To Run or Not to Run

5 situations where running may be the wrong choice

By Steve Manning,  podiatrist at intraining Running Injury Clinic, QUT Lecturer in sports medicine, SMA Qld Council chairman, coach and runner, intraining Coaching Director

To run or not to run… That is the Question.  

Whether it is better to stick to your program or to miss a run to avoid injury.  Here are five scenarios where this question needs to be asked, the factors to consider when making the right decision and what is the best course of action.

1. Obsession or dedication?

Success in running requires a large amount of dedication and commitment.  Consistency over time is one of the key factors in improving performance. It takes about 6 weeks of a new activity for it to become a new behaviour.  Establishing a routine of running at a certain time of day and following a progressive and balanced training program will help you run consistently.

Runners with a higher level of obsession and even addiction to the sport may have less chance of skipping sessions.  However, the downside of that obsession is ignoring signs that you should have a day off. Sticking blindly to your program regardless of the circumstances may lead to injury which will affect your training consistency.  Part of being a smart runner is knowing when you need a day off.

2. Niggle or Injury?

Muscle pain and fatigue is a part of the training adaptation process. Masking the pain of training may even prevent you from improving.  However, delayed onset muscle soreness needs to be differentiated from your body breaking down. If you stop for every niggle you get from running you will not end up running very much.  Being in denial about a minor injury could result in a major injury and an extended time with no running.

How do you know if it’s safe to run?

The best way to decide on whether it is safe to run or not is to look at the intensity of the pain, if you had an event at onset and if there are any secondary symptoms.  

Here are three factors to consider:

#1  If running is causing significant pain that makes you limp or changes the way you run then you should stop and seek advice from a sports medicine professional as soon as possible.  

#2  If the pain resolves quickly or is only a minor pain then self-treatment with a reduction in running may be all you need for it to resolve.  

#3  If the minor pain does not go away in 2 weeks then you should come and see us at the intraining Running Injury Clinic so we can make an accurate diagnosis and start you on the most appropriate rehab program.

There are many different types of tissues that break down causing an injury.  Some need rest while others need exercise to heal.  

BONE – Bone stress and stress fractures are one of the few chronic running injuries that require you to stop running.  Continued running with a stress fracture may lead to a complete fracture and a catastrophic injury.  

MUSCLE – You should stop running immediately with muscle cramps, spasms and tears.  Walk back home and apply ice and elevation. Avoid stretching massage or heat for 3 days.  If you ignore this advice then you may be dealing with an injury that lasts weeks instead of days.

TENDON – Most tendon injuries are chronic and degenerative and nature.  They are a result of overtraining. Initially these injuries warm up and feel better while running.  They often hurt in the morning or after rest. They may need a significant reduction in training load but complete rest will prevent optimal healing.  

Acute tendon injuries are rare.  A stage 3 complete tendon rupture will result in a complete loss of function of the muscle.  There is a sudden sharp intense pain followed by reduced pain but the loss of muscle action. Partial tendon ruptures are more painful but have a reduction rather than a complete loss in muscle function.  Continued running with a complete rupture is not possible while partial ruptures should be treated the same as muscle tears.

LIGAMENT – Joint sprains may lead to ligament ruptures.  Depending on the severity you must stop running. Some people can do a sprain with limited ligament damage.  The risk of continuing running after even a minor sprain is that you may have another sprain. This second sprain will cause even more damage that may include the joint as well as multiple ligaments.

JOINT – Osteoarthritis is degeneration of the joint cartilage with associated spurring.  There is some evidence that running may help low-grade osteoarthritis by maintaining the bone density under the cartilage and improving joint health.  While pushing through joint pain may be dangerous and cause more damage, regular training can improve symptoms of joint pain.  

Reactive arthritis and Gout also affect the joint often with temporary episodes of intense pain.  Continued running with severe joint pain may cause rapid destruction of the joint. You should avoid running during these painful episodes and wait out the symptoms before running again.

3.  Fatigue or Illness?

Training at a level that you are not accustomed is what is needed for a positive training effect.  This can cause fatigue and tiredness. If you are unable to recover from the hard training then a detraining effect will occur where your performance drops rather than improves.  

There are other causes of fatigue.  Often the first signs at the beginning of an illness is a reduction in performance while training or racing.  If you were not an athlete then you might not even notice the signs of an illness coming on. Elevated heart rate or increased effort running at an easy pace may be signs of illness rather than a sign that you are unfit.  Running with a virus that causes fever or aching muscles is very dangerous. It may be a sign of muscle inflammation. Since the heart is a muscle if you run when it is inflamed then you may cause permanent damage to the heart muscle.  Minor colds localised to the head are usually safe to run with but fevers should never be ignored.

Poor sleeping habits and stress from work or family commitments will reduce the safe threshold of training load.  You must reduce your training when you are under stress as it has a negative effect on recovery.

4. The Running Environment

Running is generally considered to be a healthy activity that has the ability to increase lifespan while significantly reducing the risk of chronic illness.  However, there are some situations where running is not good for your health and may even be life-threatening.

The most obvious of these is to do with the weather.  The risk of being struck by lightning should always be treated seriously.  If you hear thunder nearby then seek shelter (but not under a tree). Strong winds can bring down trees and power lines.

Less severe weather also brings risks.  Training in hot temperatures can lead to dehydration and hyperthermia.  If your core body temperature rises too high then it can affect your judgement and you can find yourself collapsed on the ground.  Low temperatures, wind and rain can lead to hypothermia which is a drop in your core temperature.  While it is not as common in warm climates like Queensland we are often unprepared for cold conditions with proper protective clothing.

In many places in the world, air pollution is so bad it is unsafe to go outside and even worse trying to exercise in it.  Exercise-induced Asthma or lung infections may be the result. These cities will usually have a daily pollution score that you can check to see if you should run outside or head to the treadmill.

During winter it may be dark in the mornings and evenings when you are able to run.  Running in the dark has the increased risk of tripping which can be reduced by running with light or on routes you know are well lit.  You can reduce your risk of being clashing with a car if you wear light coloured clothing with built-in reflective tape. A personal flashing light clipped to your shorts will increase your visibility even more.  You should always be aware of your surroundings and avoid wearing headphones in both ears when running in the dark.

5. Recovery

The last situation where you need to decide whether to run is after a marathon.  Marathons cause significant destruction to your muscles. While active recovery may help you recover there is no benefit from doing much running for a few days after your race.  For some people, shorter races may also require a few days off but you do not want that to be extended more than a few days. In fact, it may be better for recovery to get back to the same frequency of sessions per week but with reduced distance and no real intensity.  The longer and harder the race the longer you may need to have this easier training. Getting back to hard training too soon will increase your injury risk and delay your return to racing at your best.

CONCLUSION:

These are some of the situations where you may be unsure of whether to run.  By carefully considering the risks and benefits of running you will have a better chance of continuing running consistently and safely.  If you are unsure of what to do then you should come in for an appointment with the experienced sports medicine practitioners at the intraining Running Injury Clinic.

Book an Appointment with one of our running podiatry and physio team or Phone 07 3367 3088

We are located at 33 Park Road, Milton