The pain of high-impact activities like running

The term “high-impact” refers to activities or sports like running that put pain and stress on weight bearing joints such as the knee, hip, or ankle, and running falls into this category. The bones and joints in the legs of runners take a lot of force when activated. 

Currently, there has been no conclusive scientific evidence to suggest an increased risk of osteoarthritis because of running. However, runners are known to be more susceptible to musculoskeletal problems in the lower limbs, which include knee joint pain as well as muscle and tendon injuries.

The severity of issues ranges from simple muscular strains to joint pains or even bone injuries with stress fractures. Achilles tendon and heel pains can be quite problematic and challenging to recover from well. 

• Knee pain from running is usually felt behind the knee cap, and can be caused by excessive tightness of the thigh muscles, as well as poor biomechanics that overload the cartilage of the knee joint.
• Stress fractures can happen due to cumulative overload from volume of running, coupled with the inability of muscles to sufficiently cushion the impact. 
• Achilles tendon and heel pains tend to happen from a sudden change in training intensity where the foot and ankle fails to cope with stresses, leading to painful reactions that can persist for a long time if not addressed early on.  

Developing habits around running to avoid pain

Understandably, despite the potential issues that could result from extensive running, it is not realistic to expect leisure and competitive runners to give up and stop running marathons altogether. Additionally, joint deterioration occurs with age, and running as a lifestyle activity has not been proven to accelerate or worsen this in any way. 

Having said that, however, there are certain steps you can take to protect yourself against short-term musculoskeletal issues, and good habits to develop, so you will be able to participate in marathons across the years, injury-free. 

Start off slow to avoid running pain

Every person starts at a different baseline of running ability. To immediately embark on an extended run at the start of your marathon training would subject your muscles and joints to a lot of exertion and shock, which would likely induce stress-related injuries quickly.

If you are only able to manage a maximum two-kilometre run at the beginning, then start off with that distance. Do not feel pressured to go beyond your body’s limits – start off slow, and then gradually build running distance – the recommended increase of distance is usually around 10% a week. This will enable your body (especially muscles and joints) to acclimatise and adapt at a moderate pace. 

Don’t neglect strength training

As much as running more to improve running ability seems like a natural correlation, strength training is also an important part of the training regimen, especially if you want to avoid injury and improve running performance. 

Regular strength training offers you a variety of benefits: by strengthening your body’s muscles and connective tissues, it helps to prevent injury; by improving your body’s coordination and sheer power, it helps you run faster and longer; by enhancing efficiency of movement and coordination, your overall running efficiency increases.

Know when to stop and rest 

As much as we sometimes are tempted to try and maximise growth and improvement, by running as long as we can and as frequently as possible, it is equally important to allocate enough rest time, so your muscles can recover. 

In the midst of training, if you happen to push past your own limits, and experience any form of pain or discomfort after, it is advisable to reduce your running distance the next time round. If possible, you should take a few days off your training regime, in order for your muscles and joints to properly regenerate. 

When you are in the midst of preparing for a marathon, you should take the time to look over the different parts of your body, and check if you’re suffering from any sort of discomfort or pain. Some things may seem minor initially, but if left unchecked, can turn into serious conditions that can potentially hinder long-term performance – this applies to both leisure and competitive runners. 

Finally, regardless of the amount of preparation or care, running injuries still occur sometimes. While our bodies have the ability to heal themselves, if the running pain persists for an extended time (over a week is a good gauge) or if the pain is unbearable, it’s time to visit a physiotherapist who can help you deal with these injuries, and work towards full recovery and functionality. 

*This article first appeared on the Dec 2019/Jan 2020 edition of RunSingapore and was contributed by Core Concepts