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Yes it happens: a few weeks or even days from the race you have been training towards for months, a little niggle flares up.
You have invested hours of time and emotional energy preparing for the big day. Travel arrangements and accommodation may be booked. You may even have been eagerly fundraising and don’t want to let anyone down.
Decisions have to be made.
The following simple tips may help you decide, but bear in mind, it is written by an experienced runner not a medical professional, trying to give you common sense signposts rather than specific medical advice.
In many ways it depends how bad the injury is, how far out from the race you are, and if it is an 'injury' or a 'niggle'.
If it seems like a bad injury and your full range of movement or speed is compromised, or the impact action of running is painful in a particular area, you should make an appointment with your physio / doctor ASAP to get a proper diagnoses.
In a perfectly ordered world, as 'a fine tuned athlete' in training for a big race, and if you are still a few weeks from your event, this is definitely the best first action to take. The advice your medical professional gives you will determine what you should or shouldn’t do in the few weeks/days before the event and whether running your chosen event is possible.
If it just seems like a small niggle, and your event is very close, this may not be possible and you may have to make a decision yourself. Niggles can be run through or tolerated as long as there is not a risk of making the injury worse.
Niggles are always hard to define precisely, but simply put, although slight pain or a dull sensation is felt, general movement and/or speed is not compromised much, if at all.
Running may even be pain free, but the wee niggle reappears after exercise and is no worse. (N.B. long term niggles that don’t go away, should always be addressed with medical advice.)
In the case of a last minute niggle or injury, one may have to do one’s own 'runner first aid'. All major training will have been accomplished, so rest in the final few days will not be a problem. You don’t lose any fitness in a few days (see first aid tips later).
If you have to self diagnose, remember Google is not your physio or doctor and a screen cannot feel tissue or muscle damage, or put you through a simple series of movement tests to understand just how bad it may be.
You can, however, do the simple scale of 1-10 pain test. Whenever I have had the misfortune to visit my trusty physiotherapist, he will often ask me, “On a scale of 1-10 can you rate the pain – both when standing still, and on an easy jog for a few steps, or hopping on either leg?”.
If the answer is less than 5, the guidelines suggest a niggle. 5-6 needs a reality check on the wisdom of any immediate exercise. Anything more than a 7, logic, commonsense and normal medical opinion is crying out REST IT. Doing any exercise is liable to make it worse.
So having discovered how bad your issue is, you should now be able to make a judgement call on whether to run your race or not. It then just remains to be seen how you are going to approach the race and what, if any 'runner's first aid' is needed.
The following will never replace medical opinion, but can be the difference to getting you to the start line, or through a race.
1. Swelling or inflammation
An ice pack or anti-inflammatory gels or creams applied as soon as any swelling appears, will help to reduce it.
2. Muscle soreness/tightness
Deep heat or muscle balm can help. Compression socks or calf guards have been shown to help too.
3. Heel or foot pain
A cushioned heel pad or full length cushioned insole can relieve minor underfoot pain.
4. Knee pain
Always hard to identify but a knee support can help hold things in place and reduce the vibration that the act of running places on a knee.
5. Ankle pain
Same as for knee.
6. Taping with traditional physio tape or Rocktape
This can alleviate many injuries, and although this is best done by a medical professional in the first instance, in an emergency situation, there are many excellent YouTube instructional videos on self taping.
Although there is a simple temptation to pop a couple of painkillers, advice should always be obtained from a physio/doctor pre-race or from first aiders on the day. While they undoubtedly can help in some situations, painkillers can also mask pain and allow an injury to get worse. Prolonged use in a marathon or ultra marathon can lead to other detrimental side effects. If in doubt, grin and bear it!
1. Set a realistic goal, or even just the goal of finishing
Any idea of what time you may have been aiming for, whether real or La-La-Land, should go out the window.
2. Train the brain
Try and understand that even though you do get to the start line, without talking yourself out of finishing, are you ready to drop out if any niggle worsens to the detriment of your well being? Similarly can you transform those little doubts along the way, by rationalising any feelings into pain or discomfort. Pain usually means seeking help, discomfort can be endured to the end. Facing up to reality and all possible options beforehand will make any difficult mid-race decision making easier.
3. Walking is OK
There is nothing in any race rules that says you can’t walk some of the event, as long as you are well within the event cut-off time. If your chosen event is a marathon or an ultra, a run/walk strategy is definitely something to think through and has got many partially injured (or undertrained) runners to the finish line. The key is to start your walking breaks early on and not wait until you're tired – e.g. run 25 minutes, walk 3 minutes, or any similar variation depending on the length of the event.
4. Find a friend
This may be a friend who is happy to chum you round, or someone you just fall into conversation with in the first mile or so running at a similar pace. Either way, having a running buddy will help the miles go by and stop you thinking constantly about your issues.
5. Keep your cup half full or more
Attitude and enthusiasm are everything, and once you have made the decision to run, just make sure your cup is always half full and not half empty. While not ignoring any pain or discomfort, history shows that, whatever our sport, we can all tap into that little something, when required.
6. Remember the scale of 1-10 test
As your race progresses, honestly ask yourself, “OK this is maybe a 4-5. It is a little uncomfortable, but It is no worse than it was before the race. Or am I getting to 7? If so, you should consider seeking help and advice at the next first aid checkpoint, or inform a race marshall so help can come to you.
7. Volunteering is fun
If you have to withdraw, either from a local event or one you are committed to travel and accommodation for, many organisers are often grateful to receive offers of help on race day. Race websites usually have a volunteer request section. Volunteering for a simple task is a way of you still being involved in an event. It is good fun, you can meet new friends, and seeing an event 'from the other side' always helps you appreciate how much goes into making an event work smoothly.
8. Defer your place
It is always worth bearing in mind too, that most races may have a withdrawal or deferment policy, or at a running festival it may be possible to switch to a shorter distance, so check the event website and instructions for details on this. The closer to the event, the more difficult it is for a race organizer to change things, if at all, so do act sooner rather than later.
Finally remember, although it is good to have goals and push yourself, whatever your standard, to find out what you are capable of, it is not good to end up having to take several weeks off through making an injury worse or, rather drastically, end up in hospital. Life is precious and there is always another race.
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