In early spring of 2007 I was training for my first marathon and developed right knee pain after a fast-finish LR. I had never had a running injury before, and didn't know how to guage the severity of it, so I went to a sports med doc. He told me I had patellar tendinitis and that I could continue to train, but to cut back the numnber of running days/week somewhat for a few weeks and to take Alleve. He gave me the okay to run through the pain. Our pace leader at the AF Marathon, an Ironman himself, ran that race with a hamstring issue, and said that Ironman Triathletes usually continue to train through many injuries. Today, while running some 800s, a mild hamstring pain became quite acute. I've stretched and iced and ibu'd, and I will take tomorrow (and possibly Friday) off running to see how it does. Plus, I may choose to bag the 5K on Saturday that I have registered for. So many people here have been out for weeks if not months from hamstring injuries that I get a little paranoid. This is the first time I've had a hamstring issue, and I don't want it to turn into something that sidelines me. But that got me thinking of this question: It seems that sore muscles and aches and pains are often just a part of running and/or working out. All of you who have dealt with injuries of one type or the other during your running career, how do you know when you're dealing with something on the verge of a serious running injury, or just a sore muscle that you can run through? How do you know when it means, "Stop right now!" or if it's just "take some ibu and get out there, you wussie!"

...''When in Doubt, DON'T''.........

Holly, you should back way off because something worse could happen to you. Last year around this time, I was training for a full marathon and developed patellar tendonitis....So I cut back like your sports med guy said ....but the pain made me alter my gait so much that it contributed to a pretty bad ankle sprain. I could not walk for 6 weeks. It was almost 8 weeks before I could jog a little...but being off my feet for that long made the patellar tendonitis go away. I missed out on the first Bellingham Bay marathon (and the chance to meet Tetsujin in person ). So rest before you lose the choice to rest -- you certainly don't want to be forced to rest!

Here's a copy of an article I wrote a couple years ago for club newsletter. Hear Me Now And Listen To Me Later! Runners are supposed to be one of the healthiest groups of people, so why do we get injured so often? Quite simply, it’s because we don’t listen to our bodies. Why don’t we listen? Well there are several reasons, first there’s the no pain no gain theory. Second is the fear that we will be perceived as a pile of milk toast (soft and mushy not hard and tough), if you let aches and pains slow you down. We secretly pride ourselves on being tough by running in pain, rain and cold so we don’t want our ego to take a hit. However, I think our worst habit is the thought that we have to stick with our training plan no matter what. Saturday morning the hamstrings are tight but the training plan calls for 10- 800’s with easy 400’s in between so dog-gone-it that’s what today’s run will be no matter how much it hurts because no pain, no gain and we aren’t milk toast. The smart thing to do would have been to run easy for 3 miles then do 30 minutes of light but progressive stretching followed by several icing sessions. This new approach could keep us from hurting ourselves and likely allow for a successful 10 miler on Sunday instead of 90 minutes of agony. Sometimes it can be difficult to tell the difference between injury pain and the pain of leaving the comfort zone, which of course you must do in training once or twice a week. So pay close attention to your gait, pain from lactic acid or exertion should be equal on the right and the left sides, if it becomes lopsided then you are injured or about to become injured. I’ve been a distance runner (or at least I have tried) for about 1/3 of my 51 years and I’m still making training errors. As I age, the room I have for error is narrowing so I need to get smarter. I have suffered with hip bursitis for about a year and when it was in the early stages I made all of the above errors. The past 9 months I thought I was handling it pretty well, stretching, icing and carefully watching my increase in speed and mileage. I was having steady improvement in speed but still some trouble with long runs. I woke up on Labor Day and the hip was tight and the morning easy run was painful. I was very disappointed by this because I had started tapering 5 days earlier for the IKEA half marathon on the next Saturday. Well I ran IKEA and the last 2 miles were terrible. I had enough after this major setback so I made an appointment with a sports medicine doctor/orthopedic surgeon. During my first consultation with the doctor I described how the hip gets uncomfortably tight at about 6 miles then very painful at 8 or 9 then the pain moves into the thigh, then the knee and continues into the side of the calve and shortly after that the leg loses all muscle function making running impossible. I advised him I feared it was a nerve problem. He got a big smile and said “no it’s not a problem it’s doing what it’s supposed to do. The progressive pain was your body telling you to stop running but when you wouldn’t listen it shut you down.” Doc said my trochanteric (hip point) bursa sac was very swollen and he recommended a shot of anti-inflammatory medicine. I took the shot, now it’s back to icing, stretching, listening to my body while running and stopping before it has to scream. The next day I had an MRI, to make sure the bursitis wasn’t caused by a more serious problem, but don’t know any results at this time. So I hope I’ve learned from this experience and that by passing it along, you can too. Remember don’t force training runs, if pain is a 5 on the 1-10 scale stop running. Cross train and use the “RICE” principal when necessary. Most important, if pain forces you to alter your gait then warm-up longer and if your gait is still not correct then don’t run until you fix the problem. The mental part of being injured is often more difficult than the physical, so don’t anguish over the days you can’t run but rather celebrate everyday that you can run. Oh no, I think I’m turning into milk toast, it’s a good thing it’s going to get cold outside soon.

My only input other than what others said is : I worry more about sudden pain such as you describe vs. pain that increases over a longer period. Sounds like a pull vs. just inflamation. JMHO. Good luck Holly!! Take it easy a few days then ease back in. Larry

I'll slow my runs down.... I've found most injuries are affected more by intensity than by volume of running.

This is also my experience, specifically with the hamstring issues I had in early 2007. I'm not sure what the exact injury was but the amateur doctor in me believes that I tore a tendon attached to my hamstring just above the back of my knee. It happened suddenly during a training run and then again three miles into a half marathon a few weeks later. I had already signed up for my first marathon (October), and therefore wanted to keep up the mileage. I found that if I slowed way down I did not feel any pain, so I kept at it. My average training pace was a good 90 seconds slower leading up to the marathon than it was pre-injury. I was able to finish the marathon without a problem. Since last fall I have been running most everything easy but have kept the mileage up (for me, that is, 35-40 a week). I'll throw in a tempo run every now and then just to keep loose. When I do tempos I run 2 miles easy for warm up and cool down. I've been injury free for over a year now and have three PRs in three races this year, despite the fact that I have been training at a significantly slower pace. All this has convinced me that mileage isn't the cause of most injuries, rather it is running too high a percentage of mileage at a high intensity. So I guess this is a long winded way of bringing up two points. 1 - You may be running to much of your mileage too fast. Do you warm up enough before your high intensity workouts? 2 - It's possible to keep running with your hamstring injury if you slow way down. My experience was that intensity aggravated the hamstring, but not mileage. Hope this helps ... Good luck.