“Why does my pain get better after I run for a few minutes?” is a common question amongst my patients and an often frustrating experience for those looking to recover from a running injury. Responding properly can be the difference between a quick recovery and resting for a few weeks.
So why do some injuries feel better once you get warmed up? It’s quite simple really. The answer? Blood flow. When we start out for a run our tissues are relatively ‘cold’. They don’t require too much oxygen, so the heart diverts blood to areas more deserving (i.e. your gut). The fibers of the injured tissue are likely weakened and brittle. As you run the “feel it” sensation begins almost instantaneous to the first few steps. You contemplate the implications of continuing, but then, magically, the pain slowly subsides and you feel better. It’s not magic, truthfully. As you’re body reroutes blood flow to working muscles, your sore areas are getting better (oxygenated) blood in and bad (waste products) blood out. Tissue oxygen levels rise and the entire system get a spray of lubricant.
As you begin your run the muscles, tendons, joints, etc. can create a brief oxygen debt which is typically why you huff and puff for the first half mile or so. The tissue(s) is/are stiff and likely weak, which is typically the reason you’ll “feel it” until you warm up.
Since your pain or symptoms get better as you run, it’s tough pull the plug on the run when you’re not experiencing pain. The true test is afterwards, whether the response be immediate or after hours of delay. From the second you hit the stop button you’ll be looking to assess the damage. As your body now diverts blood away from your legs, how does your muscle, tendon, or joint feel?
With each passing minute your tissue temperature will rise and tissue oxygenation improves, causing your symptoms to subside. However, each passing step places a load through weakened, injured tissue. Something as simple as stopping to wait for traffic or tie a shoe can dip your tissue temperature down, bringing on the onset of symptoms. That’s why assessing yourself post run is important and not necessarily during the run.
If your symptoms hit before you can even walk up the drive way begin by walking around. Walking will bring your tissue temperature down gradually and help keep the blood flowing. Once you’re inside immediately place ice on the painful area. In general, you can’t over ice if you work a 20 minute on, 20 minute off schedule. Avoid heat! Heat will draw blood to the area and promote inflammation. You’ll be looking to do damage control after your run, not throw another log on the fire.
QUICK NOTE: “Feeling it” and “Pain” are completely different terms. Often you’ll “notice that something is there,” but it won’t hurt. That’s ok. Keep pressing on. Tissue remodeling can last up to six months. What we’re more concerned with is straight up pain.