Running With Pain – The Mistake Zone

In “Running With Pain – Unacceptable Pain,” I talked about pain that you shouldn’t run through. And in “Running With Pain – Breaking The Rules,” I gave examples when you can break or bend the unacceptable pain rules. Now I will explain when you will be most likely to ignore pain and injure yourself.

DISSOCIATION AND ASSOCIATION

Consider two mental processes utilized by distance runners: association and dissociation.(1) Association can be defined as internal monitoring such as paying attention to muscle sensations. Dissociation occurs when a runner distracts her mind from pain, e.g., listening to music while running.

The consensus among psychologists, according to sport-and-exercise psychologist Lee Crust, is that runners mostly dissociate (distract themselves from their bodies) in training and associate (focus on internal body functions) in competition. Interestingly enough, more injuries occur when runners associate.(2)

To explain this, Crust suggests that dissociation is an effective pain control strategy for moderate levels of pain, such as cumulative muscle fatigue during high-mileage training cycles, but it isn’t effective against major pain, such as hitting the wall in competition.(3) However, a runner can use association to overcome intense or sudden pain. By accepting intense bodily sensations on race day as part of the goal-achievement process, a runner can focus on bodily sensations, including pain that could lead to injury, while choosing not to react or even acknowledge it.(4)

GOING FOR THE GOLD

So, my question for you is: How goal-driven are you?

In the 1976 Olympics, Shun Fujimoto from Japan, stuck the landing from his ring dismount on a broken kneecap. For some, there may be a Fujimoto moment where accomplishing the goal outweighs the physical damage that is being done.

Liz, a client of mine, had a Fujimoto moment. She discovered in her thirties that she was a natural runner, so she decided to run a marathon. Her training had gone injury-free, but during the marathon she developed intensifying hip pain. Knowing that she was risking injury, Liz took the hit and ran through the pain. Goal accomplished. Was the Fujimoto moment worth it to Liz? Yes. However, there were complications.

After the marathon, Liz’s hip pain persisted. She attempted to correct what she thought was an aberrant foot strike while maintaining the same training intensity. Subsequently, she developed pain in her shin. The pain in her shin continued to get worse and was eventually diagnosed as a stress fracture. Liz missed her next scheduled marathon.

The moral of the story? Be prepared to make major adjustments in your training routine after a Fujimoto moment. It was your body that took the hit; give it time rebound.

Here are the key points to my Running With Pain protocol:

1. Unacceptable pain alters running form, is pinpoint, can occur after a bad fall, is sudden and intense and/or is a result of over-training.
2. When testing if pain is acceptable, keep in mind Dr. Meyer’s rules: After you first feel sudden and intense pain while running, reassess in 30 seconds. For all other running pain, reassess at a ¼ mile.
3. Some pain can be worked through if a treatment controls the pain as was the case with Dr. Hoffman’s hamstring condition.
4. If you are a Workout Champion (a person who trains as if every workout were a race), try training for a specific goal with a testing date in mind.
5. Be aware that on race day you’re more likely to ignore unacceptable pain than you are on a training day.
6. Go for a Fujimoto moment and be prepared to make major adjustments in your training routine afterward.

Now is the time to develop your own Running With Pain protocol. Use it and you will make good running decisions. But keep in mind that there may be a time when your protocol doesn’t provide you with a clear answer. If that occurs, it will never hurt you to listen to Dr. DiNibule’s level-headed advice: “If in doubt, keep the athlete out.”(5)

Footnotes:
(1) Crust, Lee, “THe Psychology of Sports Injury; Is ‘No Pain, No Gain’ the Path to Sports Injury?” sportsinjurybulletin.com/archive/psychology-sports-injury.html
(2) Masters, KS et al. (1992). Retrospective and prospective studies of cognitive strategies among marathon runners: Relations with injury, motivation and performance. Paper presented at 104th Annual Convention of the American Psychological Association, Washington DC.
(3) Crust, Lee, “The Psychology of Sports Injury; Is ‘No pain, No Gain’ the Path to Sports Injury?” sportsinjurybulletin.com/archive/psychology-sports-injury.html
(4) Ibid.
(5) DiNubile interview (10/23/07).