How to Tell if Your Pain Is a Running Injury

In our popular YouTube video, my colleague Julia Pak says:

“Never run through pain. Pain is your body’s way of telling you that something is wrong with the way you run. If running hurts, it’s time to start looking into changing your form gradually.”

In the very lively comments section for this video, runner after runner says something to the effect of, “If I stopped when I felt pain I would never run at all,” or posts a question about the specific pain they’re feeling. There and elsewhere, the question people ask us more often than any other is how to tell whether the discomfort/pain they’re feeling is normal or a sign that something’s wrong.

Here’s my rule of thumb:

General, diffuse, whole-body feelings of intense effort or exhaustion that are reasonable for how fast/far you’re running and what kind of shape you’re in are normal.

Local, focused pain is always a sign that something is wrong.

Do your shins hurt? Something’s wrong.

A knee, hip, or toe? Something’s wrong.

Your heels? Ditto.

Does a sharp pain appear out of nowhere or a dull ache set in after you cool down? Either way, it’s a sign that something is out of kilter about your form and it means you need to take action.

Here are a few common scenarios involving pain and what to do about it:

A New Pain You Can Easily Run Through

Most runners have local, sharp pains or aches from time to time when they run. In the UK these are called “niggles” (a term I’ve become fond of) and we take them semi-seriously. You feel them because something is out of kilter about your movement but it might be a transient thing that will sort itself out in another mile or with the next change of terrain or by the time you run next.

Take care of yourself between runs, do some stretching, cross-training, get a massage, get a lot of sleep, put some Topricin on what hurts… if the niggle wasn’t bad and if it was relatively novel, basic self-care is often enough to bump your mechanics back into their usual healthy groove.

Running is so complex, there are so many joints that need to work in synchrony, that things do go a little out of whack for all of us from time to time and often return to normal with no bad consequences if you take care of yourself.

A New Pain You Can’t Easily Run Through

If it’s too painful to run through, STOP! It’s more than just a niggle, or it’s a sufficiently serious one that it’s not going to sort itself out while you run. Go home, take care of yourself as described above, and make your next run an easy one.

If the pain’s gone, good. If not, seek help. Never push through pain that’s bad enough to make you want to stop or you risk damaging yourself.

A Pain You Have Regularly

If you have the same niggle run after run, or every time you do a long run, or very frequently, then you need to look into changing how you run. You can’t put a band-aid on this, and if you try it may work for awhile but you’ll get a more serious injury down the line.

General advice on running form may be helpful to you but in nine out of ten cases what you need is for an expert to look at how you run, identify how you’re creating the stress that’s causing the pain, and help you feel how to change your form. That’s what we do. Nearly all of our clients come to us for this kind of help… except for those who just kept running and ended up with a serious injury, a trip to the doctor, a layoff from running, physical therapy… and then they get sent to us to help them get back to running.

Take my advice: be the first kind of client, not the second.

We’ve got tons of online resources from a free “challenge” to an in-depth course or individual online coaching. Other options include finding a local Feldenkrais practitioner or, if you can’t, find a running biomechanics expert to analyze your form and help you make the necessary changes. And I’m talking about changes in how you move, not putting orthotics in your shoes!

Will You Still Be Running When You’re 80?

If you’re training for a big race it’s easy to indulge in wishful thinking and self-deception about pain, but healthy running means being able to strike a balance between pushing for a goal and pulling back when it’s necessary to preserve your long-term ability to run. It’s a judgement each runner needs to make over and over again, and with the benefit of increasing wisdom over the years. Every time I work with an accomplished masters runner I’m impressed by how well they listen to their bodies and know when to pull back. It’s what makes it possible to be a masters runner. Follow their example.

6 thoughts on “How to Tell if Your Pain Is a Running Injury”

  1. What about muscle pain from a previous run or workout? For example, I’ve been transitioning to a minimalist/barefoot running form. I’ve finally got my feet and ankles up to strength, but my calf muscles still get sore after every run from the forefoot strike. The pain is in the muscles, not the tendons. I do give it time to improve, but rarely wait for it to be completely gone before running again.

    • Adaptation in the calf muscles can take awhile but if it takes too long you need to consider whether you’re overdoing the forefoot strike. I can’t unfortunately tell you exactly how long is too long, but if the rest of you has felt good for months and months and it’s just your calves, then that’s probably time to look again at the form you’re trying to switch to: are you too upright? Is your core too tight and stable? Are you exaggerating the forefoot strike? And meanwhile, I do recommend you try to help your calves to recover a bit more between runs — get extra sleep or add a day, for instance.

  2. I have been struggling with metatarsalgia (or similar) in my right foot for several years, trying various paddings, orthotics (both from the NHS and private) and nothing is really working. I get relief for a certain time, or distance, then the pain starts, and once it starts it does not dull down. I have struggled through four overseas marathons (there is no way I wasn’t going to attempt to run them given the amount I had spent in getting there) and spend more time walking than running these days. Now my toes appear to be stiffening up, which means that the tow-off is painful. I have a GP appointment tomorrow (after waiting 4 weeks to get it), but have little confidence that I will get a workable solution which will allow me to keep running.

  3. Your blogs are very contradictory and with IT band issues I’ve found that’s all I’ve learnt. Everyone has an opinion but nobody has an answer.
    Run, don’t run. Carry on training, stop training. Build muscle, don’t bother you have what you need. Correct your posture, don’t run naturally.
    The list goes on….
    I ask people how they got over persistent IT pain and they never have an answer it just happened or they stopped running all together.

    It’s a mine field of opinions

    • Ryan, if you haven’t read my posts specifically about IT band syndrome, you should. It’s an issue of how you move, and it is solvable. As for whether you should run through it… most people find they can’t. There’s no damage, it’s just painful, but once it kicks in you generally can’t run through it. Read this post and do the entire free mini-course at the bottom:


Leave a Comment