In training and racing, three categories of pain are important to learn and distinguish. They are expected pain, manageable pain, and injury. These types of pain are your friends because they tell you what’s going on with your body, so you can know what to do. I say “learn” because initially it can be hard to distinguish between them. Through years of experience, you’ll be able to tell the difference.
Expected pain is the soreness, fatigue and exhaustion that you have come to expect from working hard and trying to achieve great things. There isn’t anything special you should do to deal with manageable pain, other than continuing your recovery nutrition plan.
Manageable pain requires an intervention of some sort but otherwise, shouldn’t result in long-term damage. This type of pain tends to be sharper, harder to ignore and more focused in one location. If the pain isn’t the same on both sides of your body, then you should be concerned.
One example is the rubbing sensation on your heel when your shoes have a rock in them or aren’t tied correctly. There’s a clear solution to that problem: take off your shoes, remove or fix the offending agent, and keep going.
Another example of manageable pain is a little tugging sensation in the plantar fascia during a longer run with some residual heel pain, especially when you wake up in the morning. That could be an early sign of plantar fasciitis, a plague on long distance runners and people trying to increase their overall distance. That should be a sign to stop increasing your weekly distance or the distance of your long run. Focus on stretching both of your calves, one at a time—three times 30 seconds three times a day—because plantar fasciitis can be caused by calf tightness. If you’re more concerned, you should look into soft night splints, tennis balls to roll out, and physical therapy.
The last type of pain is injury, which I wish that you will never experience but know, statistically, that you probably will at some point. This pain tends to be more severe and more focused on one anatomical location. For most injuries, the pain can start suddenly and not respond to painkillers (see below). Even if it started during a race or workout, it might stick around even during rest. Even when you stop increasing the intensity of your workouts, it doesn’t get better, or it might get worse. If the initial pain was in your entire leg, you might notice over time that the worst of the pain is over one specific part.
Identifying that specific focus of the pain, or the motions that make the pain worse will help your doctor know exactly what is going on, so they can tell you what you should do to make the pain better and not risk long term injury. This should go without saying, but if you’ve got injury-like pain, you should see a doctor. They’ve got the knowledge and expertise to confirm what you think about what’s going on or redirect you towards what he or she thinks is going on, and give you the tools to make it better without suffering long-term damage. If you leave an injury untreated, it will get worse, and it will interfere with your long-term performance.
That brings me to an important side-tip: painkillers mask pain in unpredictable ways, so it can be hard to tell which category your pain fits in. They also can be used to treat specific injuries, under the advice of a doctor. When you start using painkillers to manage any pain, it makes it harder to tell how severe the pain is, if it warrants intervention, or if it represents an injury.
Medical/Legal Disclaimer: The advice in this article is based on experience and opinion and may not apply to your specific situation. You are responsible for your own health care decisions. Wesley Kerr (Dr. Redtights) is a medical student and a research doctor (PhD), and is not yet a medical doctor. If you are concerned about a specific situation, please follow the advice of a medical professional familiar with your health and your specific case.