Today on the Doc On The Run podcast, we’re talking about the #1 mistake runners make in the first week of a running injury.
Anytime you make a mistake in training, push a little too hard and get injured, you have pain.
That pain creates an urgent need for answers. Specifically a need to answer three specific questions:
1. What is causing this pain? What is the diagnosis?
2. What is the treatment? What can I have to do to heal it?
3. How fast is it going to get better?
This one is critical. That’s really the million dollar question. This is what you really want to know when you go to the doctor, when you call me for a phone or Skype visit.
Basically you want to know what happened, and how quickly you can fix it. You want to put a name on the problem, start the correct treatment and have an expectation of how quickly that treatment will give you the result you want. Above all else, you want to know when you can run.
To answer these 3 question, the doctor needs to know 3 basic pieces of information.
How did the running injury happen? What were doing when it started
What did you do after your foot started hurting? Did you stop running? Did you ice your foot? Did you change the type of shoes you are using?
How much has the foot pain improved day to day since it started hurting?
The #1 mistake I see runners make is not keeping track.
You can’t remember.
You don’t want to remember.
If you could vividly recall every moment of a painful root canal, that would not be a good thing.
Your brain actually has then power to shut off and fog all of the details of all manner of unpleasant sensations.
Many years ago, I saw a woman who thought she had pain for 2 years. During our initial conversation she told me that she previously had some x-rays and an MRI of her foot.
I said, “ If I’m going to see you it will definitely be valuable to look at your MRI when I poke around on your foot and do your exam.”
I recommended she get a copy of her MRI and her medical records. It turns out she had an MRI from 8 years before. But she only thought you had pain for about two years.
She had simply forgotten, or mentally blocked out any recollection, that she had pain for four times as long is she wanted to remember. She had pain for eight years, not two years.
We don’t really want to remember all of the pain we have. Don’t really want to remember how long we had pain. And we certainly don’t want to remember Long we have been unable to run in the way that we want because of the pain.
Pain is an important signal.
Pain receptors in your skin, a strained muscle, a sprained ligament or an aching bone send a signals to your brain.
But pain is not just a physical experience. Pain is a cognitive experience…your brain is processing that information and trying to determine what that foot pain means.
You may actually unconsciously think about what the aching foot pain means to your training plan and the workouts you have planned over the next few days.
Pain is also an emotional experience. You feel fear of not being able to make it to your race. You think you may not finish your race. You think may not be able to run anymore, at all…ever. That is particularly true when you have seen a doctor who is discouraging.
You don’t want to experience all of that fear and anxiety.
You want to forget about the pain.
So we as runners don’t remember the severity of pain very well.
You are not able one week later, two weeks later and certainly not a month later, remember the pain in any useful detail.
Think about it. If I were to ask you, “How hard was your last long run? On a scale of 1-10, what was your perceived exertion during the first mile of that run, halfway through and on the last mile of that run?
Could you rate it on a scale of 1 to 10? I can’t.
If anything was off, didn’t feel right, what was it? Did you feel like it was your quads, did you feel out of breath, or was it something else?
Chances are good you can’t remember.
You need a workaround.
You simply must track that pain.
Most runners don’t.
Most runners who call me, who are frustrated, who are not getting better, who have been told to stop running by their doctor, most of them have not been tracking their pain.
We want to think and believe the pain will miraculously vanish by morning.
The next day it may be little better, but its not gone.
But in a sense, you have been rewarded by ignoring and trying to forget that pain.
The real problem is when that pain is still hanging around, forcing you to run slower, or cut your runs short, two, three or ten weeks later.
At that point, you know it is problem. You know you need to help. You know you have to see a doctor or you really have to start trying to work hard to start trying to figure it out on your own.
The real problem I see at that point is that most injured runners I talk to don’t really have a crystal clear memory of the progression of pain. They really don’t know how it has changed.
They haven’t kept track. They can’t remember how much it improved over the first 2, 3 or 7 days.
That change, that level of improvement, the response to things you are doing right now, is actually the most important piece of information when you want to know how quickly you will heal. It is the most important piece of information to any doctor (or me, if you call me) when you want to know when you will be able to run.
So right now, stop. Print out the Runner’s Pain Journal and fill it out.
Even if you have no plans to see a doctor, you never call me to get me to help you figure out how quickly you are going to get better, you need a clear record of your pain level and the exact activities that made it worse, or better.
Let’s face it. Most runners can pick a race, create a training plan, follow a plan and make it through the race. You can do that without a coach. You can do it on your own.
When you make a mistake and get a running injury, you just have to figure out how to stay fit and get back on track. It’s the same process.
Most runners have all of the tools, resources and ability available right now to figure out how to get better and get back to running.
But don’t cheat yourself. Start creating an accurate record of you pain today. It will be the most valuable piece of the puzzle in getting back to running.
Pain is the best tool to help an injured runner decide when run. You don’t have to figure out what to write down. We made a simple Pain Journal PDF for you.
If you have a question that you would like answered as a future addition of the Doc On The Run Podcast, send it to me PodcastQuestion@docontherun.com. And then make sure you join me for the next edition of the Doc On The Run Podcast!