Should I stop running if it hurts? Usually not

“Stop running” is usually the wrong advice

I’m a runner, so I tend to have lots of patients who also run. Runners understand each other and word gets around. 

Often my patients have been told that they should stop running by another health practitioner or doctor who doesn’t understand their problem, and most of the time I have the pleasure of reassuring my patients that running is not only safe for their problem, but may actually be an important part of making a full recovery when done correctly.

We run for many reasons and the effects go far deeper than improving aerobic fitness. The mental and emotional boosts from running are such an important side effect that side-lining a runner should be considered only as a last resort.

When should I stop running?

There are some instances when you should definitely stop. Stress fractures, often in the hip, tibia (shin), navicular (foot) or fibula (ankle) are instances where you could be at risk of significantly more harm if you continue to run. Stress fractures of the hip in particular require urgent attention and occasionally require surgery.

However, many of the most common running injuries such as ‘runners knee’ (patellofemoral pain syndrome), ‘shin splints’ (medial tibial stress syndrome), Achilles tendinopathy, plantar fasciitis and ITB friction syndrome can safely be managed with changes to training and physiotherapy. Severe pain and swelling may only require a very short period of rest.

So why are runners often told to stop running? Well, I assume it’s because it’s an easy thing to say and because many clinicians do not know the current research. Most pain improves with rest, but usually it does not fix the problem and the eventual return to activity leads to symptoms once again.

Many people are still told to stop running to prevent arthritis also, even though we know running does not cause arthritis and that running can actually be beneficial for arthritis in many cases. If you’ve been told to stop running, it may be a good idea to seek a second opinion.

What should I do to keep running?

Often an adjustment to your technique and training loads is all that’s needed to keep you running. Doing this in conjunction with physiotherapy treatment and exercises will enhance your recovery back to full speed and volume, bypassing the negative effects of detraining or gaining weight.

Making some changes to running form and training schedule can get you running pain free again soon. Many injuries are caused by increasing weekly volume (total distance) or intensity too quickly, so giving yourself time to build a stronger base can help your body to manage the adaptation. A simple rule is to not increase your weekly volume by more than 10%. 

Having plenty of variety in your workouts is also important for healing and getting out of pain. Many runners on the Gold Coast run the same flat runs regularly. Paradise Point, Hope Island and surrounding areas are all very flat! By adding hill sessions, interval runs and long slow runs, more muscles are forced to get stronger thereby helping with pain. Mixing up the terrain can also help - beach, grass, roads, trails and concrete.

Poor running form often leads to injuries and pain. Running with a slow cadence or high vertical oscillation are some factors that lead to injury and can be easily addressed by your physiotherapist after assessing your gait. 

Your physio will also be able to help address tight hip flexors and hamstrings, poor pelvic control and poor core strength which we commonly see in runners with pain. 

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The bottom line of running pain

Running with pain is very common and maintaining running while injured is often an important part in getting past the injury. Running will keep you conditioned and ready for the loads needed to run. Changes to training load, physiotherapy mobilisation and cross-training are some strategies to help you get out of pain quickly.

There are some injuries, such as stress fractures that require urgent attention to avoid serious injury. If you have a stress fracture, you must stop running until your doctor or physio advises it is safe to continue. Severe tendon or joint pain from Achilles tendinopathy or arthritis may require a very short rest period.

It’s important to find a physio or exercise physiologist who understands your mindset as a runner to make sure you get the best treatment. 

The physios at My Vitality Physiotherapy have worked with runners and athletes at all levels. We understand running pain and would be delighted to use our expertise to help you also achieve your best.