit the wall” for that reason.  Teaching your body to use carbs more efficiently and to be able to store more are parts of a well designed training plan.  If your’ training plan didn’t help you with that, you need a new one, or at least a knowledgeable advisor  who can help guide you in that area.

BTW – The DOMS which many of you are also reporting is a good indication of the water retention being due in some part by the repair process which is underway in your body   (DOMS = Delayed On-set Muscle Soreness).

One word of caution on eating post race. While you do need to eat well after your race to aid in your recovery, you should also make sure that you are adjusting the portions to fit your lower activity level, or the water retention weight will be replaced by fat storage.

In general, the water weight will go away over the next few days/weeks so don’t worry about that.

If you are sore for more than 3-4 days you should see a medical practitioner to ensure that you are not injured, but most times the DOMS will go away on it’s own  (just think of your runners waddle as a badge of honor!).

Oh yes, stay hydrated!  Some athletes think that since they have gained excess water weight they don’t need to drink anything.  Wrong!  Drink if you’re thirsty and make sure that your urine is a pale yellow color.

Your race didn’t end at the finish line, you are still dealing with it and these days can make a big difference in your recovery.

A good training plan will detail a post-race strategy as it’s very important to your recovery and future racing. If you don’t have one, please do some research on the internet, speak with a good sports medicine practitioner or ask here for advise.

I hope the above overview of this topic is helpful.  There’s plenty of general info available on the internet.  Since I’m not your coach (I don’t know any specifics about you from having worked together throughout your training), I can only provide general answers to general topics, but I’d be happy to help guide you with a general discussion of other running related topics, if that would be helpful to each of you.

I ask that you consider engaging with health care professionals (Nutritionist, Physical Therapist, Message Therapist, Sports Medicine Specialist, etc. as required to provide specific guidance). You are part of the small number of endurance athletes (many doctors don’t have much experience working with us as our numbers are relatively small – about 1% of the total population and an even smaller portion of that number for full marathoners).

I am in awe of what each of you have accomplished, and even after all these years, your stories, trials and tribulations amaze and humble me.  You are my inspiration and I thank you for that!  I mean everyone, from our race champions to the back of the pack athletes – if you are giving it your all and a bit more, you are a winner and I admire your accomplishments.

Best wishes,

Joe

RRCA Certified Endurance Running Coach
Executive Race Director,
The New Jersey Marathon, Long Branch Half Marathon and Half Marathon Relay

Have a question about planning for race weekend or an ache, pain, strain, injury, etc.? Let’s talk!

The New Jersey Marathon is very interested in helping you to be ready to race with us and in providing as much information and help to you as we can!

This blog is an example of that commitment to helping you as you train and plan for race day.

Our Race Director posts his weekly updates here in order to help you think through and plan for the entire weekend experience with us.  From planning for: the Expo and Race Packet Pick-up,  your arrival time prior to the start of your race, the fluids and food you will find on the course, the post race Festival, and many other parts of your time with us, he is the person with the answers.

On the other hand, if something physical is bothering you during your training, this is the place to turn for advice. Weather you are  seeing signs of wear on your body (it could be a blister, a dull ache, an occasional twinge) or perhaps dealing with a more serious pain or injury, we are here to help you sort through the many questions about what it could mean to your training and racing, what to do right after your injury, when to seek in-person medical help, and much more.

Please leave a comment on this post for Joe (our RD) or Christine (our PT) and they will get back to you as time permits.  We hope that you will understand that as we get closer to race day, these people will be increasingly consumed with that work, and their responses will likely be slower  than normal.

In addition to having a full time PT practice to manage, Christine is also a member of our Race Committee and is in charge of the exciting, free, speaker and exercise series during the expo days, as well as the  therapists who will be providing the free messages, etc. in our Recovery Tent in the Finish Area on race day.  Please note: Christine will not provide an online diagnosis of your issue, but she will attempt to help you to think about the issue in the best possible way in order to help you find a suitable resolution, as quickly as possible.  She is NOT soliciting for your business.  She is an athlete and knows what it’s like to train and work through pain and injuries.

We hope that you will benefit from their knowledge and advise.  All you have to do is ask your question,  by commenting on this or any other of their posts on this site.

Best wishes,

The New Jersey Marathon Race Committee

Running helps me to feel strong and in shape, but …. is it better to be Skinny or Strong?

‎Rebecca posted the following comment and question on our Facebook page recently:

“… I just wanted to write in and say how much all of you inspire me! Reading your posts are so much fun and give me so much great info.. I have had something on my mind and I just wanted some words of wisdom. It’s the idea of being skinny or strong. I know it may sound crazy but I battle with it all the time. I guess being an over weight kid really left a mark on me! Running helps me to feel strong and in shape. Often if the number on the scale is too high ( in my mind) I feel better knowing that the number on the road, meaning the amount of miles I run is also high so it’s better to be strong then to be “skinny.” Right? ;-)”

What an important question!  Many people struggle with this same question in several different forms!  Thank you for asking Rebecca!

Oh Rebecca, I know that you’re not alone in that feeling as I encounter it often with people I coach. I always give them the same advice knowing that it’s hard for them to follow, and that is; stop using the scale!  Don’t get me wrong, there is a time and place for a scale, but in my opinion that’s likely at both extremes of the weight spectrum, including very fit competitive athletes, as some suffer from the opposite problem that many others deal with, and that is they lose weight too easily and become underweight (for them) and weak.

I admit that I’ve never had to deal with being overweight, and so I can only tell you what I’ve learned from coaching lots of people over the years as well as training myself for a number of different sports.

The way to find your “best weight” is in monitoring how you feel and how you respond to your training to meet the goals you’ve set for yourself.  I think that using a simple measure is most beneficial .  I suggest that some students buy clothing which is heading in the direction that they want to go with their weight (either a slightly larger or slightly smaller size) and put it/them on every week to see how it’s going. When those clothes fit comfortable, and training hasn’t suffered, try a new outfit at a slightly smaller or larger size and repeat the process until  something changes in motivation, endurance, speed, etc. At that point listen to your body and perhaps back off a bit. Now that I think of it, that’s a coaching concept that could likely get me lots of students, if I had time to train more that is! I’m seeing an ad which says, Train with me and buy new clothing of your choice regularly as part of your training plan! Hummmm  …., but I digress!

One of the best ways to monitor how training is going is to keep a running journal in order to help find that ideal training weight, write in it honestly, review it every week or two and listen to your body for guidance.  You can learn how to listen to your body and to understand what it’s telling you on your own, but it takes awhile for some people to tune  in properly.

Now, as to your direct question re: is it better to be strong or skinny, I’d say that since you’re not likely making a living from the prize money you win racing (a very large percentage of the people racing with us are not making a living racing for prize money, even our Champions), I would submit that it’s better to be Strong and Healthy then it is to be Skinny.  Less weight can mean faster times, up to a point, but skinny does NOT necessarily equate to being either strong or healthy!

The lifestyle you have chosen (including being an endurance athlete) is one which only a very small percentage of the population is able and willing to follow.  The mental strength you’ve developed, although you may have been referring to your physical strength, enables you to accomplish amazing things.  Please forget that number in your head and concentrate on your health and racing goals (those are the more important numbers).  You are likely far down the road to robust health, and having a number on a scale to guide you further does not likely provide an additional benefit.  Did you know that making adjustments based on the number on a scale can be counterproductive to your training if done improperly?  As you likely know, training has its ups and downs, and so does your weight.  The weight of most serious athletes varies a bit depending on their training and racing schedule, and the times in between, and so may yours.

I say throw that scale out and concentrate on how you feel, how your training is going, and how tight those test clothes are.  But if you must count something, here are a couple of good choices: 1) Download an app that helps you count total calories in and calories expended each day.  2) Measure your resting heart rate and blood pressure often and write those numbers in you journal, or graph both of them to see trends easier (I’m a numbers junkie).  You may be amazed by how much useful info you’ll have to go along with your training journal.  It’s a bit of work at first, as is most anything new, but once you get used to it, it doesn’t take much time.

“Live Strong” may be a bit tarnished as a motto right now, but it’s true. I don’t recall ever seeing, “Live Skinny” as a motto though!

As you can see, I’m on a mission to get rid of standard weight scales for most athletes.  Feel great, train and race well, listen to your body, and be both mentally and physically healthy. That’s where the magic is!  No traditional scale required for you Rebecca!  That’s so yesterday in your life now. Live Strong and Healthy! – Joe