“It doesn’t hurt.” This simple phrase can mean so much to so many. It can be a frustrating experience for my patients when they utter those three words. Without hesitation they find themselves being bombarded with follow up questions.
Pain is different for so many. This is more than your pain tolerance. Pain is pain and it’s the one thing that dictates how you handle an injury. Pain is typically a sign of failure. Failure of a joint, tendon, ligament or muscle to accept load (you running). In prior articles I’ve talked about pain that improves while you run.
The way we talk and describe pain varies between patients, but with the right poking and prodding I usually can get the information I need to determine if my patient is ready to run or progress their rehab program..
Answers like “kind of,” “I’m not sure,” “yes and no,” and the alike cast a cloud of confusion when determining the status of an injury. My favorite thus far? “It doesn’t hurt… it just feels awful.” Yep. True story.
Boiling down the verbiage to a simple “yes” or “no” can certainly help, but those “kind of’s” may be warning signs for worse things down the road… literally and figuratively.
Pain is a product of inflammation. It can be easy to ignore as the damage is typically deep. The healing of superficial cuts and scrapes are easily seen so it’s easier to understand if you’re officially healed or not. Our tendons, muscles, and joints cannot be seen without imaging, so it’s much easier to ignore, block out, or simply neglect the healing process
Verbalizing your symptoms will not only help you avoid re-injury, but also help any clinicians who are attempting to help you return to the roads.
“Yes. There’s pain.”
Simply put, you shouldn’t run. Pain is more than your everyday ache, too. It’s often described as “sharp,” “burning,” “stabbing,” or “just plain hurts.” Pain causes you to change the way you move, often accommodating a limp or “near-limp” running. Think of it as re-irritating or worsening a cut on your skin. Pain is simply the signal that your underlying injury is tearing apart.
“It doesn’t hurt, but I feel it.”
Damaged tissue always progresses to a blurred line. “It doesn’t hurt, but I feel it.” This simple phrase is the deciding factor between bagging a run or cautiously proceeding. “Feeling it” equates to loading tissue that has not returned to its full strength. It can stay constant (feel it throughout a run) or progress in either direction (diminishes or progresses to pain).
Injured tissue can take up to six months to fully remodel. Expect to “feel” your injury site for a few months when returning to running. Most are gun shy, particularly after forging mental scars from not running during the “it hurts” phase.
The “feel it” stage enables you to reload the injury site so that it can gain strength and return to normal. Too little load and the tissue never regains normalcy. Too much load and the weakened tissue tears, regressing back to pain.
Here’s a quick video to help you fully understand:
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