Spotting pain patterns before an injury derails your running

I have yet to meet a runner who’s never been injured, and that’s not much of a surprise given anywhere between 50% – 80% of runners are injured every year. There’s a lot that can go wrong when you’re pounding the pavement with the force of 2-3x your bodyweight on 1 leg at a time. We runners aren’t exactly the conservative bunch, either, when it comes to addressing a little twinge here or tightness there. In the past, I’ve put on braces, popped Advil, injured other body parts from overcompensating, and done the runner’s walk of shame from going just a mile too far for my pain to allow me to run back. And I would say I’m a fairly typical runner!

“When it comes to gradual onset of pain while running, there’s usually a pattern of dysfunction.”

For a lot of us, running is a major mood booster and an anchor for the rest of our day, so it’s really difficult to just not run, even for a few days. If we’re in the throes of race training, it’s even more difficult to give up on all the hard work we’ve done to accomplish a race goal. We don’t like taking time off from running, even if continuing to run does more harm than good. So how can we proactively address our pain before it sidelines our regular running schedule?

If your pain isn’t from a sudden trauma, such as a fall, twist, or in my most recent case, a Hess truck slamming into your ankle after careening down the slide at a playground, then there were probably some warning signs ahead of time. When it comes to gradual onset of pain while running, there’s usually a pattern of dysfunction. This means that there were subtle or not-so-subtle hints that 1 or more muscles was weak from not working and others weak from overworking. Our muscles like to work in partnerships, so if one isn’t pulling their weight, another one will jump in to take on the load, keeping you going until you can’t. These partnerships are called subsystems, of which there are 4 main ones in the body. I’ve found connecting the dots within these networks of subsystems to be extremely helpful in the strength training programming I craft for myself and my clients.

Here’s an example of using subsystems to identify and then train to mitigate the cause of pain: I had a client who was experiencing hip pain from running. I asked to see her walk. There was a lot of swaying of hips while she walked, indicating some pelvic instability, so I started with the muscles in the Posterior Oblique Subsystem, focusing on the strength of her glutes and core. Given the patterns of dysfunction that accompany this group of muscles, I also looked at her hamstrings, which tend to be overworked when there’s instability in the sacroiliac joint in the pelvis and the glutes aren’t pulling their weight. Sure enough, her hamstrings were TIGHT from picking up the load of the glutes. With the glutes not aiding in the hip extension required during running and the hamstrings picking up the slack to make this possible, her hips were very unstable walking let alone running, contributing to the pain she experienced. I programmed foam rolling for her hamstrings and lots of glute and core strengthening exercises and then added in 1-leg exercises to build her stability, getting her back to running without hip pain.

The glutes and core are also parts of 2 other subsystems, so I typically start with assessing strength in these 2 areas. Most of the people I’ve trained could use glute strengthening, as we’re often required to sit for most of the day with commutes and desk jobs. And since I train a lot of moms, many of my clients needed to rebuild core strength postpartum. Because these 2 areas make up multiple subsystems, sometimes it takes a little detective work to figure out which subsystem is the main cause of the dysfunction. There also can be a domino effect of multiple subsystems becoming affected if the main source isn’t addressed in a timely manner.

Nevertheless, using subsystems to figure out patterns of dysfunction has been one of the smartest moves I’ve made as a runner and a coach. If we can identify common patterns, we can identify solutions before we succumb to injury.

Here are a few steps you can take right now to identify patterns that put your running at risk:

  1. Keep a log of your training. Adding 1 more thing to your to-do list may sound like a drag, and I used to share the same sentiment. However, tracking some basic data is the first step to identifying patterns. A few weeks ago my right knee started bothering me. I was able to look back at my training and realize that while I did a lot of glute abduction exercises, I hadn’t programmed any adduction in a while so my adductors were probably a lot weaker than my abductors. That error plus an uptick in my running was causing a lot of knee instability and the resulting pain. Sure enough, adding in the adductor strengthening reduced the knee pain, helping me to better stabilize while on 1 leg at a time. This is something I’m still working on, and by tracking my strength sessions and my runs, I’m better able to assess what else I need to do.
  1. Get assessed. If you’re experiencing acute pain, you should see a doctor first and foremost. But if you have a nagging pain here and there that’s not severe, or if you’ve already been to the doctor and physical therapist but you remain in a cycle of injury, you many want to talk to other runners who take a more holistic approach to training instead of treating specific symptoms. Your first stop can be your local running store, where you can get feedback on your gait and foot strike. Your pain may be alleviated by simply getting new shoes. Your next stop can be a personal trainer who specifically works with runners (like me!). A trained professional sees a fair amount of clients and has to continually keep up with their education to remain certified, so we’re able to spot movements and identify patterns that may not be as noticeable if you’re not trained to look for them. I offer free assessments online so you don’t even have to leave your house!
  1. See a specialized medical professional. If you’ve logged your training, been fitted for shoes, and regularly strength train with proper form but you’re still experiencing undiagnosed pain, it’s time to seek out a medical professional that can accurately diagnose you, not just treat your symptoms.  Don’t keep training through true pain, as doing so will only make it worse and could potentially prevent you from running permanently.

Interested in a free assessment? Book one with me here.