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Soreness and Injury: A fine line

"What is the difference between soreness and injury?" is a question I am asked quite often.

Running and triathlon can be brutal sports, built on the premises of pushing boundaries and physical limits. This unchartered territory can come with various bodily aches and pains, some expected, while others less so. The fine line between soreness and an injury that requires medical attention can be rather thin, and it can be difficult to discern this boundary regardless if you’re a new runner or a veteran. Here are some “warning signs” to look for, and what to do if you think you need medical help. 

1. The pain is consistent or worsening over >5 days.

The official definition of a running-related injury is “Running-related (training or competition) musculoskeletal pain in the lower limbs that causes a restriction on or stoppage of running (distance, speed, duration, or training) for at least 7 days or 3 consecutive scheduled training sessions, or that requires the runner to consult a physician or other health professional.”, however, I know plenty of runners who have “run through” pain for quite a while before missing a training session. It is always better to err on the side of caution, and seek help sooner rather than later. Just because you seek medical attention doesn’t necessarily mean you have to stop completely, but a professional can help guide you through and offer strategies to keep your pain moving in the right direction.  

2. The pain/discomfort changes your running gait 

In an effort to protect us, our body will automatically invent ways to “get around” pain while running. You may feel less coordinated, asymmetrical, or “heavy” on your feet. In other words, your running stride will feel “not quite right”. Pain and underlying tissue dysfunction affects our motor control and muscle firing. The longer the problem persists, the more difficult it can be to regain that smoothness prior to injury.

3.You have pain when you’re not running/exercising

Pain at rest can indicate a number of things, however it should follow and be intuitive that if something hurts while walking, it most likely will hurt while running. Depending on the type of injury, it may feel better to move and the painful or tight area may loosen up with activity. While this phenomenon isn’t necessarily a “red light” to running, it is a “yellow light” that deserves attention. Another metric to pay attention to is how long the discomfort lasts after a run/training session. The more time it takes to calm down, the more appropriate a visit to a healthcare provider will be. 

4. The pain is sharp or catching in nature

As a Physical Therapist, I often ask new patients to describe what their pain feels like, as it helps me figure out what type of tissue is involved. Sharp pain often indicates acute injury, particularly to tendon, ligament, or muscle. Muscle injuries can also feel like an intense ache or particularly uncomfortable pulling sensation. The quicker you treat acute injuries, typically the less time it takes to recover.

5. You can’t jump on the affected leg or have pain that increases with weight bearing.

These are all signs of possible bone stress injury and/or moderate muscle/tendon dysfunction. These are signs that do not fit under the “wait and see” category. Go get some help right away! 

The most common pattern I see in the endurance athlete community is that athletes experience pain or any of the symptoms described above, and try taking a week off first. This works well for some injuries, but certainly not all or even the majority. Oftentimes an injury requires some combination of proper load/exercise and change in the movement pattern that caused the injury in the first place. This is when it is time to get in to see your favorite PT or other healthcare provider. It can be helpful to see an MD who specializes in sport-related injuries, as they can order other tests to assess other health-related biomarkers or order imaging if indicated. Otherwise, it is possible to see a PT without a doctor’s referral for 8 visits or 21 days in the state of GA. To see the direct access laws in other states, click here:

PT’s are skilled in medical referral and can determine if other healthcare professionals are indicated to help treat an injury. They can often diagnose an injury through a series of tests, as well as assessing how someone moves. 

At Precision we are offering both in-office and telehealth visits to help keep you running healthy. Give us a call at 770-842-1418 to schedule! 

Keep going, you’ve got this,

Dr. Kacy Seynders, PT, DPT


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