Running is a repetitive sport and as such there is a relatively high rate of aches and pains in all runners, especially beginner runners. Below is some information on the most common aches and pains among runners, ways to prevent them, and how to treat them if they occur. Prevention is the best medicine!
Blisters occur due to extended friction between your skin and your sock. Anything that increases the friction between the skin and the sock can cause or worsen a blister, such as an increased pace, poor-fitting shoes, foot abnormalities (bunions, hammertoes, or heel spurs), heat, or moisture.
To prevent blisters, start by coating high-risk areas on the feet with a lubricant such as Body Glide. Make sure you are wearing well-fitting shoes in the right size. Many specialty running stores can fit your feet with the correct type and size of running shoes. There should be a thumb’s width of space between the toes and the end of the toe box. The socks should also fit well and be made of breathable and moisture-wicking material such as wool, polyester, or nylon; avoid cotton as it will hold onto moisture.
If you do get a blister, there are a few things you can do to lessen the pain. If the blister is small and doesn’t prohibit movement, leave it alone. The membrane of the blister helps to protect the sensitive skin underneath and keeps the bacteria out. If the blister is large, purple, painful, and inhibits normal movement of your toes, clean the area around the blister and a needle with soap and water; pop the blister but leave the flap of skin in place to protect the skin underneath. Make sure to clean the site regularly to prevent infection. To protect small blisters and keep the swelling down, cover the blister with moleskin.
There are two types of chafing: skin-on-skin and fabric-on-skin. Skin-on-skin chafing is when your thighs or underarms rub together. Fabric-on-skin chafing is when the fabric of your shirt or sports bra rubs against your skin. Chafing is caused by several factors including: loose-fitting clothing, non-breathable fabrics, and hot or humid weather.
To prevent chafing, wear tight-fitting layers made from synthetic fabrics. Again, no cotton since it can hold in moisture and increase the chance of chafing. Apply a lubricant such as Body Glide in areas that are at high risk for chafing (thighs, armpits, and nipples). Covering the nipples with band-aids is another way to prevent chafing in this area. Also be mindful of the equipment you wear while running, such as hydration vests, armbands for phones, heart rate monitors, etc. Secure this equipment so they don’t bounce and rub against your skin. It is also a good idea to apply the lubricant to these areas as well.
If you do experience some chafing during your run, make sure your shower water after your run is lukewarm; a hot shower can make the burning worse. Gently wash the chafed area with an antibacterial soap, pat dry, and apply an antibacterial ointment such as Desitin. Put on loose, comfortable clothing that won’t irritate the area.
A black toenail is caused by a blood blister or bruise underneath the toenail. This happens when either the toes are crammed in the toe box or from the repeated slamming of the toes into the end of the shoe. This trauma can cause the blood vessels underneath the toe to break resulting in bleeding beneath the nail.
To prevent black toenails, make sure your running shoes are the right size. Again, make sure you have a thumb’s width space between the toes and the end of the toe box. Too much downhill running can also contribute to black toenails as the toes slam into the end of the shoe more. Keep the toenails cut short; the more the toenail sticks out, the more they will slam into the end of the toe box. Wearing the right socks can also prevent black toenails as moisture can increase foot slippage.
If you get a black toenail, it is best to leave it alone if the pain is manageable. If the toenail is very painful, it is best to visit a healthcare provider who can puncture the nail and release the pressure. If you would rather a home remedy, heat a needle until it is red hot and puncture the nail to release the pressure/fluid. Clean the toenail immediately after with an antiseptic solution and apply a sterile dressing to minimize the risk of infection. If you notice any redness or signs of infection, seek professional medical assistance.
Muscle Aches vs Pain
Any time your muscles are pushed beyond their normal daily routine or limits, it is very normal to experience some soreness known as Delayed Onset Muscles Soreness or DOMS. The American College of Sports Medicine states that “any type of activity that places unaccustomed loads on muscles may lead to DOMS. This type of soreness is different from acute soreness, which is pain that developed during the actual activity. DOMS typically begins 12-24 hours after the exercise has been performed and may produce the greatest pain between 24-72 hours after the exercise has been performed.” Expect some DOMS at the beginning of a training period, after a tough hill workout or strength training routine, after your first long run without walking, or after a tough speed workout or race. The key is that it should not be painful during the activity and should typically dissipate within 3-4 days. Anti-inflammatory meds can help manage the symptoms and many times activity often decreases them, whereas prolonged rest can momentarily increase the pain once you start moving. There is not great research and lots of theories on what causes DOMS and there has not been much success in terms of finding ways to speed up recovery or prevent the process. It is just part of training and should make you feel accomplished that you pushed yourself beyond what your body normally does!
While DOMS is normal, pain that is brought on during running, particularly after easy runs, or increases while you run, is something to be more concerned about. Pain that limits your daily activities is almost always a red flag that you should pay attention to. It does not always mean something terrible is going on and that you will never be able to run again, but it is something that should be addressed sooner rather than later to prevent it from turning into something more limiting. The solution may be as easy as stretching after your run or getting a pair of insoles for your shoes or you may need to visit your doctor or a local physical therapist specializing in running for a more thorough evaluation of your pain. In fact, many physical therapists who are running-focused will offer a general runner’s evaluation to take a look at your gait, flexibility, and strength and give you a good set of exercises and recommendations to keep you healthy and injury free on your running journey!
Running is hard work and you should expect to be more tired when you first start! It may take a few weeks to get to the point where your body levels off and is used to the increased activity, particularly if you were not very active before you started running. As time goes on, you should begin to feel less and less tired on the days you run and will often become more energized due to your increased physical activity.
However, if you are becoming fatigued to the point that your daily activities are affected or you are no longer sleeping well, this warrants further investigation. It may be that you are overtraining and doing too much too soon, and you may need to back off. You may benefit from a doctor visit to assess your bloodwork and/or vitamin levels, as sometimes this can be cause for excessive fatigue. Another area to assess is your diet. Poor diet can be another cause of excessive fatigue when you increase activity. You will need to take in increased calories, but they should be good, healthy calories that will fuel your activity. A great place to direct your diet questions would be a registered dietitian or certified nutritionist. There are often practitioners in these fields who will specialize in athletes or running if this is an area you need more information in.
Shin splints are one of the most common runner injuries. Shin splints are characterized by a nagging, aching, or throbbing pain concentrated on the front of your leg. The pain is usually felt either during or after your run or if you press on the area. The pain is most severe at the beginning of the run but will often lessen once the muscles are loosened up.
They are caused by tired or inflexible calf muscles putting excess stress on the tendons which then become inflamed, strained, and torn. Factors that can contribute to shin splints are overpronation, worn out shoes, lack of cushioning, or running on hard surfaces. Beginner runners are more at risk for developing shin splints because they are using leg muscles that haven’t been stressed in the same way before. In addition, the cardiovascular system develops in beginner runners before the musculoskeletal system. In other words, the heart and lungs are ready to run faster and longer, but the muscles and bones are not. Another group of runners at risk are runners returning from injury. Oftentimes, these runners increase their mileage too quickly, and their leg muscles can’t keep up.
If the shin splints occur at the beginning of a season, a small amount of running may help the pain as the muscles will adapt and grow stronger. If the pain is persistent, you can try icing the area for 15 minutes three times a day. Anti-inflammatory meds can help with the pain. Ice the area immediately after a run. You may need to either cut down or stop running altogether. Recovery time can be between 2-4 weeks. If the injury doesn’t respond to self-treatment or rest, you may want to visit your healthcare provider or a physical therapist to assess if your gait, flexibility, or strength could be optimized and improve your symptoms.
IT Band Syndrome
The iliotibial band (or IT band) is a tendon that runs along the outside of your leg from your hip to your knee. Once the tendon becomes tight, it can become irritated and swollen from rubbing against the hip or knee bones. This can cause an aching or sharp pain on the outside of the hip or knee. You may also experience a click, pop, or snap on the outside of your knee or pain on the outside of your thigh.
Possible causes of a tight IT band include:
- excessive foot pronation because it stretches the IT band and brings it closer to the bones
- weak hip abductors because a weakened ability to turn the hip away from the body can cause the IT band to tighten
- pushing yourself too hard during exercise
- running on a tilted or curved surface
- lack of rest
- worn out shoes
- not warming up enough before exercise
- Increasing volume or intensity too quickly
Initially, the pain will start after you begin running. As the syndrome progresses, you may also feel the pain during the run and even while you are resting. In the initial stages, the pain will feel like an ache or burning sensation, but the pain will sharpen as the syndrome worsens. Rest, ice, and anti-inflammatory medicines can be helpful to reduce the pain.You will also want to see a physical therapist who can help treat the syndrome and prevent it from recurring. The physical therapist can prescribe exercises that can strengthen your IT band and the core and hip muscles surrounding it.
To prevent IT band syndrome, always gradually increase training volume and intensity and incorporate strength training that focuses on the core and hip muscles as well as single-leg stability.
Patellofemoral pain syndrome, also known as runner’s knee, is another common injury among runners. The pain associated with Runner’s Knee can be sharp and sudden or dull and chronic; it may disappear while you are running and then return after you’ve stopped. It can include tenderness behind or around the kneecap, pain toward the back of the knee, and a feeling that the knee is giving out. It affects women more than men due to the fact that women tend to have wider hips; this results in a greater angle of the thigh bone to the knee which increases the stress on the kneecap.
It is difficult to pinpoint a single cause of Runner’s Knee. There are many factors that could play a role:
- Biomechanical issue – shape or location of the kneecap
- Worn cartilage in the knee joint
- Flat feet
- High arches
- Weak quads
- Tight hamstring or calf muscles
At the first sign of pain, you should cut back your mileage which will lead to a faster recovery than trying to run through the pain. Applying ice for 15 minutes after each run can help with the inflammation and pain. You may need to try new shoes, inserts, or orthotics. If the pain persists, see a healthcare provider to rule out other conditions.
To prevent Runner’s Knee, run on softer surfaces when possible, gradually increase mileage, and gradually add hill work into your training program. Strengthening the quadriceps will help support the kneecap and keep it in proper alignment. You may also want to visit a specialty running store to make sure you are wearing the correct shoes for your foot type and gait.
Contact us at Team RunRun
If there are more runner aches and pains you’re interested in learning about, please reach out to us at Team RunRun for more details – [email protected]. In the meantime, keep training, keep having fun, and stay strong!
Coaches Carrie Neiman and Erin Babin co-wrote this article and are both coaches with Team RunRun. To learn more about them, check out Carrie’s profile and Erin’s profile.