One of the most common questions I hear from marathon runners who I coach is, “Should I see a doctor for my running injury?” The answer depends on several different factors and I typically run through a series of questions about the pain before offering a recommendation as to whether a runner should see a doctor or other health care professional, such as a physical therapist, for pain. Here are some questions to ask yourself if you’re wondering whether you should see a doctor for a running injury.
What Type of Pain is It?
Most running injuries don’t just develop out of nowhere. You’ll usually see some warning signs of an injury. However, there are different types of running pain and some types of discomfort are safe to run through.
Mild Pain: Pain Scale of 1 to 3
You feel this type of pain when you start to exercise, but it usually goes away as you start to warm up and continue running. The pain may be a sign of tendinopathy (for instance, pain in the front of the knee below the kneecap). This pain may be inconsistent and move around the body, or you may feel it bilaterally (in both knees, for example). This kind of mild pain or discomfort is common and considered safe to run through. Apply R.I.C.E treatment (see below) to any areas of concern after your run.
Moderate Pain: Pain Scale of 4 to 6
This type of pain appears as you start exercising, but stays at a tolerable intensity throughout your run. It rarely passes your pain threshold and it doesn’t cause you to limp or alter your running stride.
While it’s okay to finish your run with this level of pain, it’s best to listen to your body. Resting and rehabbing this type of pain should take priority if you’re experiencing pain after running, at rest, with daily activities such as walking, and/or it is affecting your sleep. Take a few days off from running and apply R.I.C.E treatment, allowing your body to heal. A couple of days of rest or pain-free cross training now can save you from a full-blown running injury that sidelines you for a longer period of time.
Severe Pain: Pain Scale of 7 to 10
This pain is severe in nature and you can feel it before, during, and after exercise. The pain increases as you continue running and will typically cause you to limp. You should never continue running when you feel this type of pain. Limping or any change in gait is always a signal to stop running. This type of pain definitely should be addressed by your doctor or physical therapist and may require some testing, such as an x-ray or MRI, to determine a diagnosis.
Is the Pain Interfering With Your Running or Other Activities?
For example, if you feel a little tightness in the beginning of a run and it goes away once you’re warmed up, it’s usually safe to continue running. Or, if you’re doing a long run for marathon training, you’re most likely going to feel some soreness and discomfort towards the end of the run, similar to what you’ll feel in the final miles of your marathon.
But if you’re dealing with pain that continues to get worse during your run, or causes you to alter your running gait, then you should stop your run. Continuing to run through it in those cases might make the injury worse or cause a new injury because you’re overcompensating or running with poor running form.
Have You Tried R.I.C.E Self-Treatment for Mild to Moderate Pain?
Most running injuries respond well to the “R.I.C.E.” treatment: Rest, Ice, Compression, and Elevation. R.I.C.E. treatment can relieve pain, reduce swelling, and protect the injury from further aggravation. You don’t need to schedule an appointment with your doctor at the first sign of mild to moderate pain. R.I.C.E. treatment should be followed for 24 to 48 hours following the initial injury. Here’s what to do:
Rest is often the easiest and most effective treatment for common running injuries. Take a couple of days off from running — it may be all you need to heal your injury.
Ice the painful area with an ice pack or a bag of frozen veggies wrapped in a towel for 15 to 20 minutes, every 4 to 6 hours. Be sure that you don’t put the ice directly on your skin or leave it on for too long. Try to ice the affected area as soon as possible once you feel pain, and immediately after a run if you are running with an injury. Heat should only be applied to an injury after the inflammation is gone, usually after about 72 hours.
Compression limits swelling and can provide minor pain relief. You can wrap the affected area with an Ace bandage, but don’t make it too tight. If you feel throbbing or excessive pressure, loosen the bandage. You can also use compression socks for lower leg or foot injuries.
Elevate the injured body part — try to get it higher than your heart, if possible. In most cases, you can do this by lying down and propping the injury up on pillows.
When to See a Doctor for a Running Injury
A doctor or physical therapist can diagnose, treat, and more importantly, help you determine the cause of your injury to prevent a recurrence. Make an appointment if your injury doesn’t respond to self-treatment and you don’t see any improvement after 5 to 7 days, or sooner if you have any of the following symptoms:
- severe pain in a joint or bone
- pain radiating to another area of the body
- injury is very painful to the touch
- significant swelling at the injury site
- difficulty moving the injured part
- numbness, tingling or weakness in the injured area
