Working out can be uncomfortable (especially when you’re just getting started), but it should never hurt. Here is how to tell the difference between the harmless twinges that go along with pushing your muscles farther than they’ve gone before and pain that should send you to your doctor.
Remember: When in doubt, rest and have your pain checked out. It’s better to spend a little time and money seeing a doctor than to be sidelined for months by an injury that you could have prevented or minimized.
SHIN SPLINTS (MEDIAL TIBIAL STRESS SYNDROME)
Shin splints happen when there are small tears in the muscles around your shin bones. You might feel a tight aching pain that fades after a warm-up or after you stop working out. It can feel painful and tender to the touch. Shin splints are common among new runners and those returning after an extended layoff, and after building up mileage too quickly. Over pronation, running on cambered (arched) roads, and wearing worn-out running shoes can also lead to shin splints.
What to do: When you feel the first twinges of pain, rest, and then slowly get back into working out. If the pain continues through the end of your run and radiates over a wide area, it could be a stress fracture; see a doctor to rule it out. The easiest and best way to avoid shin splints is to increase mileage gradually, run on soft surfaces as much as possible, and make sure your shoes offer the fit that your feet need.
Safe alternatives: Cycling, pool running, and swimming. (Avoid the elliptical trainer.)
STRESS FRACTURE
Unlike an acute fracture that happens as the result of a fall, stress fractures develop from cumulative strain on the bone. They most often occur in the foot or in the shins. It may begin as minor pain and get worse as you run. If it goes untreated, it may become uncomfortable just to be on your feet. Stress fractures can result from over training, over striding, and excessive impact. If you increase the duration, intensity, or frequency of your workouts before your body is ready, your bones can’t repair themselves fast enough to keep up. Stress fractures are more common in women than in men, usually due to nutritional deficits, low estrogen levels, and inadequate calorie intake.
What to do: Stop all impact exercise and see a doctor right away. The amount of rest you’ll need depends on the severity of the fracture and its location. If you ran through the pain for a while before you realized you had a fracture, your recovery could take longer.
Safe alternatives: Swimming and pool running. (Avoid all impact exercise until cleared by the doctor to resume.)
PLANTAR FASCIITIS
PF is inflammation of the plantar fascia, a ligament on the bottom of the foot that stretches from the heel to the toes. It feels like a dull ache or bruise along the arch or on the bottom of the heel, and can be most painful first thing in the morning and at the beginning of a workout. Over pronation and wearing worn-out shoes are the most common causes of PF. A sudden increase in hill running or running on the forefoot can also set it off, as can long periods of standing. Those with high arches are more at risk for PF, and often it’s made worse if you wear shoes with no arch support or often walk around barefoot.
What to do: You don’t have to stop working out—just stick to flat surfaces and avoid hills. Avoid wearing flip-flops or open-backed shoes that offer no heel support. Replace your running shoes every 300 to 500 miles. Ice your heels and stretch your calves and strengthen your glutes, which can help prevent pronation.
Safe alternatives: Pool running and swimming. Cycling or using an elliptical trainer can help you maintain fitness, but only if you can do those activities pain-free.
ACHILLES TENDINOPATHY
This condition is the tightening and irritation of the Achilles tendon, which connects the two calf muscles to the back of the heel. It may start as a dull ache. As it progresses, it may hurt to stand up on your toes, and you may develop severe pain and swelling—even when you’re not running. It’s caused by doing too much too soon, doing too many hills, or wearing the wrong shoes.
What to do: Rest for a few days. If you try to run through this, it may take months to go away. Avoid aggressive calf stretching and wearing flip-flops and high heels, all of which can irritate the Achilles.
Safe alternatives: Pool running, swimming, and biking. (Avoid elliptical trainers, which can strain the calf muscles and the Achilles.)