Is the pain from injury or just inflammation? Well, that’s what we’re talking about today on the Doc On The Run Podcast.
Pain is the most useful and likely most underutilized tool available to any runner who is tired of waiting for doctors to give them permission to run. But how you track your pain is important. And one of the critical components in the running injury secrets framework that I discussed in the first episode of the members only podcast in the Injured Runners Aid Station is about pain caused from damage in the tissue versus pain caused by inflammation around the tissue. You cannot run without understanding the difference, at least not safely.
The whole name of the game and everything I teach in the frameworks that I use with runners is about trying to figure out how to get your real pain numbers, how to track what you’re doing, how to remove the inflammation so you have real pain numbers and then how to get your accurate assessment on what you can do at each phase of healing as you progress through running as opposed to just waiting four weeks or the next doctor’s appointment or waiting six weeks for the X-ray or waiting two weeks to come out of the boot or anything else. But you got to know the difference between pain in the tissue because of tissue damage and pain in the tissue because of inflammation.
The thing is that when you get tissue pain, what are you really getting? Well let’s say you have a torn ligament, okay? You have a little bitty rip or a little bitty tear in the ligament itself and when you move the ligament and you stretch it, it hurts. That’s what you’re trying to track when you have a running injury. But how can you get pain that’s similar? Well, let’s say you have had a sprain, and you get a little pain in there. It causes some swelling, and you step on it and it distends the nerves and it causes more pain that stimulates more inflammation. So, sometimes when I see runners with chronic injuries, all they have to do is remove the inflammation they have almost no pain, then we just have to reduce some stress and strain on that piece of tissue and then keep running without any difficulty. But you’ve got to know the difference.
One is that you’ve got pain because you’re hurting something that’s broken like a stress fracture. You have a crack in the bone, okay, so you step on the foot, you run, you push off and you actually bend the bone, and it distends and stretches and pulls on the crack. Well, that hurts. But if you have inflammation in the bone, the bone is basically swollen and so it hurts and if you remove the swelling, that pain goes away, that helps you figure out very quickly how much activity you can actually sustain if you know the difference between those two things. So, you’ve got to be able to tell the difference between the swelling pain and the tissue pain.
The key component, the framework that I use with runners is that for any injured runner, they can do this on their own but only if you can track your pain precisely. And if you’ve tracked your workouts and you’ve been paying attention to your running form, you should be able to do it all on your own. But you must be able to remove the inflammation induced pain to get an accurate read on the pain numbers that you’re using to gauge your activity.
Again, inflammation can creep back in as you wrap up your volume and intensity and if you don’t believe me on that, just think about the number of tools that you see in running magazines or on websites about compression socks, recovery sandals, pneumatic recovery boots and various massage tools, therapy, guns, all that kind of stuff. All of that stuff is designed in part to target and remove that excess inflammatory fluid that can slow down your recovery even just your recovery from hard workouts, and it can actually delay your ability to return to workouts as quickly. All that inflammatory fluid has got to go, and the inflammatory fluid is one of the things that really confuses your picture as an injured runner who’s trying to ramp up your activity.
If you want to check out some more stuff about that, I do some live trainings. I have some resources available in the Injured Runners Aid Station where you can ask me any questions you want there, anytime you want, and I do live trainings where I do live Q and A’s as well and you get access to www.docontherun.com/aidstation. So, go check it out and I’ll see you in the aid station.