It can be a fine line ya’ll. I wish the human body came with some sort of light or alarm to let you know but alas evolution hasn’t provided us with a sure fire way to tell just yet. Running especially and working out generally, can lead to all sorts of pains and aches but which are serious? This comes from my years of running experience but you should rely on your own experience too. I find that a lot of it came from the same trouble spots. Over time I got good at determining which was a flare up of an old injury and what’s just a temporary inconvenience. For this post we will be going through each type of niggle or pain or at least a lot of them and some summary information at the end. Keep in mind though while I am a doctor it’s of proteins not medicine so your best bet is always to check with someone who is.
You can’t walk in the morning
Verdict: injury or sore
This is a tricky one on one hand if you hurt the next morning that can be a sign that you’ve got more going on than just a niggle but it isn’t automatically an injury. If you’re just all over sore or tight than you’re probably good to go. You might also notice a specific pain after your run and then (oh no) it’s not gone in the morning. This happened to me after my last run. I felt some pain in my right knee and hip while going along but nothing really after that evening. The next morning though it was back with a vengeance. It subsided throughout the day to an extent and was gone the day after. So this can be a sign that you are in fact injured and should take a break but it could also pass. So here’s my take if you wake up with a specific pain the day after a run then that is an unscheduled rest day at the very least. So verdict wait and see.
You have pain while you’re running
Verdict: Probably just sore
Running and the sports can be just overall tough on your body. That means you can have some pain as you go. So if you have pain while you’re on the go do you need to call for a ride home? Usually not, overuse injuries are not made in a single run and a few weird steps along the way is par for the course. The rule of thumb is that you don’t have to stop unless your gait (or how you step) is affected. Another good tip is to take a good one to two minute walk break. When you return to running is it back just as bad right away? If either of those is the case it is probably best to walk or call for a drive home. But most little niggles while you’re out there are no big deal. PS does it help if you loosen or tighten your laces, that often helps me!
Going down stairs sucks
Verdict: Probably sore
Descending stairs is a movement that seems to amplify any pains that might be hiding. We have a ‘normal’ set of stairs in our house that are built to code and one set to our basement that are way steeper. Those will often hurt even when the other set doesn’t. Descending stairs can bring out an injury or just regular run of the mill soreness. If it’s just been a day or two and it only hurts when you go down the stairs you’re probably fine. If you’re sore at other times too and it’s been the best part of a week then maybe you have something starting.
Those first few steps hurt when you stand up after a while
Verdict: Probable injury
Surprising right? If you have a specific point of pain in the same spot after sitting for an hour or so you very well might be injured. If this doesn’t change after 24-36 hours after your run and it feels the same in the morning as the evening this is a serious indication that you’re not just sore. This is actually called movie goers syndrome and even if it clears up in a few steps it warrants a trip to the doctor. If on the other hand you’re sore all over every time you sand up for a day or so after a workout and it goes away as the day goes on that’s just a sucky reminder that you previously went for a run. In this case two days out you should be able to forget about if by the evening.
You have a whole area that feels tight and hurts
Verdict: Probably REALLY sore
Injuries tend to focus in one specific spot over time. They may feel more widespread by the evening or first thing in the morning but you tend to be able to point with one finger at one specific spot and just know in your heart that it just starts exactly there. If on the other hand a whole section of a limb always aches and or feels tight consistently it’s probably just a REALLY tight muscle. It can be worryingly consistent though. Try foam rolling, a deep tissue massage and a very hot and long epsom salt bath. If any of those things have a dramatic healing effect and lasts the rest of the day you likely just have a persistent tight muscle. Keep rolling it out, stretching it out and taking walk breaks when you need to and it should resolve itself in a week or two, In the mean time it really could feel terrible.
Those first ten steps hurt the same everyday
Verdict: Probably just sore
If those first few steps to the bathroom hurt (maybe even a lot) in the same way everyday and then totally go away you’re probably fine. But I literally mean the first few steps of the day only and it’s not getting worse or lasting longer at all. This only happens to me when I’m in heavy progressive training. When I was marathon training this year literally every morning that trip to the bathroom was filled with pain in one foot. I can’t remember which one, it’s been a while. It felt like a plantar pain but it never got worse and it was gone by the time I took two laps around the upstairs. As long as you’re being honest and that’s as bad as it is you can probably ignore it. I like to think it’s a niggle that just needs to get moving everyday. PS this didn’t happen to me before I turned a certain age (38 to be specific). I’m old now an old parts need more time to get moving right?
Muscle spasms (aka the butt twitch)
Verdict: Not even sore really
As long as it’s the kind of twitch where you aren’t in pain but rather a certain muscle group is fluttering then you’re probably fine. You may have had this in your eye at some point along the way. I know I did when I would spend a week on the microscope! A fluttering spasm is not usually something to be concerned about in most cases. It’s just something that happens when our brains send signals they really shouldn’t be to our muscles. Hiccups and that leg thing that happens when you’re falling asleep are part of the same phenomenon. Anecdotal evidence does say that they are more common when you’re muscles are a little tiered. I often find it resolves itself after the next workout. Maybe I’m alone here but a good butt twitch always makes me giggle!
So are there some generalizations here, yes. In general if something hurts after a workout, maybe the next day and then goes away completely it’s probably a temporary thing that you can mostly ignore. It is a good thing to note in your training journal or a post it at least though. If it keeps happening after most runs then it could be something more serious. If whole sections are sore or hurt and you can’t really pinpoint where it hurts then its likely just soreness. One other helpful tip is that if both sides of your body feel the same crappy way at the exact same time it’s very, very unlikely that you’ve caused yourself two identical injuries in the same workout. So if both sides hurt the exact same you’re likely fine. Also things that go away for the day pretty soon after waking are usually just a sign of activity and maybe advanced age.
On the other hand something that hurts consistently for a long time after your workouts it’s almost definitely an injury. So if you’ve taken 5 days off and your knee hurts every time you stand up it’s time to get to the doctor. If your pains are always in the exact same specific spot that’s not a good sign either. If one day its the left knee, then the right hip and next week your arches that can just be a sign you’re getting older or training harder. Now what about those sharp pain that happens when you’re actually working out? Most times this is not a huge deal and a bit of a break later it’s gone. Most of the injuries that we’re talking about come from over use and not one stand alone movement like a step. However… sometimes that happens and it’s a really big deal. Tears and fractures can happen like that. But… I would say when that happens you just know. Maybe we would say it just hits different and you’ll probably know. After a good (walk) break if you try to immediately get back to your workout you’ll definitely know then!
This is a double edged sword for athletes because we desperately want to keep doing our sport but we also want to miss zero weeks due to injury. Truthfully it’s a fine line between really, really sore and the very first signs of injury. Did you just overdo it or did you damage something? This is just generalizations for specific medical advice see someone with more knowledge than me! What signs have you noticed mean that you’re just really sore and what means you might be actually injured? Leave it in the comments below!