Ask the Coach: Pain and injury

Q. I have a question that I hope you can shed some light on. I'm a runner, running approximately 20 miles each week. I balance the running with yoga one or two times a week, some other cross-training activities such as the elliptical machine, and weight lifting. Recently I've noticed that my right hip hasn't been feeling quite right ... slightly painful when I turn my body a certain way or hold a yoga pose such as triangle.

My biggest fear is an injury that will prevent me from doing what I love -- working out. Do you think it could just be a case of me needing to back off a bit and have a lighter week or should I see a physician for pain like this?

A. There have been a few questions along the lines of pain and injury. I'll try to address several of the questions similar to Stephanie's, in this reply. First, there's a difference between discomfort and pain. There are a few types of physical discomfort. One type is typically muscular in nature and goes away by decreasing intensity within a workout. A second type of physical discomfort is the kind that shows up a day or two after a hilly ride, run, or a tough weight-room workout. This is called DOMS or delayed onset of muscle soreness. These types of physical discomforts are common to athletic training.

Pain, on the other hand, comes in various levels, some of which need the attention of a physician. Pain that surfaces after a workout, like a bit of knee soreness, but goes away either the same day or within 24 hours is probably nothing to worry about.

One of the most common immediate treatments recommended by the medical experts to speed this kind of pain or injury recovery is RICE (Rest, Ice, Compression and Elevation.) An option is to take anti-inflammatories (aspirin, ibuprofen and naproxen sodium.) Be cautious of consuming anti-inflammatories for any extended periods of time as they can cause stomach and other problems. Also be careful working out when you are taking anti-inflammatories since they mask pain and can put you at risk of further injury.

Pain that occurs during a workout, but doesn't force you to stop, can be treated the same way as after-workout pain. In this case, consider taking a day or two off to rest, giving the injury a chance to heal.

Pain that occurs throughout a workout, interfering with your ability to complete the workout, pain that forces you to modify your form, or pain that persists when you are doing normal activities outside of the workout world needs attention. You are injured -- take a few days off, use RICE, consider anti-inflammatories, but also seek professional medical attention. Too often athletes try to train through an injury, only making it worse. It's important to learn the difference between discomfort, minor pain and injury.

For self-coached athletes, it's important to plan a rest week about once a month or so. This means intentionally reducing training volume to about half of "normal" to allow your body a chance to absorb training benefits. You can keep some intensity in the workouts during your rest period, but be sure to actually feel rested at the end and eager to start working out again. Take a break before a break takes you.

Do you have a specific training or sport related question? Have world-renowned coach Gale Bernhardt answer it! Send your questions to

Gale Bernhardt was the 2003 USA Triathlon Pan American Games and 2004 USA Triathlon Olympic Coach for both the men's and women's teams. Her first Olympic experience was as a personal cycling coach at the 2000 Sydney Olympic Games.

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