When I started running, pain was something that I understood would be inevitable, but assumed would be temporary and periodic. However as I progressed my training over the years increasing my mileage as well as the intensity of my sessions, I came to realise that pain could be a pretty constant companion. At the moment, as I am logging regular 65-70 mile weeks, I wake up every morning with a very tight, sore right ankle. Following my easy morning run and after an hour at my desk my right knee twinges. By lunchtime there is a pain in my lower back. And before I set out for my session in the afternoon my IT Band feels like a tensioned steel cable. These niggles are a part of being a marathoner.
The regular companionship of mild pain or discomfort has, however, made me think about what it is like for other runners and especially 100+ mile-per-week elite athletes.
Elite runner, elite pain
In Charlie Spedding’s brilliant autobiography, From Last to First, he describes how, when he was training full time, pain was something he had to deal with constantly. This was especially true for his Achilles tendon, thanks to which he almost died after a negative reaction to an operation he was having.
So what about contemporary elite athletes? I had the opportunity to ask Ben Moreau, an aspiring Olympic marathoner, Scott Overall, whose 2:10:55 at Berlin in 2011 secured him the first place on the Team GB marathon team and Alyson Dixon who is also hoping for a place in the Olympic marathon for Team GB.
When I asked Ben about whether he deals with constant pain he said that, thankfully, he doesn’t. However Ben went on to tell me that he has trained through pains that have lasted for weeks and that in fact at the moment – with 13 weeks until his shot for a place on the Olympic team at the Virgin London Marathon – he has a hamstring issue that has been going on since early December (that is for around seven weeks). Ben said that this pain has meant that he has reduced intensity of training somewhat but that his volume of training has remained constant.
Scott Overall was similarly sanguine about pain when I asked him, telling me that
I think the aches and pains that athletes have are natural as I think its quite un-natural to be running over 100 miles per week, week in and week out
and he went on to say that in his experience a pain is often a sign of a problem away from the site of the discomfort. In his case calf pain was due to hip issues:
once I had a calf problem but the cause of this was because my pelvis was out of alignment and the pain was showing itself at the weakest part of the chain. No amount of stretching or icing the calf would help it because the root of the problem was with my pelvis, and it was this that needed to be corrected.
Last weekend I was at a marathon training conference in Brighton and had the opportunity to run with Aly Dixon, who is looking to take the third and final place in the Team GB Olympic team for the London Games. When I asked Aly about managing pain she laughed wryly, after all Aly has only recently returned from injury having run last year’s World Championship marathon in Daegu with a the double whammy of fracture to the distal phalanx (big toe) and sessamoid (ball of the foot) that she thinks started when she ran the Great South Run in 2010.
Aly is reported as saying that she was in pain during that race “but thought it was because I needed to change my shoes as they were worn out.” Aly went on to tell me that because the pain was intermittent she assumed it was a natural part of having increased her mileage and that it was something she just had to manage. In interviews Dixon described how the physios at Team GB in Korea did a great job at managing the ‘niggle’ to allow her to run after which they discovered the broken metatarsal.
Pain is inevitable. Suffering is optional (according to the Buddha)
So we have established, from some of the best runners in the UK, that with hard training comes pain and niggles. There is of course, quite a challenge in telling the difference between natural soreness or tightness and the start of an injury. So what do the experts say? Well Scott Overall told me that
Elite athletes tend to be very in tune with their bodies and would know why something is sore, it might be my calves are sore because I did a session on the track the night before, or my Achilles is sore because I’d stupidly been walking around in flip flops the previous day. A lot of the time there is a reason for the pain and you can generally narrow it down to what’s caused it.
and Ben Moreau gave me tips on how he manages the inevitable discomfort:
- if I feel like I’m changing my running style to accommodate it [the pain], I’m on a hiding to nothing and so will have to rest
- if it is getting worse constantly, that’s a bad sign, so I’ll rest
- assess rest vs healing and see if a reduced training amount now will impact the end goal vs possible benefits
Aly Dixon, now something of an expert in dealing with pain and recognising (or ignoring) injury, told me much the same as Ben – that she tries hard to recognise when pain is constant or worsening and affecting the way she is running and then decide whether, with a goal in mind, rest is possible and appropriate or whether she simply needs to push on and manage the issue.
How does that affect me?
To summerise, it seems that pain is an inevitable part of being a marathon runner and to avoid all pain would mean that the runner was not able to train enough to really reach his or her potential. The challenge comes when the pain is not a niggle but actually an injury. Scott Overall advises that
It’s important to nip these niggles in the bud before they get anymore serious. Keeping on top of things and getting regular physio and even massage can really help – if those things are not an option then just simply stretching or getting a foam roller to massage yourself.
One thing I have learned from talking to Ben, Scott and Aly is the importance of getting to know your body and recognise the difference between a niggle and an injury. Obviously being overly sensitive will mean that one doesn’t run enough whilst not being sensitive enough means that a serious injury could develop whilst the runner stubbornly refuses to acknowledge it.
I think that my advice would be that if you feel sore before you run, get out of the door and go for a 10 minutes warm-up. If after that the pain goes then it is fine to carry on (but get a physio to check out the area of pain anyway) but if the pain really remains or worsens, go home and immediately book an appointment with your favourite physio!
To conclude this ramble about pain, I think that my coach Nick Anderson of runningwithus, gave me some great advice this morning. We were out running together and I mentioned my sore ankle. I told Nick that the pain subsides within a couple of minutes of waking and goes completely once I have been walking or running for a minute or two. Nick said that this meant that the problem is manageable at the moment, but with three months until my ‘A’ race – the London marathon in April – I should get the ankle checked out by a physio now to avoid problems later as the volume of training continues to increase. I think that this is pretty good advice for all you marathoners out there so please let me know what you think and what you are doing to be the best runner you can be despite the pain!