Find the one thing that causes the most pain when you’re running. That’s what we’re talking about today on the Doc On The Run Podcast.
Every time I’m talking to runners, and I’m trying to figure out what they’re doing, and what’s going on, and what’s causing all their trouble, I always ask them to keep a pain journal. Why do you think that is? Well, because that’s the most abundant information and the most useful information you have to actually guide your recovery. So if I had to get into a contest with other doctors and try to get people back to running faster, and I could use pain and they could use MRIs, x-rays, CTS, and everything else that they wanted, but could not follow their pain, I bet I’d get runners back to running faster. And that’s why it’s so important. I really believe it’s super helpful, but it’s ignored by most of us.
Most runners who call me are not tracking their pain, but they’re tracking their heart rate, or they’re tracking their perceived exertion in their workouts, or their wattage or some other metric that they think is really important because it shows up on their watch, but their pain does not, so you’ve got to track it. Now, here’s what I’m talking about. When you’re running, I’ll tell you one of the hardest things is that to track it when it’s really, really subtle.
When it’s really bad, it’s easy. You know, have a four out of 10 pain when you step out of bed first thing in the morning, or you have a six out of 10 pain when you do box jumps or something, like you have something very specific that hurts a lot, it’s easy to track it because you have a bigger difference between when it really hurts and when it doesn’t really hurt at all.
It’s also, there’s a difference between workouts. So if you’re doing varied workouts like, let’s say you’re doing suicide drills or sprints on a football field where you’re running from one line to the next and then further out and back and further out and back from line to line, and you’re alternating. That sudden change in direction can cause a lot of pain to one specific structure with one particular motion. But when you’re changing direction, running on a trail, or running on a track up and down the field, I mean, a football field up and down the field, and you’re really changing direction a lot, it’s easier to pinpoint the motion that actually causes the most trouble. But when you’re running on the road, straight line, flat surface, very little variables at all, and you’re not changing direction, you may have very little pain when you’re actually doing that. And in that case, it’s really important to make sure that you see if it hurts during the activity, that evening or the next day.
But the thing that’s really important is what actual thing causes the most pain? Because you have to stop doing it if you want to get better faster. It’s just an indication that you’re stressing that structure. So if you’re changing direction, and you even noticed that it really bothers you when you go left on the curves on the track, but it doesn’t hurt on the straightaways, that’s useful information. It may be that if you literally run the opposite direction, that it won’t hurt at all. That would be useful information because then you could stop doing the one thing, going around the track counterclockwise and you could start going clockwise and be able to train for longer without any pain. And that’s really the game when you’re trying to use pain to direct your activities as you ramp up your training, particularly if you’ve had an over-training injury.
If you like this episode, please like it, please share it, and I’ll see you in the next training.
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