When To Go To The Doctor

A little pain or discomfort when you begin running, increasing your mileage, or complete another training workout (hills, intervals, cross training, strength training etc.) is not uncommon and most of the time expected. It is part of why we stretch, foam roll, ice and use other modalities after a run to help ease the DOMS (delayed onset muscle soreness) or mild discomfort we might feel after a run. No pain, no gain, right? Discomfort is the body’s way of letting us know we have done something new; we’ve added a new stress to our system and it is adjusting to that new stressor, that is how we get stronger and build endurance. However, discomfort is NOT the same as debilitating pain that makes running and everyday activities intolerable. How do we recognize the difference? At what point do we stop running and seek medical advice and treatment?

This article will outline how to know if you are feeling the normal aches and pains that come with training for a marathon or if you should consider seeking out a medical professional. I will also give you tips for finding the right provider for you!

Take a look at the list below of general guidelines to help you determine if you need to seek out a medical professional for the pain you have been experiencing. If you find your pain is causing any of the following it is recommended that you speak with a doctor or physical therapist who can assess your pain/discomfort and give you advice for how to safely return to running without sustaining a more serious injury.

• The pain causes you to wake or keeps you awake during the night.
• You are unable to perform your everyday activities (work, household chores, etc.) without pain.
• You complete a proper warm up and still feel pain - or the pain does not go away after exertion (i.e. if the pain comes back after you’ve already taken time off from running). Allison Huyser a doctor of physical therapy at Pinnacle Physical Therapy says “as a rule of thumb your pain should decrease back to mild or no discomfort within 30-60 minutes after your run, with the exception of muscle soreness”.
• You have swelling, numbness, tingling, burning sensation, sharp shooting pain, or other sensations.
• If your pain has required you to take medication to find relief.
• Your pain during exercise increases past the point of mild pain (1-3 on a scale of 1 - 10, 10 being worst imaginable).
• If your gait changes due to discomfort (limping or other changes in gait). Changes in the way you walk or run can lead to compensation in other areas of the body and can cause additional injuries and will only compound your problems.

Dull aches and pains are a normal part of running and not cause for concern. However, it is important to be proactive when you first feel discomfort or pain during training. Rest, ice, compression, elevation and anti-inflammatory medications are great preventative steps to avoid sustaining a more serious injury. Take 1-3 days of rest at the first incidence of pain, and then decrease your mileage when you begin running again. Try gentle, foam rolling, stretching, and massage to decrease symptoms. If after several days of rest and preventative care do not work to decrease the pain or discomfort it is time to seek help. When in doubt have it checked out! If you are experiencing any of the above it is best to check in with a doctor or physical therapist. If you do not already have a provider that you trust, take a look at the list below for tips to help you find the right provider for you!

How to Find The Right Provider For You

Finding the right provider can be difficult. A lot of physicians will tell you to keep running despite the pain you may be having or tell you that you shouldn’t run at all. To find the right provider for you try:

• Asking your running friends for a recommendation of the physicians or physical therapists they see and trust.
• Ideally find someone in the sports medicine field that works with runners or is a runner themselves.
• Call the clinic you are interested in going to and talk with someone about the experience the medical professional you will be seeing has with working with runners.
• Check with your insurance to find providers and clinics in your area. Find out what your insurance covers and what your benefits are for seeing your doctor or a physical therapist - you may not need a referral from your doctor to see a physical therapist.
• It is not always necessary to see your doctor before going to physical therapy. Physical Therapists are doctors that are able to diagnose and create a treatment plan for you. They are movement specialists and have a greater understanding of the human body’s musculoskeletal system than primary care physicians. Allison, DPT, says “you can often forgo the middle man (your primary care physician) and go straight to physical therapy for an evaluation, which will save you time and money”.
• Look for someone who has a more holistic approach to wellness and rehab. Often the area you are feeling pain is not the root cause of the problem. Finding someone who will address you as an individual and look at all the pieces that could be contributing to your pain (shoes, biomechanics, nutrition, etc.) is extremely important.

Remember mild discomfort is a part of being a runner, but if you are having any doubts about whether it is a more serious injury it is worth seeing a medical professional for an evaluation. You want to stay as healthy as you can for training and races, taking care of things before they have the chance to get worse is a must!

~Sierra, The Tunnel Marathons Trainer
trainer@tunnelmarathon.com