The Gray Area: What to Do About Lingering Post-Race Pain

You crossed the finish line. You ate all the post-race snacks. But after a few days, that pain you pushed through during the race is still there. Now you're wondering: Is this normal, or is this a problem?

Welcome to the gray area of post-race injuries, where the line between "needs rest" and "needs a doctor" feels frustratingly blurry. Here is a breakdown of when to seek care, and how to stay active while giving your body the rest it needs to recover.

How Do I Know If I Should See a Doctor, or If Rest/Ice/Stretching Will Handle It?

This is the million-dollar question. Here's a practical framework:

Use the RICE protocol for 7-10 days:

If you follow the RICE protocol (Rest, Ice, Compression, Elevation) plus gentle stretching and mobility work for 7-10 days and you're not seeing improvement, it's time to call the doctor.

Use the pain scale honestly:

Rank your pain on a scale of 1-10, with 0 being no pain and 10 being the most painful:

• 1-3: Mild discomfort that doesn't affect daily activities. Use conservative home treatment.
• 4-6: Noticeable pain that affects how you walk or move. Watch closely and consider a consultation if you don't see improvement in 5-7 days.
• 7-10: Significant pain that limits normal function. See someone this week.

The morning test:

How do you feel when you first wake up? If pain is worse week after week in those first morning steps, that's a sign something isn't healing properly.

The compensation test:

Are you limping, changing your gait or avoiding putting weight on something? If you're compensating, you're at high risk of creating a secondary injury. Get it checked out.

Red Flags: Don't Wait, Get This Checked Immediately

Some symptoms should not be ignored, even if you think, "I'll give it a few more days." Seek medical attention within 24-48 hours if you experience:

• Sudden, severe pain that came on during or immediately after the race
• Inability to bear weight or walk normally after the initial post-race soreness has passed (about three days or more)
• Visible swelling that's getting worse, not better, or is isolated to one specific spot
• Numbness, tingling or weakness in your foot, ankle or lower leg
• Pain that wakes you up at night or prevents you from sleeping
• A "pop" or "snap" you felt or heard during the race
• Pain that's sharp and localized to one specific point rather than general muscle soreness
• Any chest pain, difficulty breathing or heart palpitations (this should be evaluated immediately, and you should go to an urgent care or ER)

Special note on stress fractures: Stress fractures are sneaky and can present as a very specific, pinpoint area of pain that doesn't improve with rest. Common locations include the metatarsals (foot bones), tibia (shin), femur (thigh) and hip. If you have a specific spot that hurts more when you press on it, get it X-rayed.

Tibial stress fractures can often mimic shin splints. However, shin splints usually have a broader area of tenderness with no swelling. Shin splints often improve after a proper warm up and modification in running terrain, whereas the discomfort from a stress fracture does not and often persists with rest and walking. The femur and hip have a large soft tissue envelope surrounding it, so point tenderness is not always present if a stress fracture exists. If you have thigh or hip pain that does not improve with rest or activity modification, an orthopedic evaluation is warranted to rule out a stress fracture.

Can I Cross-Train While Something Feels "Off," or Will That Make It Worse?

The frustrating answer: it depends. However, you can use a cross-training hierarchy as a framework to think through your options. This hierarchy moves from non-weight bearing and low impact activities to high impact and complex movements.

The Cross-Training Hierarchy (from safest to riskiest when injured):

Generally safe:

• Swimming
• Pool running with a flotation belt
• Strength training (Avoid exercises that load the injured area. Ex: If your knee hurts, choose upper body or core exercises)
• Cycling if the injury is above the knee and cycling doesn't aggravate it

Proceed with caution:

• Elliptical
• Rowing
• Yoga (great for mobility, but be careful with weight-bearing poses)

Usually a bad idea:

• Plyometrics, jump training or HIIT workouts
• Stair climbing or incline walking
• Anything that makes you limp or compensate

The Golden Rule of Cross-Training While Injured:

If it hurts during the activity, stop. Pain is information. If something feels "off" during a workout, that's your body telling you it's not ready for that stress.

The 24-hour test: How do you feel the next day? If your injury feels worse the morning after cross-training, you overdid it. Scale back intensity or choose a different activity.

The Bottom Line

Post-race pain that lingers in that gray area is your body trying to tell you something. Taking two weeks off now to evaluate is better than being forced to take six months off later.

When in doubt, get it checked out. An orthopedic sports medicine physician can diagnose issues that home treatment can't address and provide personalized treatment plans to help you get back to running.

Schedule your consultation today at resurgens.com/schedule