Before you call the doctor…
Consider this scenario, a runner with persistent pain that came on gradually, “That nagging pain keeps getting worse. It is getting difficult to forget about it during my runs now, and after my runs the pain persists. Maybe there’s some swelling. This is no longer fun. I wonder if I’ll be able to make that race. It’s certainly going to be tough to make that PR. Should I make an appointment?”
Don’t panic. Think rationally about your injury, your problem. What have you done to provoke this? Where is the pain? What makes it worse? What makes it better? What has changed in your training regimen; more mileage, new route, hills, surface, speed work? Have you been running without stretching? Is it those new shoes? Have you had this problem before?
What have you done to promote healing of your injury? Have you given your body a chance to heal itself? Have you adjusted your training program, tried cross training, changed your route or intensity, reduced your mileage? Have you tried icing, stretching, or over-the-counter anti-inflammatory medications? How is your diet? Are you getting enough sleep?
What about the usual first-aid measures? Although the “best” healing will occur under the condition of absolute rest, this is not always practical, or even possible. The next best thing is relative rest. This means decreasing exercise duration or intensity, or substituting complementary activities, e.g.- low-impact swimming or cycling for running when recovering from shin splints. The goal is to maintain aerobic fitness while allowing healing of the injury, under conditions of diminished stress.
All running injuries are accompanied by inflammation. Injury to living tissue causes damage and death to cells, life’s basic building blocks. When cells die, enzymes are released that trigger the inflammatory process. The cardinal symptoms and signs of inflammation are pain, swelling, redness, and warmth (Latin: dolor, tumor, rubor, and calor, respectively). Although inflammation is the first stage of healing, suppression of inflammation also facilitates rehabilitation and ongoing function. Inflammation is inhibited by ice, wraps, elevation, and anti-inflammatory medication (aspirin, ibuprofen, naproxen, etc.; acetominophen is not an anti-inflammatory). Inflamed tissues tend to be tight, because of the swelling and healing scar tissue, hence the need for religious stretching when trying to get over the hump.
Finally, consider biomechanics. For example, the pronated foot (flat-foot), contributes to many types of injuries that may manifest as foot, leg, or knee pain. A change in footware may lead to a change in arch support, alteration in foot alignment, and biomechanical alterations on up the “kinetic chain” of the leg.
If you have thought about and perhaps tried some or all of these things, and you see no progress, then perhaps it is time to consult a professional. It would be wise to think about these topics before your appointment, or at least while you’re waiting for the doctor. A good medical history for the injured runner will include questions and conversation about all of the above, so be well-prepared, and bring your favorite shoes and shorts. Happy and healthy running!