Running through the Pain - Can I Run While Injured?
by James Laughlin, PTA

Kinetic Edge physical therapists treat lots of runners ranging from fitness enthusiasts, high school cross country and track athletes, to elite level runners. The number one question on every runner’s mind is whether they can continue running while injured. There is no short answer to this question as every individual’s situation is unique. Ultimately, this question comes down to a risk to benefit ratio. I will outline questions that you and your physical therapist should consider when making these decisions.

Is your injury recent or a recurring chronic injury?

If you are in the acute (0-4 days), or sub-acute (5-14 days) phase of an injury you likely would benefit from relative rest. The risk of aggravating the condition is high and the benefit to continued running is low considering the time frame needed for most acute injuries resolve. If you are a competitive athlete training for an event you should calculate the number of days to the event and calculate your risk analysis with your physical therapist.

With a chronic injury the answer is more nuanced and should be a collaborative effort between you and your therapist. Again, review the risk-reward ratio. Some injuries take longer to heal and are best served with relative rest. You may be able to perform alternative training activities to maintain your conditioning while reducing the training loads and stress on the healing tissues to an appropriate intensity.

Does your pain persist or improve with running?

It’s common to feel twinges of discomfort as we return to running after an injury. Twinges that resolve quickly and allow you to continue without ongoing symptoms usually present a low level of risk.  Modifiable activity may also decrease the level of risk. One should never run through pain, especially if the pain is increasing. Pain is an indicator that something is amiss and should be respected and assessed.

Running modifications include altering gait, cadence, surfaces and volume. There is plenty of research that links overstriding to increased ground reaction forces and increased stress to the running muscles. By increasing cadence, you will shorten your stride, possibly decreasing ground reaction forces and symptoms. Another method of reducing the ground reaction force include altering the surface. I particularly like the treadmill in this situation as pace can be controlled and most treadmills today have some cushioning element to the deck. Reducing volume allow you to return to running below pain threshold and progress as symptoms warrant.

What if the pain persists regardless of modifications?

If you are unable to tweak modifiable components without continued pain then you should stop running. This is an indication that the underlying condition demands attention and the healing phases of recovery should be respected. Your therapist will conduct an evaluation to identify the source of your pain, and develop a treatment plan, including corrective exercises.  Treatment may also include complimentary training or cross training to help you maintain aerobic fitness.

Complimentary training works the body in a way that is similar to the primary activity. Examples include Alter G treadmill or pool running, as two specific examples. Cross training is effective in maintaining general fitness while reducing the stress to the specific injured tissues. Runners typically look to biking or swimming as cross training options.

As you can see, there is not one single answer to the question of whether to run through an injury. Your body uses pain as a signal and that signal should be respected. Ultimately the decision to continue training, at any level, has a specific risk and reward benefit that you and your therapist must answer.

If you are an injured athlete, I would encourage you to contact one of our clinics and schedule a no obligations injury screen or set up an evaluation to get to the root of your problem and back to the activities you enjoy.