03/06/2026
I was hesitant to post about this on social media because it’s a nuanced topic (and social media isn’t exactly known for that).
But this is one of the more frequent conversations I have with returning runners and fundamental to returning from injury.
After an injury, how do you know what any pain you’re feeling means.
There has been a reframing in pain research that pain can be a protective output and is not necessarily a direct measure of tissue damage.
That means your nervous system can create phantom sensations of pain and even after your body is technically healed.
I’ve included the framework I use in my coaching practice to think through symptoms with athletes. It is not a diagnostic tool. It is a way of organizing observations. These are broad ways to categorize the type and appearance of pain.
Two things I want to be very clear about:
First- This is not medical advice and it’s NOT a diagnosis. In some situations: anything that lasts more than a couple of days, anything that escalates or increases over time, any sharp, acute pain, anything that worries you, goes to your medical team.
Second- if you’ve felt confused, second-guessing, exhausted by trying to figure out what is or isn’t a problem, that is completely normal. You are doing the harder half of the work that returning from injury: the mental return. Structured progression, graded exposure to running, in the right doses, with the right adjustments helps refocus the body.
Save this as you return to remind you how to navigate the mental challenges as you return.
Send it to the runner you know who’s trying to figure out their way back.
