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Universal Truths about Running Injuries

Some posts this week at Runners’ Lounge, including Take It and Run Thursday, are dedicated to running injuries.

Mss Injuries are a major blow to a runner.  We’re caught off guard and the timing is always rotten.  When injured, we tend to do dumb things—run through it, self-diagnose, ignore the cause, and ultimately delay our actual recovery.  I’ve lived a very fortunate runners’ life, but not free of injury.  Below are some universal truths I've discovered about running injuries.

We own responsibility for our active recovery

Not every injury is our fault.  But we do govern the details of our recovery. The minute we’re injured, the body starts healing, even though it doesn’t always feel that way.  We can accelerate the process with cross training, sleeping well, eating well, and fueling our minds with positive thoughts. 

We also need to stop being our own worst enemy by coming back too soon using the old excuse of “running a little just to see how it feels.”   A premature return to running is generally a double setback.  It’s like pulling up plants to check if the roots are still growing.  Yup, they're growing, but now the plant's natural progress is traumatized.  Couldn't I just leave the content plant—or my injury—to rest?

Beware of amateur diagnosis

We may refer to an injury by a common name, but it ain’t necessarily so.  A friend thought he was battling plantar fasciitis after another runner had convinced him he had it.  After asking a few questions, it was clear to me he didn’t have PF.  Instead he had Achilles tendonitis.  I assured him there is a difference, but that he should have it confirmed.  So the lesson here is one runner’s pain is not identical to another’s.  For example there is a bucket full of types of knee pain, and the sooner we find out what it is, then the cause, the sooner we can correct it.

May strength be your guide

Many injuries can be prevented or treated with more strength.  As runners, we are prone to building muscle imbalance.  The range of motion in running builds Everests out of some muscles and reduces other muscles to silly putty.  A brilliant PT once explained to me an injury related to four muscles in my calf.  The two inside muscles were the problem, but the outside two  muscles were not.  So the PT taught me to apply the “muscle buddy” system, by strengthening the healthy buddy muscles around the sore muscles.  After a few days of recruiting the healthy muscles to help out the inflamed muscles, the pain went away.  Since then I’ve learned to strengthen all muscles in the area of soreness.  Which leads me to the next truth.

Healthy_runners_handbook_2 We are smarter runners after an injury 

The most important stuff I know about muscles I’ve learned related to an injury.  In those runner crises I’ve learned to identify—and sometimes even pronounce—which muscles are upset with me, the difference between a pull, a strain, and soreness etc.  When I’m healthy, I run naively along ignoring what’s going on.  When I’m injured, a chart of the muscular-skeletal system is my friend.

When we're injured, we're often nasty.  Filled with frustration and impatience, we're miserable company.  Later, we're indebted with gratitude when we finally nail the cause and remedy to an injury.  Injuries humble us with so much to learn.  Great resourcea on the topic of injuries are the Healthy Runner's Handbook and The Competitive Runner’s Handbook.  Both discuss:

  • Questions to Ask When Injured
  • Warning Signs For Injury
  • Psychological Aspects of Injury—Denial, Anger, Depression, and Acceptance
  • Specific Treatments for Common Injuries—the questions to ask when Injured

Find and make maximum use of the BEST physical therapist

An awesome physical therapist is worth his/her weight in gold.  The key is finding the right one.  Ask around until you find a PT who is also a runner or who serves the bulk of runners in your community.

  • A good physical therapist is capable of diagnosing an injury and treating you on the spot and sending you on your way with exercises to recover. 
  • A great physical therapist will also educate you to understand your injury, its cause, and how to reduce the chances of it recurring.
  • The best physical therapist will do everything possible to keep you running while you’re rehabbing .

Reading about running injuries is like reading a lover's diary detailing a break up.  Still, we learn a lot from each others, and we believe this week’s focus on running injuries will be enlightening and helpful. 


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I agree about the "best" PT aspect. In fact, I would suggest that one that stops you running throughout the entirety of your recovery might actually be faulty one. As one who has been recovering or enduring through an injury, it was the reports after my runs that gave my PT the best idea on how far I had progressed or the magnitude of the injury. Very often bigger pains can mask smaller ones, or biomechanical motion problems can disrupt more than just the immediate painful one.

Count me glad I found a great one...


I went to a sports therapist my knee pain. Best $50 I ever spent. He helped solve the problem rather... can't say enough about it.


As I sit here with 0 miles ran since my half marathon, I greatly appreciate this post. It makes me want to rest yet another day before I push it too far.


I learned the hard way about injury. Great post, Tom!


Well said, Tom. I should probably print this out and make myself read it the next time I'm injured.


oh man is this a great post. this was my favorite part:
We also need to stop being our own worst enemy by coming back too soon using the old excuse of “running a little just to see how it feels.” A premature return to running is generally a double setback. It’s like pulling up plants to check if the roots are still growing. Yup, they're growing, but now the plant's natural progress is traumatized. Couldn't I just leave the content plant—or my injury—to rest?

you said it all right there. i have been pulling the plant up just to see if the roots are still growing for 5 weeks - kept going out "just to see how it feels"... it wasn't until i got ill (on top of the injury) that i actually stopped checking those roots and let them be - for 6 full days. what a pleasant surprise to find PAIN FREE runs after that! if only i had done that weeks ago! why do we always have to learn the hard way? this is a great, great, post. thanks guys!


I know a great chiropractor in Wisconsin, too! :)

Database Diva

When I developed heel pain, I assumed it was plantar fasciitis, because I had some of the classic symptoms, like severe pain when getting out of bed in the morning. I waited 3 weeks to get an appointment with a podiatrist, and ran very little during that time. The diagnosis was peroneal tendinitis. He said it would clear up on its own, but he offered me a cortisone shot if I wanted to speed the process. So far it hasn't cleared up.


I am pleased with the praise for physical therapy! I want to expand on the comment of "best PT". It is important not to automatically assume a MD or PT who tells you not to run is a bad one. I don't believe this was the intent of the author of this post. We must give the body time to respond to rehab without the stress that helped to cause it originally. As a PT, I often have my running patients rest. In our current health care system, by the time they get to me it is not in their best interest to continuing to try to run through it. Most have already tried that and it hasn't worked. One of my biggest battles is to get my runners to actually stop "testing it out". I try to get my patients back to running as fast as possible but very carefully. I follow the rule of, if I feel my symptoms walking around doing my daily activities, then I have no business trying to run. I start back at a very low level/ walking then progressing to walk /jog then to continuous running. Each phase of this must be symptom free before progression to the next phase.


Great post!! We probably all need to print it out. You also set me up with a great PT Guy. :D

Bob Allen

I'm smarter after my meniscus surgery and I think my excellent physical therapist was THE key to quick recovery and running again. I only saw her in the hospital after surgery but she clearly laid out what I needed to do.

Nike Free 3.0

I like how you worded this. I'm glad that some schools have the Cross Country programs. It is important for our kids to learn these lessons. I'm wondering about trying to get something started at my daughter's school. I'm reluctant because I never had any cross country experience of my own.

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