It’s not as bad as it looks

Notes from 35 years of minor injuries

A mountain near the Canadian border. It’s big, but not as big as it looks. 2020.

Before we start: I am not a doctor, and all of my advice is simply the result of my own experiences running for 35 years. So the first rule is always: Ask your doctor.

Recently, I bled through my left running shoe.

Like, so much that the upper was completely saturated. So much that I thought I had sustained a puncture wound and might need stitches. I anxiously peeled the shoe off and cleaned my entire foot to reveal…that I just had a particularly bumpy joint rubbing up against a new shoe upper.

Yes, all the skin was gone, like every layer, and yes my entire foot was covered in blood, but it wasn’t a bad injury; it was just dramatic. Neosporin, Bandaid, and done. I had a photo of this I was going to post, but it’s just too yuck. Just imagine a blood-soaked entire shoe upper with more blood bubbling up out of it. Gross.

This was not the first or second or even third time I’ve bled through my shoe(s), though, so I chalked that run up to as a miss, and went out the next night.

In my years of running, I’ve learned that a lot of times my injury just isn’t as bad as I thought it was. I’ve only sprained an ankle once; the other dozens of times it was only a strain. I’ve never had a stress fracture, just some stress. I once thought I had torn my meniscus and took 9 weeks off; it turns out I just had incredibly weak adductors.

None of this would matter except that minor injuries misdiagnosed as major ones sideline runners more than anything else. This is particularly true if you’re just starting out and haven’t experienced a bunch of minor injuries before. For these runners, anxious to do the right thing and not try to run through the pain, the danger is that any pain at all is interpreted as a reason to stop running for days or weeks at time.

The problem with this is that if you take more than a few days off, it really sabotages your training. It stops the habit of running and erodes the gains you’ve made in your fitness. And worst of all, it doesn’t treat anything except minor inflammation, so if the injury is more than just inflammation, it comes back. What to do?

Since I’m definitely not a “no pain no gain” person, nor will I ever say that anyone should run through pain, all this raises a few questions:

1. How do I tell if my injury is bad enough that I should actually take several days or weeks off?

2. What do I do in the meantime to actually treat an injury?

3. How can I at least avoid losing a substantial amount of the fitness I’ve worked so hard to build?

4. How do I safely build back into running?

There’s a certain amount of pain that’s just inherent to running. It just is, and there’s no way around it. The difference between pain that makes me stop and pain that I don’t worry too much about is whether it’s sharp (stop) or dull (I’m fine) and how long it persists. Bodies are always telling us something; we just have to listen.

Sharp pain is how I ended up taking 9 weeks off for that adductor injury I thought was a meniscus tear. The trick is, when you stop, you should go to a doctor and ask their professional opinion. I didn’t do that with my not-meniscus tear, and I lost 9 weeks of training because of it.

When I treat an injury, I go all in. RICE at first, then all the physical therapy I can get my hands on. I will do any silly movement to get back on the road. PT always looks odd, but it’s the fastest way to heal.

To avoid losing fitness, I cross train. A lot. I frequently do 2 rounds of cross training per day when I’m not able to run, just to ensure I’m doing something to keep myself fit and to ensure that my on-ramp back onto running isn’t too hard. I prefer Pilates, barre, and ballet, but if you like weights or something else, go for it.

Safely building back to running is more complicated. I don’t usually take the recommended amount of time off, but that’s because I personally tend to feel okay running before the doctor’s deadlines arrive. You will have your own calculation to make, but I generally start running again when the pain from the injury has receded to dull-and-not-constant. And then I start small. Even if I end up running about 50 yards, I don’t mind; I count it as coming back to running. I really take stock of my fitness and try to push myself a little more every day, keeping the injury top of mind. But the advice here is just to start, to start small, and to be aware.

There’s no short cut to healing an injury, but the good news is that most injuries aren’t as bad as you catastrophize them to be. If you’re willing to listen to your body’s signals and deal with the normal pain that comes with running, minor injuries won’t get in your way. Let me know your injury questions in the comments, and for today, remember: go run.