A recurring question that hits my inbox or DM is: should I still run when I’m injured? Is it possible to recover fully from an injury while continuing to run frequently, even daily? The type of people who ask this question are typically similar to me—stubborn, type A, and borderline obsessed with running. The answer, per usual, is that it depends.
When it comes to continuing to run while injured, there’s a lot of grey area—it can certainly be subjective.
Over the past few years, I’ve experienced my fair share of running injuries, with varying degrees of seriousness. To-date, I’ve been lucky enough to make a full recovery while continuing to run. So while I do think it’s plausible to continue your training while treating an injury, there are still a myriad of factors to consider when determining what the right decision is for you. I was initially hesitant to curate this post, as I didn’t want you to read this article and deduce the final takeaway as: “Emily (someone with no credentials whatsoever in physiotherapy) said I can run on an injury, so I guess I’m good to go.” Please take this article with a grain of salt, the last thing I’d want is for you to worsen your injury or sustain long-term (or permanent) injuries. With that, I will share me experience with you and take from it what you will. But I am not soliciting any medical advice—I encourage you to seek out your own advice from accredited professionals. It would be irresponsible for me to suggest otherwise.
My Process When Injured
Over the past 4 years, I’ve created what I’ll call a “process” for myself to determine the severity of my injury—beyond just the regular soreness and discomfort (sore knees, DOMS, etc.).
After I inflict an injury and something just doesn’t feel right, I become acutely aware of the area and use my runs to gauge the seriousness. I ask myself the following questions:
Is the injury getting worse each day, it is improving, or staying the same?
How painful is it to run when referencing a scale from “uncomfortable” to “excruciating?”
Am I able to walk or perform normal functions or do I feel a little limp in my step?
If the pain is mild to moderate, getting progressively worse each day or staying the same for a week plus, I’ll always book an appointment with a physiotherapist. I want to understand what the injury is, the degree of seriousness and learn some rehabilitation exercises.
If the pain seems to be subsiding/getting better, if it’s tolerable pain (more annoying than anything), doesn’t impact my running performance too much, and I can walk and strength train as normal, I’ll follow my instincts and just take it easy (in pace and mileage)—self-monitoring the symptoms until I’m feeling back to normal.
Gauge Your Pain
You know your body better than anyone else—pain is a subjective experience. If the injury isn’t severe and you can tolerate the pain or discomfort while you run, then I encourage you to tune into your body and define your own personal limits.
One of the most important considerations to be aware of is gauging your pain. There are a few ways to do this, but one of the most helpful ways is to place the pain into a scalable silo—either mild, moderate, or severe.
Mild (1-3)—This feels more like discomfort than pain. It may persist while you run, it might come and go, or it might just feel uncomfortable at the outset and dissipate as you continue your workout.
Moderate (4-6)—Moderate does insinuate that you’re feeling a bit of pain and uncomfort. If it’s a 4, it might persist during the workout, but does not substantially impact performance. If it’s on the higher scale (6), the pain could become worse as time progresses and start to impact your performance.
Severe (7-10)—This pain is intense and you feel it all the time: both when exercising and during rest. Exercise enhances the pain and may cause you to limp during or after your run. It highly impacts performance and can feel unbearable.
If you’re in the mild to moderate category, this is when you can individually assess whether you still want to (and can) run or not. Scott Weiss, DPT writes, “when you cannot complete your run without thinking of the injury the entire time, it’s time to call it quits.”
If you find yourself falling under the ‘severe’ category, I definitely suggest taking time off and seeking out the advice a professional as soon as possible.
There are some reoccurring injuries (or soreness) that a lot of us experience, which I’ve outlined below. You can likely run with these injuries in tow, so long as you’re aware of your pain threshold:
- Knee pain
- Shin splints
- Piriformis syndrome (bum pain)
- Achilles tendinitis (overuse injury)
- Plantar fasciitis (mild or moderate pain only)
David Reavy, PT and owner of React Physical Therapy in Chicago, suggests that you still might be able to run on even more severe tears:
If you have a torn ACL but have strengthened your quads and hamstrings in order to dynamically stabilize the knee, it may be okay to continue running on flat ground or a treadmill.
Once again, the best course of action is to see a PT and come up with a plan together. My PT always warns me of the risks of running while injured—I then assess out whether I want to risk further injury or impede the healing process. I encourage you to do the same.
When You Need To Hang Up the Shoes and Rest
Acute injuries, like broken bones or ankle sprains, and potentially torn ligaments definitely require rest to recover…unless you’re a superhuman like David Goggin’s and can run on broken legs. However, most of us mere mortals don’t tick that box, so I’d suggest staying off the injury.
Throughout my own journey, I did experience severe and worsening pain when I inflicted a third grade hip flexor strain. I didn’t take my own advice but had to scale back and moderate my training substantially. That was the one injury that inflicted such severe pain that I was limping throughout the day. I couldn’t even walk down the stairs without sharp pain in my groin region. Even when I was hobbling into my PT appointment, I had to use the walls as a crutch in order to get myself through the front door. Naturally, my PT said “absolutely no running” and warned that if the injury worsened then it may require surgery.
On the way home from this appointment, I vacillated quite a bit on whether I would continue to run or not. Not to sound dramatic, but it caused quite a bit of internal turmoil. The next day, I decided to try and continue with my workouts, breaking up my run in two sections. I ran 2 kilometers on the treadmill at nearly double my normal pace (8’15/km). Afterwards, I performed the rehabilitation exercise, took some Advil, and iced the injury. As the day progressed, I noticed some improvement. I decided to push my luck a bit and ran 3 kilometers outdoors and while the pain was still noticeable, it didn’t feel debilitating.
The following day my injury felt even better and I ran 5-miles on the treadmill at a decent pace, ensuring I slowed down if I felt tightness or that I was reaching my pain threshold. Each day, I saw minor improvements and after a week or so, I was back to my normal self. I think luck played a huge role in my recovery and the reason I kept going was because I was seeing marginal improvements each day. I told myself that if the injury started to worsen or regress to the degree when I first went into my appointment, it was time to stop the streak and really rest. I had to think long term—it wasn’t worth the price of potentially losing running forever.
There’s a degree of risk here that only you can decide based on staying in-tune with your body. I can’t give you that answer.
How to Recover Quickly While Continuing to Run
If the injury is serious enough once the PT does their assessment, most of the time they will tell me I need to stop running—but as we all know, that’s my last resort. I do the next best thing…I incorporate the following protocol into my routine until I’m feeling back to normal:
- Lower the mileage or break up my streak run in two chunks to give adequate rest and stick to low intensity running only.
- Actually take the time to stretch (SHOCKER, I know.)
- Perform the rehabilitation exercises multiple times a day.
- Ice the inflicted area to help with inflammation.
I also find it helpful to adjust my stride (taking more steps) or running exclusively on one type of terrain, whether that’s on soft terrain or the treadmill.. Another idea is to walk in between each mile or kilometer to give your body a bit of a break. Running uphill can also be a great way to recover (depending on the type of injury). Be careful of going downhill though—injuries like sprains are more likely to occur. Try doing hills on a treadmill instead—to reap the rewards of hills while eliminating the risks of downhill running.
Re-Evaluate Regularly
If you are seeing improvements with each passing day, then that’s great! You’re well on your way to recovery. If, however, you’re on the mend and then stall or find the pain worsening a bit, it might be time to adjust your routine a bit.
My latest diagnosed injury was as cuboid syndrome—the highest degree of chronic pain I’ve experienced thus far. The cuboid is a bone smack dab in the middle of the foot connected to a joint that helps your feet maintain mobility when walking. Cuboid syndrome occurs when the bone shifts from its position causing pain on the outside and underneath the foot. The cause? My physiotherapist said it was from either dropping a book on the top of my foot or from doing jumping squats with weights (not something I normally do). While the pain was mild and more of a discomfort than anything, over time, it slowly started to dissipate. As I write this, I no longer have any pain on the bottom of my right foot, but it did take a full 2 months to fully recover normal. Perhaps if I stayed off of it for even a few days, it might have had the potential to heal quicker—but who knows!
Conclusion
So, back to the question at hand: should you run on an injury? If it’s severe, probably not. The overwhelming literature says you should rest to expedite recovery—but if you’re training for an upcoming event with little lead time, relying on exercise or running for your mental health, or if you’re just stubborn like me, running while recovering is plausible depending on the extent of the injury. So long as you consult with a physiotherapist, assess your own risk, listen to your body and are aware of your own limitations, I support your decision to run on an injury 😉