Ask Stew: Don't Just Push Through Running Pain or Injury

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A runner trains on a track. (National Guard/Cristina J. Allen)

Runners know that it is not a question of whether you have pain or injury, but when that pain or injury will occur. Studies show that more than 50% of all runners get injured every year, some from accidental sprains or falls, but most injuries are simply from overuse.

Many of us are used to the typical overuse aches and pains and tend to brush them off after a thorough warmup. However, when the aches turn into pain and start to reduce your performance and abilities, it is time to readjust your training for a few weeks.

When you start to "feel something," you should back off a bit and listen to your body as it talks to you. If you don't pay attention, eventually that body will start yelling at you. Here is a question from a Navy recruit preparing for boot camp.

Hey Stew, I have been getting slower over the past few weeks. I am nursing some hamstring (biceps femoris) tendon or muscle pain that now hurts when I walk. The pain seems to be coming from the connection up top and under my glute. I tried doing a 1.5 mile run and it took 16 minutes, which was WAY slower than a few weeks ago. I have been doing some extra yoga but that has not been helping. Any suggestions? Thanks Gus

Gus, here are my rules when it comes to running:

1. If it hurts to run, stop running.

2. If it hurts to walk, don't run.

3. If it hurts just sitting or standing, go see a doctor.

Of course, you can see a medical professional at any time if you're experiencing any of the three levels.

You may have to adjust your cardio training to incorporate your lack of running, and you may take a break from the bike, elliptical or rowing machine if it hurts when you walk. Give each a test, but do not be surprised if even the safest non-impact cardio option still hurts the hamstring.

Here is how I would recommend adjusting your training week:

1. Make your upper-body days hard, since that will be the most calorie burn you will get in the next few weeks.

2. Skip leg day. I know that most of you do not want to break the routine of leg day, but replace any leg-day routine with physical therapy or the very basics of massage, gentle self-care and rest.

3. Do not stretch the hamstring. It may seem counterintuitive when you are feeling this kind of tightness in the back of your leg and butt area. It is likely that sprinting or jumping caused that muscle to stretch too far, and that is what caused the pain. Stop the yoga for now. Obviously, there also will be no sprinting or jumping for a while, either.

4. Test out the non-impact cardio options and see whether there is no pain. This may be one of your only sources of cardio activity. The other option is to swim with a pool buoy between your legs, which will prevent you from kicking.

Place swim paddles on your hands to work the upper body even more, using a variety of strokes (arm pulls) without the kick. This may be your best cardio option, since you can get very tired swimming without having to use your legs at all, other than for an easy kick off the wall.

For your cardio and recovery days between upper-body days, you can do a version of the Mobility Day. Try this:

Repeat 5 times

Non-impact cardio: 5 minutes

Stretch (just not the hamstring), foam roll, massage: 5 minutes

You can follow this "day-off routine" with swimming (no kicks) or save this bit of cardio for your upper-body cardio days over the next few weeks. The goal right now is to keep training while working around your injury and letting it rest.

If any movement or activity hurts, stop and do something else. Keep moving, but be patient and do not rush that injury. It can get worse and take months to heal if you continue "working through it."

Stew Smith is a former Navy SEAL and fitness author certified as a Strength and Conditioning Specialist (CSCS) with the National Strength and Conditioning Association. Visit his Fitness eBook store if you're looking to start a workout program to create a healthy lifestyle. Send your fitness questions to stew@stewsmith.com.

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