If you’re a dedicated endurance athlete, chances are good you’ll eventually experience a musculoskeletal injury. Most running-related injuries occur from the waist down and can involve muscle, bone, and connective tissues (ligaments, tendon, cartilage).

The most common recommendation for any running-related injury is to “apply ice”.  This is certainly a safe and smart recommendation, but I want to suggest some options I’ve had success with when treating my own running aches and pains.

Please note:  the information that follows is based on my own experiences dealing with minor running injuries – see a medical professional if you’re experiencing a more severe chronic injury.

Step One:  Analyze

I’ve learned to discern the difference between a muscle tissue injury and a connective tissue injury. This in an important distinction. Medical professionals almost always recommend ice treatment during the first 24 hours for any injury and I totally agree, whether it’s a muscle strain or a connective tissue problem.

Once an injury “settles in”, I have had more success treating a muscle strain with gentle heat than continuing with ice treatment. If I am certain I’ve suffered a connective tissue injury (tendonitis, ligament strain, etc.) I stick with ice treatment. These are inflammation injuries and the ice helps calm the inflammation.

Muscle Strain: Can’t Beat Heat

If I’m certain I’ve sustained a minor muscle strain or pull, I immediately start gentle heat treatment using my trusty heating pad and an ace bandage. I always keep the heat setting on low, place the heating pad over the problem area, and then secure the heating pad against the muscle using an Ace bandage.

For muscle strains/pulls, heat seems to help the muscle area to relax and begin the healing process. Heat draws blood to the area and when a muscle is healing, and blood helps bring nutrients and carry away the bad stuff.

If you have access to a whirlpool or hot tub, hydrotherapy is a great way to provide warm, gentle relief to a sore muscle area.

More words of caution. If you’ve suffered a muscle tear do not use heat to initially treat the injury – ice is best for a torn muscle. Quite often you’ll see skin discoloration and you’ll feel more severe pain with a muscle tear. A torn muscle is bleeding and initially using ice helps reduce the swelling and stop the hemorrhaging.

Lastly, never go to bed/sleep with heating pad applied to a sore area.

Tendonitis/Ligament Strain: Ice is Nice

Tendonitis is a very common running overuse injury. I have an old-fashioned ice pack that I keep handy, along with an Ace bandage.

You need to exercise caution when treating an injury with ice. Applying ice directly against the skin can be uncomfortable and can damage tissue if left on the skin for too long. Using an ice pack provides a thin layer of protection between your skin and the ice. If I’m treating a foot injury, I’ll wear a thin sock, then apply my ice pack over the sock, secured on the area with an Ace bandage.

Keep your ice treatments to 15- 20 minutes. Any longer and you might injure your skin tissue.

Ice treatment tip: fill a small paper Dixie cup with water and freeze overnight. You can use the frozen Dixie cup to apply an “ice massage” to an injured area. Just peel the paper away from the ice and gently massage. Keep a towel on the floor under the injured area as you apply the ice massage.

Don’t Stretch!

When we first sustain an injury, there’s always a tendency to want to stretch the sore area. Let the problem area rest during the acute pain phase. Stretching can tear injured tissue that is trying to heal. Once the pain subsides and the healing process has started, then you can introduce some careful, light stretching to the area.

Fred’s Two “should I be running?” Injury Rules

I’ll run through an injury as long as the two following rules are honestly adhered to:

1.  The injury pain is not getting any worse

2.  The injury is not causing me to adjust my running stride compensate for the pain.

Fred Klinge works for Varsity Sports and is currently certified by the American College of Sports Medicine as a Health/Fitness Specialist. Fred has completed 29 marathons, with a personal best time of 2:18.15. He can reached at fred@varsityrunning.com.