The Fort Collins Trail Runners Facebook group is the largest running public forum in Northern Colorado. Almost every week there is someone posting about their injury, asking for help, and many people tend to weigh in with their opinions and home remedies. Unsurprisingly, lots of people still recommend total rest for running injuries. As a running-specialist PT, I can tell you that this is NOT great advice. There are many ways that we can keep injured runners training through injury and see good progress at the same time. But occasionally, someone has what we call “unacceptable” levels of discomfort which need to be calmed down a bit before trying different running-specific interventions to get them back to training ASAP.
Runners typically come to me with two initial thoughts when running is no longer tolerable due to injury:
“I need to stop running so this can get better.”
“I need to be completely pain-free before I try running again.”
Taking time off from running can be detrimental in many ways and rarely is the best decision for a runner. In reality, getting a runner back to “tolerable running” as quickly as possible is the number one priority.
There are definitely situations where we cannot use this approach (a bone stress injury for example). Also, there are ground rules regarding pain that we need to lay down before starting this process.
Keeping a runner running helps to maintain fitness, tissue capacity, and is an important stimulus for tissue rehab. It is the best indicator of progress … not to mention the psychological benefit to the runner.
Here are some things we can play around with to see if we can get someone to better tolerate running:
Modify running frequency, duration, intensity.
Adding walking to warm-ups, cool-downs, or walking intervals to break up continuous running.
Change the terrain (uphill/downhill, single-track trail vs wider trails, technical trails vs smooth trails, road camber, soft vs hard surface, etc).
Gait modifications such as cadence, and/or cues such as “run softer, wider, quieter” etc
Change footwear (heel-toe drop, cushion, width, stability, weight, etc.)
And the list goes on.
In review, having pain with running doesn’t always mean you need to stop running. A healthcare professional who specializes in running can help you get to where you need to be quicker, safer, and possibly without ever stopping running.
