Pain Is Not Injury

Last night, I set out for a frigid, easy 7 mile run.  By 40 feet into my run I felt something in my knee then a sharp pain in my right hip!  Over the next 1/4 mile I tried to figure out what was going on and whether I should push through, or turn around and go home.  I did both. I turned around to go home, though took a different road that would at least get me to a mile if that was to be the extent of the run.  Making my way back up the hill into the blustery sub zero air, my hip pain disappeared and the knee was never an issue since that first early step.  7.5 miles and an hour later, I was finally home, recovery drink in hand and warming up.

Injury is what happens when we are unable to overcome a barrier.  Sure, the barrier can be a broken bone, sprained ankle or pulled muscle.  Those are clearly injuries and trying to work through them will cause pain.  But how do we know when we can work through pain without causing injury?  There are two extremes to this answer,  with the truth lying somewhere in between.  If you've never been injured before, then you will likely work through any injury thinking you're invincible.  If you've had a history of being injured, then you may develop a hypersensitivity, and be concerned with every ache and pain you feel.  To work through pain and not become injured, you must have confidence in what you are doing physically and a sense of reasonable expectation.  As a physician, I will tell my patients that if pain worsens during activity or is worse the next day, then it may be heading towards injury.  If the activity doesn't make the pain any worse, then it can most likely be worked through with a very slow increase/progression if desired.  As an athlete, the answer is a little more gray.  Depending on where the athlete is in his or her training, the type of event they are training for, and the desired goal, there may be reasons to work through pain or reasons to shut someone down temporarily.  For instance, if pain sets in during base training, then it can likely be worked through with increasing rest days between activity, or increasing cross training activity.  If pain occurs during a build phase in training, then the focus may shift towards maintaining the key work outs and being sure not to miss those, but switching the less important activities around.  If the pain occurs during the taper, then shutting activity down for a brief stretch may be preferable.  

Try not to think that any pain you feel is a pending injury, yet at the same time, respect what the body is trying to tell you.  Of course, sometimes it's best not to think at all...