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“Pain is inevitable. Suffering is optional.”

I’ve been thinking a lot about this quote in the past week or so. It comes from the Foreword of the excellent What I Talk About When I Talk About Running by Japanese author Haruki Murakami.

The quote may be more about the mental than the physical side of the sport but it’s been on my mind because twice in a week I’ve had niggling little injuries that have put me in two minds about running - should I “harden up” and run or should I be conservative and have a rest day?

It makes sense that pain doesn’t have to equal suffering. There’s certainly plenty of pain in an hour of hill repeats, but it’s “I’ve worked hard” pain, not “My body’s breaking” pain. It’s satisfaction rather than suffering.

It follows that a bit - or a lot - of pain when you’re running is okay … unless it’s the sort of pain that is a precursor to injury. But where does one end and the other begin? It’s a dilemma that can have disastrous consequences if you get it wrong.

In the past week I’ve twice found myself questioning whether I should go ahead with my planned run. The first was due to a sore big toe on my right foot. In trimming my nails I’d managed to rip not just the top of the nail off, but also the side of the nail where it meets the skin.

Over the next day or so it turned red and angry and started throbbing. After some prevarication, I ended up running. My logic was this may be sore, but it’s not likely to turn into any kind of chronic issue.

I figured in the worst case, running would make it extra tender and instead of missing one run I might be out for a few days. So the stakes were pretty low. Using that logic I went out and, of course, it was fine.

The second issue was a bit more complicated. I suffer from Achilles bursitis in both heels. This is due to a particular form of arthitis I’ve been diagnosed with, the main effect of which is ossification of tendons and ligaments, which means over time they harden to form bone spurs.

I have a heap of these in my spine, and apart from making me stiff and restricting my ability to turn and look over my shoulder, they don’t give me too much grief. But the bone spurs in my heels are a different story, especially for someone who likes to run.

Time for a quick biology lesson, in lay-person’s terms… A bursa is a sack of fluid that sits between a tendon - the Achilles for example - and the bone just above the point that the tendon attaches to the bone.

The bursa’s job is to lubricate that junction, so the tendon doesn’t fray when rubbing against the bone.

I have bone spurs that are compressing the bursa between the bone and the tendon, causng the bursa to become inflamed. This means any pressure on the back of my heel - for example from a shoe - hurts. Sometimes a little, sometimes a lot.

After a reasonably standard 9k on the flat on Wednesday afternoon, my heel was especially sore. It felt like my entire left ankle was on fire. And this general soreness was punctuated by the occasional sharp pain. As anyone who has suffered from any kind of bursitis will atest, it’s not a barrell of laughs.

So, I’m writing this on Thursday afternoon, wondering whether running this evening will be fine, or whether it will land me in a world of pain for the best part of the next week.

Should I stay or should I go?

Of course, my heel issue is a chronic condition that I’ve been aware of for years. But when you’re out on the trails, not every pain comes with a documented history. So what should you do if pain starts suddenly when you’re out on a run?

I stress that I’m not an expert, but I’ve done some research and there are some commonly quoted, “commonsense” tips that are worth sharing.

Firstly, it’s worth thinking about the difference between pain and discomfort. I’m not sure I’ve ever been for a run that hasn’t been marked by discomfort (maybe that’s just me!). Discomfort you can run through, but if you’re in pain, then you need to be careful.

If you decide you’ve crossed the threshold from discomfort into pain, then it’s worth using a 1 to 10 scale to rate that pain. If it’s a 1-3 and it doesn’t get worse, then it’s probably okay to persevere.

Once the pain reaches 4 or 5, then you should proceed with caution and anything more painful than that should be the trigger to stop. This is sometimes referred to as a “traffic light” system, for obvious reasons.

In addition, there are some instant red lights to be aware of. If you have a dull but consistent pain, that’s probably okay - at least in the short term. But a sharp or stabbing pain is a different story.

A pain that means you change your gait, develop a limp for example, is also something to be wary of. You may get away with it for a short time, but compensating for an injury in one area can often lead to a problem elsewhere.

You should also stop if you feel localised bone pain, tingling or numbness or you experience joint swelling. These can all be signs you have a more serious issue on the way.

As always, if in doubt, go and see a specialist - that’s what they’re there for.

PS: So after much soul-searching, I decided not to run on Thursday evening and I skipped a planned speed session on Friday morning too. It’s frustrating because I have no idea if I’m doing the right thing. But with nothing major in my calendar until the end of May, I feel like a conservative approach is probably wise.

Upcoming Events

There are way too many events for me to list everything that’s happening around the country, but here is a selection of upcoming races (with a bias towards South East Queensland).

The Running Calendar website is a great source if you want a comprehensive understanding of what’s available around Australia.