Whether you’re a newer recreational runner or elite athlete with many races under your belt, there’s one thing most of us runners have in common: we’ve likely dealt with some aches and pains. Running injuries seem to pop up at the most inconvenient times and always linger just a little longer than we’d like. As a physical therapist at 6:33 Physical Therapy in Mount Pleasant, I work with a range of runners, from those training for their first 5k to ultra runners training for yet another 100-miler. We work together to rehab current injuries and prevent new injuries from forming by improving strength, stability, run form, and identifying training errors that may be occurring. After working with hundreds of runners, I’ve come to realize there are some common misconceptions circulating about running injuries. I’ve chosen 3 common myths to debunk which we often hear at 6:33 Physical Therapy.
1. I got injured because I don’t stretch enough
While stretching has its benefits, the majority of running injuries are NOT caused by a lack of stretching. Injuries develop when a tissue in our body (muscle, tendon) is unable to tolerate the load we are asking of it. Typically, this is because that tissue needs to be strengthened, rather than stretched. When a weak muscle is loaded over and over again (as it is in running), it will tighten up over time. Do you stretch your hamstrings all the time and they never seem to loosen up? What about those calves? You can spend all the time in the world stretching, but if we do not address the underlying cause of the tightness (which is usually weakness), the muscle will never loosen up.
There are other factors that must be considered as well. At 6:33 Physical Therapy we will bring runners through an initial evaluation in which we evaluate strength, stability, and mobility throughout the entire body. We must look at the entire body because an issue in the foot could be causing pain in the hip, and vice versa. Again, if we do not identify and address the root cause of pain, the issue will persist. Although stretching can decrease tension in a muscle in the short-term to help you feel better temporarily, long term we need to implement a strengthening regimen that will address the underlying deficits.
2. When I’m injured I just need to rest until the pain goes away
I’ve noticed there are two types of runners out there. One group of runners will continue running despite any and all pain. The idea of resting is repulsive to them and they have the “no pain, no gain” mentality. The other group of runners will notice an ache or pain starting to form and will decide to rest until pain goes away completely. That might mean resting for days, weeks, or even months. Once their pain resolves, they return to running.
As with most things, the best solution is usually somewhere in the middle. Many injuries will require some modification to the runner’s regimen, particularly if training errors such as increased volume and intensity of training contributed to the problem in the first place. However, complete rest is rarely, if ever, the solution.
When we completely stop running and exercising to allow pain to subside, our muscles and tendons will weaken. And unfortunately, it takes much less time for us to lose strength than it does for us to build it. Now, let’s circle back to a point from our first myth: injuries tend to form when a tissue in our body is weak.
Okay, so let’s say you pull a hamstring — the underlying cause was a weakness on one side compared to the other. Now you completely rest until the pain goes away — this takes about 5 weeks. During this 5 weeks your muscles get even weaker, but that hamstring actually needs to be strengthened to heal and avoid reinjury. You are finally out of pain and return to running. Well, now what happens? Now you are more likely to injure that hamstring (or another muscle) again because your training tolerance has significantly decreased.
This scenario could also go a different route. You pull a hamstring and decide to schedule an evaluation with a physical therapist who specializes in working with runners like yourself. Your physical therapist evaluates your movement and strength, and speaks with you about other factors such as diet, stress, sleep, and exercise habits. She creates an individualized plan that addresses the deficits which likely contributed to pulling the hamstring in the first place. You spend the next 5 weeks performing a strengthening program and then gradually progressing into running under the guidance of your Doctor of Physical Therapy. You return to running 5 weeks later pain-free, with improved strength and resilience throughout your entire body. But most importantly, you are equipped with the knowledge about how to keep your body healthy long-term and are a more confident, efficient runner.
3. It is normal to have pain as a runner and there is nothing I can do about it
I am a runner myself and love working with runners. Our friends and family members think we are quite crazy, and we can’t blame them for saying that because it is (kind of) true. Runners are a special breed and we know how to endure suffering. However, this does not mean that we should constantly be in pain by any means. In a normal resting state we really should not experience pain. Of course, runners will get some aches here and there which are perfectly fine to work through. However, it is important to understand what type of pain is okay to push through and what type of pain we need to address. In general, the earlier we can address injuries the better our outcome will be, which means less frustration and less modification is required in our training plan.
There are two rules of thumb I use with my clients at 6:33 Physical Therapy. First, “does your pain increase significantly DURING your run?” If you have a low grade ache or “awareness” of something that doesn’t change much during the run, this is typically okay to continue to train through. However, if pain rises more than 2 points on a pain scale (0-10) or becomes sharp or shooting, your training session likely needs to be modified. Secondly, we need to evaluate the pain response following a run. If it subsides right after the run or shortly after, this is a good sign. However, if it lingers for hours and hours or into the next day, that training session was likely too high in volume and/or intensity and we need to modify our next session.
The good news is that when runners do develop an injury, there IS something they can do about it. At 6:33 Physical Therapy in Mount Pleasant, we work with runners every single day who are limited by pain or injury. We perform a runner-specific evaluation to understand the root cause of injury, get them out of pain, and give them the tools needed to keep the pain away long-term. We have great outcomes with our clients because we are able to spend a full hour with them every single session, always one-on-one. Our holistic approach to rehab includes creation of an individualized plan for our runners that will improve their health and well-being long-term. If you are a runner who is dealing with a nagging injury, we’d love to help you feel better!
To schedule an evaluation with us, please visit our website
633physicaltherapy.com or shoot me an email at alisonberglund@633physicaltherapy.com.
Happy Running!