When is it Bad to Run with Pain?

You’ve likely seen it in many a televised marathon – a runner grimacing, hobbling and possibly collapsing as they cross the finish line of a race. As they lie in agony on the ground, perhaps clutching a knee to their chest, one can wonder whether pushing through the pain was worth it. While the answer to that question is likely varied and subjective to the runners unique set of circumstances, it is a cautionary tale for those everyday runners who likely face the same dilemma – if I’m in pain while I’m running, should I stop?

As sports medicine physicians who have treated a variety of patients – from elite runners working toward earning their personal best time in the next big marathon to those runners who engage in this type of exercise as a necessary means for stress relief – our advice isn’t always the same for every patient. But there are some key distinctions that can help anyone determine what pain during a run is trying to tell them.

First, we should begin with a distinction of the difference between pain and soreness. Especially for avid runners, soreness can be a common occurrence and there’s actually a medical definition for it: Delayed Onset Muscle Soreness (DOMS). DOMS refers to the gradually increasing discomfort that happens between 24-48 hours after activity. This type of soreness is common and normal and can often mean that the muscles are getting stronger. Another distinction between pain and soreness in runners is that soreness often feels better, not worse, with movement. And though it may occur during the first few moments into a run, it usually subsides as the runner gets into a rhythm and the run continues. Pain is a different story and tends to occur with a specific movement.

One important way to recognize pain that should make you take notice during a run is whether or not it is localized. Is it a whole body soreness or is it a pain that, for example, is most definitely coming from your knee? As you proceed through your run is the pain reaching an upsurge as you move? If the answer to these two questions is yes, it’s best to stop the run and take a rest and some time to assess the situation. Also, as important as the sensation of acute pain is the identification of other sensations. Obvious swelling, immobility, numbness or tingling are also signs that an injury may have occurred and should be evaluated by a medical professional.

Continuing to run with even a minor injury can set you up for bigger problems in the future. If pain is evident and severe, take some rest. Over-the-counter anti-inflammatory medications and icing the affected area can help. Listen to your body and seek medical attention for any pain that is severe enough to stop you from performing everyday activities like walking.

Injury cautions aside, when the pain from a run is not severe and inflammation, not a structural issue, is likely to blame, refraining from exercise for an extended period of time may in fact prolong recovery. Taking a break on running doesn’t mean to stop moving. In fact, more recent research has indicated that injured muscle tissue can actually heal better when it’s under some type of stress. But this doesn’t have to include running at the same speed and intensity level as you did before you were injured – at least for a while. Try some lower impact activities like walking or swimming as you ease strained or inflamed muscles back into running.

While it’s important for you to be able to distinguish running pain form soreness, don’t ignore either. And also consider ways you can help prevent them from occurring in the first place. Are you consistently warming up and stretching the areas that seem to give you problems during a run? If not, it’s important to start. In addition, strength-training and cross-training can be beneficial to help you develop core strength and to mix up your fitness routine. Make sure your shoes are properly fitted and that your running is mainly focused on smooth, flat surfaces to avoid falls. With the right mix of prevention activities in your fitness routine, you can help avoid the pain of running altogether.

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