PAIN - Breaking It Down Before You Break Down - An Ultra Endurance Athlete's Take

“Make friends with pain and you will never be alone.”

-Ken Chlouber

RD, Leadville 100 Mile Endurance Run

If you love to run, and by that I mean LOVE to run, whether it's on trails, roads, the track, as a stand-alone event or after you've swam and biked preceding that run, you have personally made friends with pain.  Either that, or you dread running hard (and racing to the peak of your ability).  So here is the chief problem: if we are completely at home with pain, and we've made our peace with it, then where should we draw the line on what's acceptable to run through?  What is the pain we're supposed to stop for?

Marathon training programs, large charity fundraising groups and now ultra distance running & popular media have clouded our perspective a little over the last decade or two.  We laud toughness. We respect gritty, gutsy efforts.  We love to watch the video of someone crawling, yes, literally c-r-a-w-l-i-n-g across the finish line...

TEENAGE RUNNER CRAWLS ACROSS X-COUNTRY FINISH

*see 1-min, 10-sec in to 2-min, 14-sec

How can we determine the appropriate line in the sand?  What should be considered "desirable mental/physical toughness" and how do we know what is "foolishly putting our future physical health at risk"?  Holland Reynolds (the girl in the video above) is photographed with her "winning team" in an ambulance after this race.  I don't even know what side of the fence I am on when it comes to foolishness vs. courage/toughness.  After all, I run 100-135 mile races.  I've made friends with pain.

I do, however, have a little mental checklist I made for myself years ago and have shared with many of my runners.  It's four parts, and I hope it can help you stay healthy the way it has helped me over the past 10 years.

THE FOUR TYPES OF PAIN

I am sure there are many more than four types, but if I break my friend pain down into these four basic sub-categories, it helps me determine if this pain is something I can run through or something I should call it a day for.

TYPE 1 - the pain of EFFORT

This one is very simple. You run fast, you fall into oxygen-debt (i.e. anaerobic state) and that discomfort reaches the pain point.  To decrease the pain of effort, simply decrease the effort/pace.

TYPE 2 - the pain of CUMULATIVE FATIGUE

This one is a touch more tricky.  Cumulative fatigue can be from running for an extended duration, can be from the swim/bike prior to the run, and it can also be the built up fatigue from a hard week/month of training and/or work/life stresses.  The bottom line is you don't feel great, you aren't in a groove and things just feel off. Maybe you're achey, maybe you feel generally horrible.  Cumulative fatigue is going to happen the longer you go, and in many long runs, longer races and big week/weekend miles it will be there.  You have to ask yourself this in training: "is running through this, now, serving a specific purpose in my training?"  If the answer is no, you need to make a judgment call to adjust the workout or shut it down.  In a race, the answer is simple: keep running.  You get to rest when it's done and cumulative fatigue is a part of the game (especially in that marathon at the end of an Ironman and 50-100+ mile trail running races).

TYPE 3A - the pain of 'Correctable' IMBALANCE

This pain can show up in many different scenarios.  It can be muscle imbalances, flexibility imbalances or something you tweak.  My rule of thumb for imbalance is: are you favoring something?  Are you compensating in your form/stride?  If this is something we can correct (stop and stretch a tight muscle, massage something out, etc.) and get our form/stride back in sync, then I keep going.

TYPE 3B - the pain of 'Non-Correctable' IMBALANCE

This pain is essentially the same as described above, the difference being when you can NOT make things right, or at the very least you can't stop favoring something.  Maybe you rolled an ankle, tweaked a hamstring or your Achilles isn't 100% on one side, but the bottom line is you are in pain and you have a hitch in your stride or are outright limping.  This is a game changer.  I personally call it a day in this scenario.  The last time this happened to me in a race was the Oil Creek 100-Miler in 2010, I pulled myself at Mile 76 flirting with a Top 3 finish.  Frankly, it was a no-brainer.  I had "Type 3A" pain early in the race and had been stopping to get stretched out all day, and was able to run hypothetically even.  But it deteriorated into "Type 3B" late in the race, somewhere after Mile 62.  I came running into the Mile 76 aid station with every intention of continuing.  Ate my calories, high fived some people, kissed my wife Kate and stood up to run out.  I couldn't run.  I couldn't even really pick up my right leg anymore.  Game over.

RUN & RECOVER SMART

We, as athletes, need to pick our battles.  Yeah we deal with pain on an almost daily basis (hopefully the pain of running effort, not chronic ailments and injuries), but that doesn't mean we should push through every type of pain.  Speaking specifically to the 100-mile trail run, we have become so conditioned to significant pain on a self-inflicted level not experienced in anything else (save childbirth, broken femurs and car crashes), that the line begins to blur as to what we should take extra rest days/weeks for and what we should push through.  Most of us push through things we shouldn't, rationalizing that the rest of our obese society refuses to push through even a simple urge to eat healthier, let alone work out.  We tell ourselves things like, "if I give in and stop then I won't be mentally tough enough later".  It's nonsense.  If you want to have a long career doing what you athletically love, it's time to implement a system of checks-and-balances or soon, we'll be on the sideline watching what we love while we go through physical therapy.  Or worse.  I know this pain all too well, as my last hiatus from running was almost a year long with quadriceps tendonitis from November 2002 through August 2003.

Train hard.  Race tough.  REST SMART.  I look forward to seeing you out on the trail, running...