Pain in running has almost every jogger. Just keep running or take it seriously? Depends on!
Some time ago, the tendon under my kneecap began to hurt while jogging: every step, especially uphill, sometimes piercing, sometimes dull. What to do: pause or ignore? I stopped for a few days, but it did not get better. I kept walking, nothing changed. So I went to the orthopedist. And he found: nothing. I was frustrated. And astonished. Can you be in pain without hurting anything? And if pain is not synonymous with injury – what are they a signal for?
The expert knows: Most of the pain in runners is the result of an overload
For Dr. med. Matthias Marquardt is nothing unusual. The internist and sports physician from Hannover specializes in runners, and it is not rare that his patients have no visible medical findings. X-ray, ultrasound, MRI? Everything unobtrusive. “That’s because a lot of the running discomfort has functional causes – the pain comes from overwork and miscarriage, but nothing is broken,” says Marquardt. “More than 80 percent of the complaints in runners are overload damage – ie inflammation of the knee or Achilles tendons, nonspecific back pain, tibial nerve syndrome, problems in the forefoot.”
On the other hand, less than a fifth are due to acute injuries that can be seen in imaging procedures, such as a torn ligament after bending on a tree root – and where a break must necessarily be inserted so that the damaged tissue can heal. “Chronic congestion, on the other hand, is not necessarily better when you’re sitting around,” says Marquardt.
“If nothing is broken, broken or compressed, you can usually continue to run to some extent, maybe you have to change the training a bit”
Pain is actually a warning signal of the body. Above all, however, it is a construct of the brain: “If it persists for several months, it can develop into an independent disease and detach it from its physical cause,” says the pain specialist Dr. med. Tina Schleper from the Hamburg Hospital Tabea. Receptors in muscles, joints, fascia and tendons send unfamiliar signals to the brain, which concludes a danger and sounds the alarm. For runners, however, this mechanism can also be triggered by an increased training scope or a changed posture. Pain is therefore not always synonymous with injury.
So what if it keeps tweaking in the same place while running? First, find out what’s going on – preferably with a sports doctor who has experience with runners. “If nothing is broken, broken or compressed, you can usually continue to run to some extent, maybe you have to change the training a bit,” says Marquardt. “It is important to find the cause of the symptoms, to remedy and restore the function of the affected body part: for example, with deposits, a change in running style, a tendon therapy or muscle training.”
Targeted muscle training can prevent the typical symptoms: Which exercises help?
Fortunately, we have a lot of it in our own hands. The most common mistake we make is overtraining: “More than half of the running discomfort goes back to running high, too fast or too short recovery times,” says Marquardt. The rule of thumb of training scientists is: increase distance before speed and increase the distance from week to week by a maximum of ten percent – less is often more here.
Often, shortened muscles and fascia – because they pull on the joint and exert pressure. Specific exercises for stretching or strengthening leg, hip and trunk muscles help here. As researchers from Ohio and Indiana found out, for example, a training of the abdominal and back muscles reduces the discomfort of runners in the lower back, a hip strengthening the pain on the patellar tendon. And also on the running style you can do something. Knee problems, for example, rarely occur in forefoot runners, Achilles tendon problems rarely in heel runners. (Specific exercises for the runner complaints can be found here: Running injuries at a glance).
Paradox: The love of running makes the pain even stronger
However, when the pain does not diminish but occurs again and again, it can also be the head that torments us. The brain remembers unpleasant experiences. “The ongoing pain can leave traces in the nervous system, a pain memory develops,” pain specialist Schleper. The result: next time it hurts earlier and stronger. Mood, stress, experiences and fears can also increase the pain. The more importance we give to running, the greater the agony can be.
Paradoxically: You love running and have to stop because it hurts so much. And then grief over it worsens the problems. And there is something else to it: If enthusiastic runners set off with their sport, the idea that there is something bad going on in the body intensifies in the brain. Catastrophizing and fear and avoidance behaviors call it experts when dramatizing the symptoms and developing strategies against movement to prevent pain in the future. “If there is no acute tissue damage, it is therefore important for the head to move on, rather than to protect itself,” said Schleper.
Incidentally, my knee problems were gone after I replaced my running sessions with biking, squats, lunges and a daily stretching program. Since then, I have not only focused on running, but pay more attention to my body, the necessary breaks and above all: strong and flexible muscles. Running.