Sports
Running Soreness or Injury? Dr. Caroline Neves Explains
An orthopedic specialist details how to tell training discomfort from stress fractures and the dangers of masking pain.
Feeling sore after intense training is normal, but ignoring persistent overload can lead to severe issues like stress fractures and tendinopathy. Orthopedic surgeon Dr. Caroline Neves explains how to spot warning signs, why rest is crucial, and why medication shouldn't mask pain.
For road runners, the line between normal fatigue and the onset of an injury frequently causes confusion. The temptation to push through discomfort to stay on schedule often leads athletes to ignore clear warning signs from their bodies. Dr. Caroline Neves, an orthopedic and trauma specialist focusing on the foot and ankle as well as an active marathoner, breaks down the mechanics behind common running pains and shares criteria for deciding when to keep going or seek medical advice.
PUBLICIDADE (GAM) — 1250x250
Post-Run Muscle Soreness vs. Warning Signs
The first step for any runner is learning to identify patterns of discomfort. Muscle soreness resulting from training overload is typically mild to moderate, subsides within 24 to 48 hours, and does not interfere with daily activities like walking or going down stairs. In contrast, localized discomfort that lingers for weeks, progressively worsens, or presents joint swelling (edema) calls for clinical evaluation.
Another critical distinction lies in the mechanical behavior of the pain. Inflammatory conditions such as tendinitis or plantar fasciitis often ease up once you warm up during the first few miles, only to return after muscles cool down. Conversely, bone-related issues—such as stress fractures—do not improve with a warm-up and tend to worsen steadily with every foot strike.
Stress Fractures: The Link Between Mechanics and Metabolism
The significant increase in stress fractures across the running community is not solely caused by rapid mileage jumps or uneven terrain. This type of injury develops along both mechanical and metabolic pathways. Bone tissue undergoes continuous remodeling, and nutritional deficiencies—especially calcium and vitamin D—or hormonal imbalances can disrupt structural recovery.
Factors like sleep deprivation and relative energy deficits directly impair bone regeneration. Without adequate rest and balanced energy intake, bones initially develop bone marrow edema, which can progress to cortical microfractures and eventually full fractures if impact continues. For this reason, the standard protocol in these cases is an immediate halt to running paired with multidisciplinary care.
Tendinopathies and the Most Overloaded Structures
Among the most frequent clinical complaints are Achilles tendinopathy, plantar fasciitis, peroneal tendinopathy, and iliotibial band syndrome (commonly referred to as runner's knee). In the case of the Achilles tendon, limited vascularity in a specific zone naturally slows recovery, requiring prompt intervention at the first sign of pain.
Weakness in core stabilizers, such as the gluteus medius, is a primary driver of biomechanical flaws that place excessive strain on the knee and the lateral leg chain. Dr. Neves emphasizes that strength training should be tailored and coordinated between physical therapists and coaches to prevent supplementary workouts from adding fatigue to already inflamed tissues.
The Risk of Masking Symptoms with Medication
Relying on painkillers and anti-inflammatory drugs to get through workouts or reach race starting lines is a dangerous habit. These medications merely mute pain signals without addressing underlying biomechanical or metabolic causes. Running under their influence removes the body's natural defense mechanism and accelerates injury severity.
Furthermore, using medications prophylactically before long-distance events places extra strain on the kidneys and liver during periods of dehydration and elevated physiological stress. Local corticosteroid injections into tendons or the plantar fascia also require extreme caution, as they weaken tissue fibers and significantly raise the risk of a complete rupture during a run.
Longevity in the sport requires the discipline to stick to prescribed training paces, adjust volume around daily life, and recognize that rest is a fundamental part of training. Managing expectations and seeking professional evaluation before symptoms escalate will ensure runners stay healthy on the road for years to come.
PUBLICIDADE (GAM) — 1250x250
