Post-run aches and pains: When does it cross the line to injury?

Ignoring pain due to running could slow down healing or make a minor injury worse.

Whether you’re a hardcore or recreational runner, you’d have experienced some kind of annoying pain while clocking up mileage. But if you want to continue enjoying your time on the pavement, don’t run away from the problem.


Jogging or running takes the second spot as the most popular sports activity in Singapore1. With the growth in the number of running events and running clubs here, we can only expect its popularity level to climb further.

Running is a good form of aerobic activity that increases your heart rate and makes you breathe harder. This helps increase your heart and lung fitness. While running and other forms of aerobic activity can improve your health, it’s equally important to listen to your body.

Some people equate pain with muscle growth but pain does not necessarily equate to gain, according to Dr Andrew Quoc Dutton, orthopaedic surgeon at Elite Orthopaedics (Mount Elizabeth Hospital), who has seen a growing number of patients consult him for running-relating pain. Today, this group makes up 40% of his patients.

“It is not normal to experience pain. Temporary aching after a run is common and is usually due to the buildup of lactic acid in the muscles as part of the energy consumption. However, distinct pain, swelling or continued discomfort should be assessed.

“If there is persistent pain, swelling or discomfort for more than three days, then this usually indicates that there may be something more serious causing these symptoms,” he adds.


Running through the pain

Common running-related injuries include sprains, iliotibial band (ITB) syndrome and shin splints.

Sprains can usually be treated by getting plenty of rest and possibly using crutches until you are able to walk without feeling pain, according to Applying an ice pack for 10 to 20 minutes every one to two hours during the day and using a compression wrap also helps. Elevating your foot may also help decrease swelling.

ITB syndrome causes pain over the outer aspect of the knee due to friction between the band and the knee bone, says Dr Dutton. He recommends cutting back on exercise, stretching before exercise and icing the area after activity.

Medial tibial stress injuries, more commonly known as shin splints, are usually caused by a sudden increase in frequency or intensity of impact exercises. This damages the bone’s internal architecture and is usually associated with bone marrow swelling. Dr Dutton says: “Shin splints require lots of rest, stretching exercises and taking it slow when you return to running.”

While most of the common running injuries tend to occur in the legs, Dr Dutton notes that pain can also be experienced in other sites, such as the hips and the feet as these joints are inter-related.

Runner’s fix

But what if the pain isn’t alleviated or worsens? This may signal that you need specialist help. Some of the more serious warning signs are an inability to bear weight, severe unrelenting pain and a sudden and large amount of swelling over the injured area.

“Other signs include severe tenderness to the touch over the injured area and the joint feeling unstable,” adds Dr Dutton.

Some people believe that “pushing through the pain” is the way to go, although this may not work out for the best. According to Dr Dutton, bone injuries usually take eight to 12 weeks to heal, while ligament and muscle problems need six to eight weeks. Ignoring any problems may delay the healing process, or even worsen the injury.

For instance, ignoring shin splints and pushing on with your training programme may cause a hairline fracture of the shin bone. Left untreated, a meniscus tear may “propagate or become displaced and cause the knee to lock”, says Dr Dutton.

Specialised treatment

Specialists like Dr Dutton can make a critical difference in treating such injuries. One of the keys to successful treatment is getting up to speed with the extent of the running injury. This starts by the specialist taking a full history of the injury and the patient, followed by thorough physical examination, which in turn leads to a provisional diagnosis.

“After that, I would discuss various treatment options for the patient that may include medication, injections, physiotherapy, bracing or keyhole surgery,” he explains.

Even after the injury heals, patients still need to take it slow before donning their running shoes again. A rehabilitation period of two to three months is often needed before runners can hit the asphalt again. This is all the more reason not to ignore prolonged pain, so you can get back to enjoying your favourite exercise with minimum discomfort and delay.




1. Source: Sport Singapore, Sports Index Participation Trends 2015, released in June 2016.


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