Every runner knows that sensation: training is going fantastically well until, all of a sudden, your foot hurts, your knee hurts, or your hamstring hurts. More often than not, pain is the sign of a running injury – or a problem that will develop into a debilitating injury if you continue to train through it, especially if the pain is related to a muscle, fascia, or tendon (soft tissue). Soft tissue injuries are one of the most common yet easily preventable causes of injury in runners and taking these smart steps at the first onset of tightness or pain can reduce the chance of developing a full-blown running injury.
Soft tissue running injuries include IT band syndrome, plantar fasciitis, muscle strains, Achilles tendinopathy, and other similar muscle, tendon, or connective tissue injuries.
Always heed the advice of your physical therapist, doctor, or your running coach. These guidelines for dealing with a running injury are not intended to substitute medical advice. If the pain is severe, please visit a medical professional. These guidelines apply to soft tissue injuries, not bone injuries – if you think you might have a stress fracture, stop running and visit a doctor for a diagnosis and treatment.
Runners do not want to skip a day of training, but it is far preferable to miss a couple of runs than to worsen the severity of your injury and be unable to run for months. A general rule of thumb for any pain on a run is to cut the run short and call it a day. If the pain persists or was severe on the run, then rest for a few days up to a week. If you feel something pop or snap, rest for a few days up to a week. This rule ensures you rest during the acute phase, which is the 24-72 hours after the start of an injury when inflammation is the highest.
This rule has kept me running through plantar fasciitis, IT band pain, and other minor soft tissue injuries. When I apply this rule, at most I’ve missed one week of a running – a small blip in the overall scheme of training. The one time I ran through the acute phase of an injury – a sprained foot – I ended up taking a month-long break from training.
Don’t be a slave to your training plan; listen to your body. More evidence points to the fact that perfectionists – those who are unable to take a break or diverge from their training plan – suffer from more overuse injuries. Discipline applies to both running and necessary rest; the smart, disciplined runner is the one who knows when a few days off are beneficial.
For some injuries, depending on the type of injury and the severity, you can still run once you are out of the acute phase. However, you want to rest relative to your training load as the injury heals. For example, if you can run without pain but are dealing with a minor musculoskeletal injury, slightly reduce your mileage and avoid any interval workouts. Speedwork, especially intervals, places strain on the muscles and tendons as you cycle through accelerating, running fast, and then stopping, and can worsen a soft tissue injury. For some injuries such as Achilles tendinopathy or ITBS, you want to opt for flatter routes, as hills can aggravate the injury.
Running produces some degree of inflammation – that is part of the adaptation process. In regular training, you want this inflammation to heal itself naturally – that’s why popping an Advil for basic muscle soreness can hinder your training.
However, high levels of inflammation occur when a muscle or tendon is injured. In this case, you do want to reduce inflammation and speed up the recovery rate. Applying ice to the site of the injury will reduce inflammation and aid in recovery. Icing protocols are most effective when done two to three times per day for 10-15 minutes. In addition to icing, non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen will reduce inflammation.
Kinesiology tape certainly isn’t a panacea, but it can be a useful tool when used in conjunction with other recovery methods. Kinesiology tape is a flexible, breathable tape, rather than the restrictive traditional athletic tape, that can be worn during exercise. Kinesiology tape promotes recovery by improving blood flow to the area and increasing range of motion.
Taping is not a license to run through a severe injury; rather, it can aid in both injury recovery and assist in returning to running after a proper recovery period. For less severe injuries, taping can help prevent pain on a run.
It is worth noting the lack of clinical studies on the efficacy of kinesiology tape. However, it is commonly used by professional and elite-level athletes. For example, Molly Huddle swears by KT tape as a means of enhancing recovery, although she does note that the impact is “subtle.” Sometimes, the science and practice diverge. I think it’s worth observing not just what the science indicates but also the common practices amongst those who achieve peak performance in the sport.
Anecdotally, I have seen kinesiology tape work for both myself and the runners I coach, particularly with issues such as runner’s knee, IT band pain, and minor muscle strains (after proper rest and recovery during the acute phase).
You can find an array of videos on taping for specific injuries on KT Tape’s website.
Foam rolling is most useful in treating soft tissue injuries. You never want to directly foam roll the site of a strain or sprain, but foam rolling the surrounding muscles can speed up recovery. For connective tissue injuries like Achilles tendinopathy or plantar fasciitis, foam rolling surrounding muscles such as the calf can release some of pulling on the injured tissue.
Foam rolling is best done in short, deliberate sessions, spending approximately 30-60 seconds on the muscle. Overzealous foam rolling can worsen an injury, especially in cases such as IT band syndrome
Foam rolling will not aid in the recovery of bone injuries such as stress fractures, shin splints, or bone bruises. Please do not foam roll over a bone injury.
Support Your Feet
As a running coach, I observe a sharp increase in the number of Achilles and foot injuries in summer. Why? Unsupportive footwear is a popular wardrobe choice in summer, from strappy sandals to flip flops. If you are dealing with an injury such as plantar fasciitis, Achilles tendinopathy, or other foot or ankle injuries, one of the best steps to recovery you can take is wearing supportive footwear when you are not running.
Balance Out Biomechanical Irregularities
Biomechanical irregularities cause a variety of injuries, from ITBS to plantar fasciitis. Yes, training load is a significant factor as well, but oftentimes weak or imbalanced muscles limit the training load that the body can handle.
In addition to strength training, preventative exercises can aid in recovery and prevent future injury. These exercises target weak muscles, especially in the feet, ankles, hips, and glutes.
These preventative exercises should be done consistently and indefinitely to fully be effective. Do not stop doing these exercises once the pain subsides, otherwise, the pain could recur.
Try these exercises, based on the type of pain you are experiencing
Eccentric heel drops: Achilles tendinopathy
Towel scrunches: Plantar fasciitis
Clamshells, banded walks, and glute bridges: runner’s knee, IT band syndrome, plantar fasciitis, almost any injury!
Disclimaier: I am a certified running coach, but I am not a physical therapist or sports medicine doctor.
How do you address an injury when pain appears?
What running injuries have you dealt with?