Injury vs. Niggles: How to tell the difference and what to do when either strikes

Coach Hayley [00:00:00]: As soon as you start panicking about that injury, you're gonna be increasing your stress levels, and that's actually probably gonna make things even worse. So I have found that not panicking about a niggle is actually quite helpful. But it can be hard, especially if you've got, like, a big race coming up. So well done if you cannot panic about it because I haven't really mastered that yet.

Cory Nagler [00:00:21]: That clip from coach Haley Munn is a bit of a teaser for a discussion on managing running niggles and injuries, Including the impact of nonexercise factors like stress and sleep. Haley is currently a full time coach with our team, but has a background in physical therapy And joins us to discuss the difference between niggles and injuries as well as what you can do about each of them. This was such an interesting conversation. That's entirely changed my perspective on injury prevention and treatment. I don't wanna spoil everything, but Haley is a huge advocate for a holistic approach to treatment That's tailored to the individual. I know injuries can be a huge source of stress, and even the most experienced runners can struggle to separate a small niggle From a more serious injury. Me and Haley go on to discuss tons of great tips for staying healthy and injury free. So stay tuned for some great topics that include, What is a niggle and how is it different from an injury? How thinking more positively about an injury can actually help in the recovery process? How much whining is appropriate if you think that you may be injured, and strategies you can use to maximize your chances of getting to the start line in good health.

Cory Nagler [00:01:26]: So let's get into it with injuries versus niggles. Hello, runners, and welcome to the Run to the Top podcast, where our goal is making you a better runner with each and every I'm your showrunner, Corey Nagler. And I'm not an elite runner, but together, we'll explore new strategies and topics to take your running to the next level. This podcast created and produced by the expert team of coaches at runnersconnect.net, where you can find the best running information on the Internet as well as training plans to fit every runner every budget. Alright. Hailey, welcome to the show. Excited to have you here to talk with me about injuries and niggles. And my understanding is you are not only healthy, but just crushed your 1st ultra marathon.

Cory Nagler [00:02:19]: Is that correct?

Coach Hayley [00:02:21]: Yeah, it is. I mean, I can definitely feel it today. I am very, very sore. Not injured, touch wood. I mean, I don't think I am, but my legs ache so much that it's hard to tell at the moment.

Cory Nagler [00:02:34]: Yeah. And, so how far removed are you from that ultra marathon? And is it starting to feel a little bit better?

Coach Hayley [00:02:40]: So this is, like, 48 hours later. So it was on Saturday. So I think that's when DONGs is kind of at its worst. So I am in a bad way right now. The stairs are definitely hard.

Cory Nagler [00:02:54]: Yeah. Yeah. I can imagine. I think whether it's a marathon or ultra any of those ultra endurance events, they they hit you hard for a long time. Curtis, just because our topic is related a lot to those little funny feelings, nickels, and and injuries, where where does Dom's or, any muscle soreness kind of fit into that Spectrum.

Coach Hayley [00:03:13]: Yeah. I mean, that's an interesting question because, there isn't actually, like, a universal kind of, agreement on what actually causes dongs. Like, it's not solely a case of muscle damage. There's probably, like, a lot of other things going on as well. Like, it's kind of out of proportion to the amount of damage in the muscles. So, I've had theories, like, to do with, like, nerve endings being affected and, like, different, chemicals being released that sort of sensitize the nerve endings, things like that. Because, you know, obviously, it feels like worse than than some injuries that you get. Like, I mean, I I literally car walked down the stairs, and it is quite painful.

Coach Hayley [00:04:01]: But, the actual amount of damage there is probably not anywhere kind of in line with that. And obviously, hopefully, most likely, in a few days, I'm actually gonna be feeling fine. So even though it kind of maybe hurts more more than a lot of injuries, a lot of injuries than I've had anyway, it it's not so much a case of damage, and it's gonna heal up just fine in a few days. But, yeah, I think Dom's is a really interesting one. Just because we don't fully understand why it happens. And, you know, there's not a lot you can do about it, which is unfortunate for me. Yeah.

Cory Nagler [00:04:45]: I think we've all had that kind of penguin walk after a tough race where you're you have that soreness, and it it's tough just to get around. Yeah. Just coming back to our topic for today. So you have a background in physical therapy. What do you think is the difference between a niggle, and what is a niggle, versus an actual injury? And then another thing I'm curious on is, Is the term niggle something you actually use, when you're when you're studying some of some of these ailments, in PT school?

Coach Hayley [00:05:17]: Yeah, so firstly, I have to say, I'm not, like, I'm not currently, like, a physical therapist. I don't work as one. Like, I did the training, but then chose not to, like, join the register and thing. Like, I just, chose to become a coach instead, which is kind of more my passion. So I'm pleased about that. But, I guess to answer one of your questions, a niggle isn't really, like, a term that physiotherapists we'd routinely use. And there's not really, like, a direct definition of it. Obviously, we runners kinda use it all the time, and I use it.

Coach Hayley [00:05:56]: But there's not like a dictionary definition of it. There is probably a dictionary definition of of injury, which would be like actual tissue damage occurring. But then in some cases, that hasn't actually happened, which which is kind of an important point. That, pain and damage aren't the same thing, which I kind of alluded to with with the Dom's discussion, so you can have, like, no tissue damage and a lot of pain or tissue damage and no pain, which I think is quite relevant to to the discussion. Because then when we're thinking of, like, an injury and a niggle, you know, it's not that 1 is kind of, oh god. There's a lot of damage there. 1 is like, there's no damage there. I think when we run a user, it's more used to describe how much pain we're having.

Coach Hayley [00:06:53]: Am I right? Like we say it's a niggle if it's a little bit uncomfortable, but we call it an injury if we're like, you know, it's it's affecting our running a lot. It's really painful. So there's probably, not a definition of such. And I I didn't really hear physiotherapists use it. But I definitely do use it. I think how I use it is I'd call a niggle more, like your body's warning sign that you need to address something. Whereas an injury it's more related to damage actually having occurred. So whilst that's not always the case, I think it's a good general rule.

Coach Hayley [00:07:38]: So when you've got a niggle, your brain is trying to protect you, because pain is like an output of the brain, which is kind of a complex topic. So, I'm gonna I'm gonna give some resources for for people to read about when I start to explain this stuff because, modern pain science has kind of taught us a lot, which isn't necessarily what people understand or have been taught. But the the pain that you feel isn't necessarily related to the damage that you have. What it what pain is is a warning sign that your brain is giving you to tell you that you need to address something. It wants to protect you. So I like to think of a niggle as as that happening, your brain telling you, look, you need to address something or you are gonna damage the tissues. But in the case of a niggle, not always, but often the tissue damage hasn't actually occurred yet. Whereas when you've got an injury, it's often when you've ignored that niggle.

Coach Hayley [00:08:43]: And therefore, when your brain's been warning you, wait. You could be doing some harm. You've kept running or you haven't changed something. Then you've actually caused tissue damage to occur. Does that make sense?

Cory Nagler [00:08:54]: I think it makes sense. It sounds like the the nickel piece is more an an injury or Sorry. A a warning sign of a potential injury oncoming. Yeah. Is that correct?

Coach Hayley [00:09:05]: Yeah. That's how I like to think of it. Like, with a niggle, you might be feeling something that's uncomfortable, but often, the body hasn't actually been damaged. Your brain is just producing this pain to tell you, wait a minute. You need to change something. Don't just keep doing what you're doing. So you want to take action. But also there's probably nothing actually wrong with you yet.

Coach Hayley [00:09:34]: That's how I like to think of a niggle. Whereas when I think of an injury, I think tissue damage. There might be some swelling. There might be some bruising. There might be some redness. Like, tissue damage has occurred. Now it's more a case of healing rather than prevention. Like I said, people use these sounds in different ways.

Coach Hayley [00:09:50]: That's kind of how I've come to using them and what I like to think of them as.

Cory Nagler [00:09:56]: Yeah. And I I I like having the the perspective of a a coach with a PT background because I think runners have a tendency to use Nagle in a sort of dismissive way as a way to sometimes pushing off, taking any action, if something doesn't feel right, perhaps even if it is pretty severe pain, often runners have a high tolerance. So assuming you don't have any kind of redness or swelling or very obvious visual cues, how do you think runners can tell whether it Truly is just a niggle or a warning sign or whether there is some of that tissue damage present?

Coach Hayley [00:10:30]: Yeah. I mean, it's very tricky. And to be honest, you can't fully tell, like, hunt you can't a 100% know. Like, I know athletes who have gone, oh, I've got a niggle in my shin. And they've they've literally trained for for 3 weeks with this niggle in their shin. And then they just decided to get it checked out, and they've got a stress fracture. So you you can't really know for sure. You know, like you say, pain is pretty subjective.

Coach Hayley [00:10:57]: And as I mentioned earlier, pain is not equal to damage. Pain is like pain is like our brain's warning signal, and how much damage it, like, how much it thinks it needs to protect us, rather than an accurate measure of the damage to the tissues. So, like, some people might have a lot of damage, but not actually really have much pain. Whereas for other people, they might have, you know, just the potential for damage or a little bit of damage, and they might have a lot of pain. Like, it's really it's genetic. You know, your individual kind of pain threshold, is it's related to a lot of things like, how much pain you experience is related to many factors other than the state of the tissue itself. So it's very hard to actually know. But that being said, I do have some some things that I consider to be a little bit more worrying.

Coach Hayley [00:11:51]: And when I might tell someone to to seek help sooner or consider cutting their training back on or not running at all. So I'm definitely always more worried about a pain that worsens throughout the run. And these are just kind of general things rather than, like, you know, like gospel or anything because they can still, still not be completely right. You know, you might have these things and still have a little bit of of an actual tissue damage. But I found them to work pretty well for me. And, actually, in my kind of 20 plus years of running, I've kind of been right pretty much every time. So they have worked they have worked for me. If something's getting worse throughout a run, that's a bad sign.

Coach Hayley [00:12:37]: If it seems to warm up as I go, like, just kind of ease out, then I'm less worried. If it's just getting worse generally over, like, a matter of days or or weak. I'm more worried rather than if it's just staying the same. I I kind of take more of a more of a a kind of concerned approach to to pain that seems to be like on a on a bone, like like a shin or a foot kind of pain that that does feel like it's on a bone, because then it can be suggestive of a stress fracture. I think that the level of pain, although I as I said, it's not completely related to damage, it is important. And not just for the reason that it can suggest a more severe injury, because it doesn't always. But just because if you're running in a high level of pain, you're likely gonna be not running as you normally would, and that's just gonna, put you at risk of actually stressing out other tissues and and causing other problems. So a very high level of pain for me says, okay.

Coach Hayley [00:13:43]: Stop running and just kind of reassess this, or see if you can do something to to get that level of pain down. I'd never want someone to be running with a high level of pain, damage or or no damage. I think that's just bad on a lot of levels. And it's kind of a a sort of vicious cycle that you can get into of just, you know, getting kind of a well, more chronic pain, kind of developing where you you just have pains that kind of move around. There's definitely things I've seen before. And that's when you need to kinda stop and and make sure that cycle doesn't doesn't start.

Cory Nagler [00:14:19]: Yeah. I I think that It's a great point about making sure it's not getting worse, whether it's on the run or or outside just because, again, runners, We we tend to wanna run and it's, it it's hard to forget that sometimes these things will will progress if you don't, take action to resolve them.

Coach Hayley [00:14:37]: Yeah.

Cory Nagler [00:14:38]: Yeah. I mean Oh, sorry. Go ahead.

Coach Hayley [00:14:41]: No. I was just gonna say, for me, because I, like, I feel like I know my body quite well. I sort of take an approach of also, have I had this before and what happened then? Because there's a difference between a new pain that pops up, and something you've had before that keeps kinda coming back or is like a common issue for you. Often when there's a new pain, it's a bit more concerning. But when there's a pain that keeps coming back, especially if you've had it before and you sort of know what improved it or, you know that it didn't just keep getting worse and worse. I think that can be less concerning. It also less can be less kind of suggestive of damage because there's good research that, if you've had a pain for a certain length of time, your body actually can even, like, learn that pain. You your kind of nerve connections in your brain get kind of stronger, so your body can produce that pain even if the damage or what caused it isn't there.

Coach Hayley [00:15:41]: So then you you kind of can be less, less worried that there is some damage there. That's not to say that you wanna just keep running through it and not take any action. But I think pains that I've had before always less worrying to me than a completely new pain. Unless, of course, they're a pain I had before and it had disastrous consequences, then then I might worry.

Cory Nagler [00:16:04]: Yeah. Definitely. So I wanna kind of walk listeners through how they might respond if they think there's potentially something going on beyond just A niggle or a warning sign. And as you've said, it can be very difficult to actually tell if there is something wrong, let alone What that damage might be. So, I guess, going through the steps, if you think there's potentially an injury, where might you go to to seek that, professional help or somebody to help you identify it. And then once you've done that, before you're waiting to see somebody, because oftentimes that Depending on where you live in the medical system, there can be a gap there. How do you respond? Like, can you keep training in that time? What do you think?

Coach Hayley [00:16:46]: Yeah. So, like, firstly, to address your question about who to see. I think there's so many different types of practitioners out there now. Right? Like chiropractors, osteopaths, PTs, sports doctors, even, like, just general doctors and massage therapists. Like and I think the actual type of practitioner is, like, less important than one that you've got, like, a good relationship with and he has, like, have kind of kept themselves up to date with, like, how the field has changed and, the most more recent research in in sports medicine. So, like, I think just have someone who either kind of build that good relationship with, you know, a physical therapist or or a sports doctor early like, even when you're not injured, just have someone you go to see to kind of get, like, a general check or if you can. I know it's kind of expensive and not always, like, available. But I think just having that person who, like, kind of does know you as an individual a bit as well.

Coach Hayley [00:17:48]: And, like, understands how important running is to you. And also, like, your sort of background and, like, how what you're doing and and, like, what your goals are, I think it's kind of really important to have someone who you have that relationship, if it is possible at all. And, like, that's something you can, kind of, do before you even get injured. You can, kind of, just, I know that, in the UK, physiotherapist often offer, like, MOTs, where they'll just tell you, like, you know, you can do these strength exercises because you're weak here or whatever. And I think just having someone like that, who you know you can trust and, go and see if you do have a problem. It's kind of a a great thing to establish if you can, even, like, before you're injured. But then if you don't already have a person like that, just getting recommendations from other runners can be really helpful because I've had quite a lot of bad experiences with, you know, therapists and doctors who don't understand runners and I think it's really important that they do. And then also that they do have, like, that kind of modern physiotherapy training.

Coach Hayley [00:18:59]: I think anyone who tells you just stop running completely without, like, a good reason, I would be a bit distressful of. Like, anyone who's, like, really quick to tell you to stop running completely without a good reason or if you're not in, like, the kind of pain that I said was, kind of not great to to continue with. But, I think any practitioner who doesn't consider you as an individual and ask you about other aspects other than your training. Physiotherapist these days get talked a lot about what they call the biocyclesocial model. So they don't just consider, like, the biology of a person. They'll ask about, like, their their sleep, their stress, because all of these things have a massive impact on pain levels. And if they don't start asking about those things, they're probably not they probably haven't got that kind of modern training, and they might not be able to give you the best treatment plan because they might not be considering you kind of holistically. So I think it's just really important to find that person you have a good relationship and who seems to have the experience with runners and the correct training.

Coach Hayley [00:20:10]: Because, there are lots of different practitioners out there. And it's not that, like, one is better than the other because you can have, you know, a physical therapist who who kind of doesn't understand runners and and hasn't kept up to date with the latest training. Whereas you could have, like, just a general doctor who has. So I think that's kind of more important. I mean, obviously, you want some with a with a qualification in sports sports injury. But there are so many different people you can see these days. And the exact person that you see is less important than, the exact type of person you see is less important than than, you know, their experience and and sort of expertise.

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Cory Nagler [00:23:19]: Yeah. So if if runners don't have that preexisting relationship with, with any of those categories in the medical field you brought up, what what what should somebody be looking for? Is it really just a matter of who has the most

Coach Hayley [00:23:41]: recommendation from other runners is important. Because runners tend to be good at at, kind of, picking therapists and things that they like, and that kind of often tends to be ones that are pretty good because they're asking about them as a whole person. They're considering how important their running is to them. So I think recommendations from other runners are useful, whether you, like, post on your your club's Facebook page or if if you have one or, just like asking any runner friends. I guess, like, if you if you can't do that, I suppose it differs per country as to, like, how you find them. Like, you can look on, like, registers and and things. But, I guess when you see them, you wanna just be sure that they're asking about you as an individual. They want to know, like, about other things apart from just your training, they have experience with with sports people, like because often for us runners, the amount of exercise we do kind of seems a bit insane to to, sort of, people who if you don't run or don't do a sport but we know fast, it's it's pretty normal.

Coach Hayley [00:24:53]: But, the the sort of general idea of exercise these days, you know, it makes us feel like we're doing kind of really a lot. But for us, it's normal and we know that. But if you see someone who doesn't understand sports people, it just have become a bit of a, like, guilt trip situation where they're like, oh, you're doing all this running. No wonder you have these pains. And that's just, like, the worst thing. And if that kind of conversation start to come up. That's when I would probably find another physiotherapist or of whatever therapist or doctor you're seeing.

Cory Nagler [00:25:39]: Okay. So let let's assume that you have some type of help, and and you have a sense whether you're dealing with a niggle versus an actual injury. How would you, kind of, separate the 2 in terms of how you approach them? So I guess, kind of, first with a niggle, how would you recommend somebody in order to make sure it doesn't turn into an injury. And then if you have an injury, what does that treatment process look like, is is kind of a generalization. I know there's a lot of different injuries.

Coach Hayley [00:26:05]: Yeah. I guess, like, because, like we we said, like, the pain and damage aren't necessarily, like, completely correlated. And because, like, a nigger that a runner thinks is a nigger could actually be something more, that diagnosis is really important, like you say, if if it's something someone is concerned about and and isn't resolving. And then once you kind of get the diagnosis, it really does I think more than whether it's a niggle or an injury, it kind of just depends on the location. Like, I know, that makes things probably a bit more tricky, but, it's really hard to to come at it from the niggle versus in g angle. I guess, like, I guess it it's more in terms of, like, the kind of, the strength of the response that you kind of throw at it. So with a niggle, you maybe don't need to take such drastic action. Like, obviously, it really does depend more on the type of injury, like soft tissue versus bone, you know.

Coach Hayley [00:27:16]: But, like, with that niggle because, if we do think of it how we thought of it earlier, in that it's your body warning you, but the damage hasn't really occurred yet, then it's likely that you can make some changes to your training or life that kind of prevent it getting worse and starting to to cause damage to the tissues. So I think that's when you kind of and this is hopefully what a good practitioner will help you to do. Like, looking at all areas where, all areas that could be having some kind of effect on that niggle and making sure you're kind of taking the right steps to improve things. So, if you look at, if you're looking at the training side of things, can you change your training? Like, if it's attending in, attending complaint, can you, cut down speed work but still, you know, keep doing easy running? Because in a lot of cases, that can help with attendant complaint. Like, you know or if it's more like a loading thing, can you decrease your mileage. Like, if we're thinking about it as a niggle in the way we talked about a niggle earlier, we don't need to maybe do something drastic. Like, stop running completely or, yeah, take complete time off or whatever. It might just be, can we reduce the load if it's kind of a load related injury? Can we reduce the speed work if it's more like a tendon complaint.

Coach Hayley [00:28:44]: But like I said, a good physiotherapist will continue will consider, like, the whole person. So, like, they'll use what they call the biopsychosocial model. And there is a really good, a practitioner that, like, writes a lot about this and does a lot of, you know, videos and and resources about that. So, she's called, doctor Rachel Zofnes. And we can, like, maybe add a link to that in the show notes. But she she writes a lot about this biopsychosocial model of pain, and how you need to consider, like, the whole person because it's not just the training that you're doing that's that's impacting on your pain levels. So if we think maybe about more like the, psychological side, like how do you stress? And the lifestyle side, like, how's your sleep? Those things are really important when you're thinking about preventing the niggle getting worse. Like, they might not seem to be, but actually, they could be even more important than changing your training.

Coach Hayley [00:29:44]: In a lot of cases, perhaps just getting some more sleep and reducing your stress levels could put your body in that kind of state where it's actually building up rather than breaking down without any changes you're training. So I guess it's about considering all the areas, like, holistically, like sleep, stress, training, nutrition, and strength training and thinking, which of these am I not quite getting the balance right? Like, yeah. Maybe my training load is sensible, but, like, is it considering I'm not sleeping well and I've got a lot of stress? I've got, like, you know, like a job interview or an exam. Like, in that case, maybe my train load isn't sensible given those conditions. So I need to either change the stress and sleep or change the training load. Like, it just gives you a like, I think the biopsychosocial model just gives you a lot more angles to kind of look at when you're considering the needle and trying to to get it kind of to to get under control and not get worse. And I know that I've had things crop up when I've had a lot stress going on and perhaps not sleeping well and without even increasing my training. And then when when the stress is resolved, it's actually gone away because my body's in a kind of more positive state and can actually can actually, like, heal and get stronger.

Coach Hayley [00:31:04]: So yeah. I think for a niggle, it's just a case of assessing, seeing what things you could do better. Like, have you have you increased too quickly or not focused on recovery? Whilst also not panicking, because I think that can kinda make things worse. And definitely within that biopsychosocial of mod model of pain, which hopefully we're gonna link to, one of the things that can make pain worse is is stress. So as soon as you start hanging and panicking about that injury, you're gonna be increasing your stress levels. That's actually probably gonna make things even worse. So, I have found that not panicking about a niggle is actually quite helpful. But it can be hard, especially if you've got, like, a big race coming up.

Coach Hayley [00:31:47]: So well done if you can not panic about it, because I haven't really mastered that yet.

Cory Nagler [00:31:54]: This this may be a detour from our main discussion here of how to deal with an injury, but, but I think it's very much related. You touched on this piece of stress and rest and all that being very related to injuries. How much of this is actually stuff when as you were studying PT that would Come up? Or or to what extent do you focus on that, that stress piece in comparison to, I think, where people's mind immediately goes, which is kind of the more physical rehab?

Coach Hayley [00:32:19]: Oh, you know what? I don't know whether it's the same in every country, but, like, physical therapists in this country, they love the biopsychosocial model. Every exam, it's like I'm pretty sure the mark Dean says, did they consider the biopsychosocial model? Did they consider the person holistically? Like, it's just it's just like the thinking on injury, especially I don't know what it's like in other countries. But in the UK, the thinking that physio physiotherapists have taught, at universities and the way they're they're trained and examined on is completely switched. Like, I know when I was when I was younger running, when I was, like, a teenager running, I would go to physiotherapist and he would just be like, oh, what what's your training like? We need to change your training. But when I did the physical therapy training, like, every class, it was like bringing it back to this. Because there's all this new evidence inside, which is so interesting, but way too broad a topic for me to go into on this podcast about how these, like, psychological factors, like stress factors, social factors, like, affect pain levels, affect healing rates, like, how it's all so interconnected that it just can't be separated. And it's like it is physical therapy training these days. Like, it's basically, you know, considered with every, every kind of musculoskeletal complaint, that that was kind of taught and discussed.

Coach Hayley [00:33:47]: Like, it's it's like the new way they think about it, really, and they always bring it back to that. So, it's great there. It's given me, like, a new way to help athletes as well because I feel that there's so many more avenues to kind of address if someone because if someone has an injury and they've changed their training or or a niggle or a pain, you know, like I said, I'm not, a massive fan of, like well, I am not a massive fan of kind of putting them into different pockets because I think, like, it all occurs on a spectrum. And, like, when does a niggle become an injury? It's so blurred. So kind of find it hard to think about it that way. But, it gives you if we just call it, like, pain for now, it gives you so many other ways to address pain and discomfort. Because there's so many cases that where an athlete has changed their training, but it things haven't resolved. And they start again, and it just keeps coming back.

Coach Hayley [00:34:40]: But now with, like, the new training that I learned, and I keep learning about it even though I'm not trying to be a physical therapist anymore. I try to keep up to date and read all the latest things. And, and I feel it's given me so many more avenues to kind of talk to athletes about because there's so many cases where they do all the right things, and the injuries are better. But then you start to dig deeper and you find out they're not sleeping or, they're so stressed or even that they're so stressed about the injury. It's amazing the research that suggests that fear of an injury makes the pain worse. Like, because pain is generated by your brain to protect based on its kind of assessment of the situation like, pain neuroscience is actually so fascinating, and they teach a lot of that. Because because the pain is a result of your brain trying to protect you from hurting yourself, if you start to worry a lot about that pain, you're actually your brain is just actually gonna ramp up its protective mode more, and you're gonna feel that pain more intensely. So in some cases, actually, physiotherapists just use, like, reassurance and, like, say to someone, okay, look, this is not there's no damage here.

Coach Hayley [00:35:52]: This is this is just something that's tight. We can do strength. We can do some kind of load management, and this will heal. In in some cases, that actually just really helps people with pain. And considering things like this, I just find it so useful because it's just giving me whole new ways to help athletes who do have persistent injuries. And I can actually refer them to these resources that I've learned about and say, like, I think this will really help you. I think, actually, one of the reasons your injury isn't clearing up is because you're working kind of 40 hour weeks, not because you're not because you're training. You know? Like, I've had quite a lot of situations like that with my athletes, and I wouldn't have I probably wouldn't have considered that in the past.

Coach Hayley [00:36:30]: But since since doing physiotherapy training, I just feel so much more equipped to help athletes. And myself, actually. You know? Like, I've I've had a lot more success in reducing my own pains and aches and pains. Since learning this, I've been able to keep myself running, touch wood.

Cory Nagler [00:36:50]: Yeah. Well, again, based on, recently completing an ultra, I think it it seems to be working in the health department. I'm sure there was a lot of mileage behind that.

Coach Hayley [00:37:00]: Corey doesn't mention that I actually got lost on this ultra, so I wasn't able to help myself. I I can be as injury free as I like, but, you know, I still can't navigate. So there's, there's still a problem there.

Cory Nagler [00:37:14]: I guess there's no amount of PT that can prepare you For, staying on a race course in the woods?

Coach Hayley [00:37:19]: No. No. I just need maybe some, like, map reading skills or I don't know. Just more more, like, focus would help rather than being like, oh, you know, look at the beautiful scenery. I'm so I'm so pleased to be running this ultra. And then you realize you're, like, 4 miles out of the way, and things don't seem so happy anymore.

Cory Nagler [00:37:39]: No. And it and it is a tough balance. But I get on the whole when you touch on this relation between stress and injury that, on balance, one of my takeaways is that being a a happier runner, at least a less stressed one, is is likely to lead to, preventing injuries. Is that fair?

Coach Hayley [00:37:56]: Absolutely. Yeah. Like, yeah, just being kind of relaxed and calm and your if your muscles are relaxed, then, like, then you're putting yourself in the right state for kind of healing for, like, rebuilding, for recovering, and that's just so important as well. And I think it does get forgotten about. I know that to me, I used to get way too stressed about running, and I definitely experienced a lot more aches and pains. And with the kind of new things that I learned doing the physical therapy training, I think it all makes so much sense. So, yeah, I 100% agree with you. Plus it's just running is a lot more enjoyable if you kind of, make the effort to kind of do things that you enjoy.

Coach Hayley [00:38:39]: And, I think often, like, physiotherapists kind of talk about, again, especially in this country. I don't know, in other countries but a lot of UK physiotherapist talk about kind of, for a lot of people, it's helpful to kind of focus less on the actual pain and just focus on your, like, overall wellness and your overall recovery, and your overall kind of happiness. Because, like, mental health actually has such a huge bearing on injury, and pain. And there's so many studies, like, linking those things. And, I think it can seem really unusual to people if they've not considered that, but there is just such such links between things like anxiety and feeling down and low mood and pain, and, like, it's such a new concept to some people. But, like, I think if you think about it, you'll you'll probably find examples. People will probably find examples in their own running where they've they've kind of felt stress or they felt low and, like, some some injury has felt worse. Like, some kind of persistent thing that they have has kind of popped up or, like, something they've been struggling with it's felt worse.

Coach Hayley [00:39:44]: Or even they've developed a new aid campaign. And, and now we have, like, science to back this up and research studies to prove it. And, like, I think it's just such a great and interesting area. And there's so many great, like, people who talk about it. Like physiotherapists and, and sports doctors and even psychologists, you kind of publish videos and books and things on this area, and it's just a whole new and, like, fascinating area.

Cory Nagler [00:40:12]: Yeah. I I couldn't agree more. I think it's it's completely fascinating how much, just mental training can can Play into all of this. Just taking it back to kind of the practical what what when you are facing kind of a discomfort, we'll call it, In dealing with it, you you've already mentioned that for the most part, with the exception of some really serious injuries, generally, some type of running or exercise It's going to be okay. So bringing that in mind, I think, again, runner's temptation is always more and more and more to wanna push through it, which may also not be the answer. So No. I'm hoping maybe you might have some kind of golden rule or general principles runners can follow if they wanna know what is that Right amount of load, to continue doing if you're experiencing some kind of discomfort? Yeah. I think, like, the most important thing is just that it's kind

Coach Hayley [00:41:04]: of a positive experience, you know? And I know that's also kind of a bit subjective. But, like, say you went for a run, and you were like, that wasn't that bad. It was actually better than I expected. Like, that's, like, a yes. But if you went for that run and you were like, oh, that was terrible. I really didn't enjoy it. I can't you know, I don't wanna do the next one. I'm not looking forward to it.

Coach Hayley [00:41:24]: And that's kind of a negative. And that's like, you're doing something wrong. Like, do less. And that less might be stopping, or that less might be just shorter. Like, you wanna just keep reinforcing that positive experience. And that's, like, another thing that's really big with physiotherapists here. Like, rather than just setting, like, a standard rehab or a standard kind of running progression is, like, did you, like, assess how you felt? Was it a positive experience? Did you feel things were better than you expected? Like, I think better than you expected is such a, like, a key phrase, like, if it was, like, worse than you expected and you felt really like, I don't think it's getting better. Like, I dread this run.

Coach Hayley [00:42:03]: Like, that's, like, a negative. And, and I know this is quite subjective as well, but I've used this rule and I found it easier than I thought to apply. Like but if you went for a run and you thought, ah, that was actually positive. Was better than I thought it was gonna be. Like, it's generally on the up, then, like, you're doing things right. And it can be a little bit of trial and error trial and error. Because you might go for a run and think, oh, no. Actually, that just made it worse.

Coach Hayley [00:42:27]: And, like, that was too much. But then, for the most part, that's just, like, okay, and that might happen. And and, you know, as long as it's not one of these, like, serious things that we talked about and, like, got that okay, hopefully, from, like, a a practitioner who say you can run or, like, you yourself have decided, like, you don't think this is kind of a serious thing for now. It's, like, not the end of the world if you do do a little bit much and flare it up. But then, like, you need to learn from that. And, like, the next time, do less until you do find that that sweet spot where you're having that positive experience, and it's generally better than you expected. And then hopefully, you can just kinda increase more and more while still, like, positively building where, like, you don't finish your run thinking, oh god. That was awful.

Coach Hayley [00:43:15]: You're kinda like, That was better. That was better than I thought it was gonna be. And, like, it wasn't that bad. And that's kind of the state that you wanna keep in. Like, that's not to say there was no pain. That's just, like, That wasn't, like, you know, that wasn't awful. I still enjoyed it. Like, I think enjoyment is a really good, a good test, actually.

Coach Hayley [00:43:32]: Because if something hurts, like I mean, maybe not for some runners because some runners just, like, love pain generally. But, like, I think, for me, definitely, like, I've had pains where I thought, oh, I just dread running. I just hate it because it hurts. And those ones, you you just shouldn't be doing what you're planning to do. Like, you should do I mean, if it's at that level, you should probably be cross training, like, or depending on the thing, like wrestling. But, like, you know, there's runs where I've gone for a run and I'm like, That was actually okay. On balance, I really enjoyed it. Then, like, it's a kind of a sign that you're doing the right thing, and then hopefully, you can do more and more feeling like that and not, like, flare it up.

Cory Nagler [00:44:11]: Yeah. Generally, when I go to my chiropractor or physio, they often use this, know, is it worse than a 3 out of 10 or or getting better? And it's it's hard to quantify what, what a 3 out of 10 is.

Coach Hayley [00:44:22]: I do not like pain scales. Like, I feel like somebody's 3 out of 10 is, like, another person's, like, 8 out of 10. Like, it just yeah. It just, like, it doesn't seem great to me. Like, I mean, I I kind of have used it in the past, so I'm gonna put my hand up there. But, like, I try to get away from it. Like, I try to use, like, more, like, descriptive things. Like, do you feel like it was getting worse? Or, like, you know, did you feel like it was better today? Rather than, like, what was the pain out of 10? Because I just felt, like, so, so subjective.

Coach Hayley [00:44:58]: Like, literally, there are studies where, like, many people had exactly the same damage on a scan, but for that same damage, 1 person's pain was, like, a 10 out of 10, and 1 person's pain was, like, a 2 out of 10. So, like, pain is just dependent on so many factors, like, like, just getting back to all this modern pain sciences. Like, science agrees now that it's the brain that causes pain, and it is not in correlation to the tissue damage itself. Your brain kind of your brain has these inputs from the area, but then, you know, it has inputs from other areas that kind of give other information and that determines the pain level you'll feel, not the damage in the area itself. Again, there are people who do great videos on this stuff way better than I could ever explain it. So, check those out because it's, like, super interesting, at least to me, but I'm quite nerdy. So, yeah. Like, pain scale is kind of work, I guess, if you like.

Coach Hayley [00:46:00]: They can work if you're using them with the same person. You're always comparing like to like, but just going, like, what's your pain, like, to start with? Can be like unless you have that long term relationship with the therapist, like, it can be really, really just so varied between people.

Cory Nagler [00:46:17]: Yeah. And and just for context, I think my Cairo was great. And we do have that preexisting relationship, so I kinda know where that stands. But I think for me, just in terms of a way to think about it, May maybe that pain scale works really well for for others. But for me, I find that just, like, do I still look forward to the run, or is it so painful that I dread the run is kind of a good baseline.

Coach Hayley [00:46:37]: Yeah, definitely. Like, things like, are you changing your your stride as well? You know? Is it causing you to change your form? It's another good one. The the do you dread the run one is a great one. Yeah. There's, like, better ways of of quantifying or at least having some kind of quantification on the pain than, like, a number out of 10.

Cory Nagler [00:46:57]: Yeah. Yeah. Definitely. I I think this has been some great strategies For runners, but, you know, there's there's so much variety in the types of injuries that can pop up or the treatment can vary so much for One person versus another. Just to kind of put it all together and summarize, generally speaking, if a runner is feeling some kind of discomfort Further thinking, maybe it's a niggle, maybe it's an injury. What what do you think is the the overall approach they should be taking that's That's most likely to kind of put them on the right path to to healing? Yeah.

Coach Hayley [00:47:29]: I think the most important thing is to, like, I mean, it's hard to hard, but try not to panic. Try to make, like, a rational kind of assessment of the situation. Like, as if you were talking to a friend about an injury, and it wasn't your pain or discomfort or whatever. And, like, because everything is just gonna, like, take into account so many factors. Like, yeah. I was trying to sum this up, but there's just so much that going in that goes into it that it's hard to give a very quick answer, but, like, just consider your individual circumstances. You know, if you feel a pain and you think it might be a stress fracture because you've had one before, maybe you have some risk factors like red s or low bone density, then you're gonna think about it in way different way from someone who, has good bone density and has never had a stress fracture. You know? It's like, be calm.

Coach Hayley [00:48:23]: Assess your own personal circumstances. You know, maybe see if you can get in with that person that you trust. If, especially if it's been going on for more than, like, a couple of days. But if it's the 1st run you felt it, just don't panic. Like, the other thing to remember is that the brain is not always right. Sometimes you get a pain and the brain is literally making a mistake. Like, you should just stay calm and see how it, like, changes. If it's still because I've had so many pains that pop up on one run and then, like, never again.

Coach Hayley [00:49:01]: And that's because, like, because it's the brain that decides pain and not the area, it can make a mistake. Like so if you feel something once and it's not that bad, just wait and see if it's there the next day. Like, don't panic. If it is there the next day, maybe assess, like, what am I worried about? Could I change anything? Like, could I maybe do less today? Or, like, could I maybe not do that speed workout? You know, when things are still mild, you can still make decisions like this. And then, like, if it's a terrible pain, like and you feel like, oh my god. I don't wanna run. Then, like, you cannot immediately make that decision to say, okay. I'm gonna cross train tomorrow.

Coach Hayley [00:49:42]: Or if that even hurts, just rest. Like, I think it's just taking that calm measured approach. Understanding that pain is not always equal damage and that your brain can make a mistake and that, you can just see how things develop rather than making, like, rash decisions and thinking, oh, my race is over. You know, I think that kind of calm approach is is what's helped me most definitely in my own running.

Cory Nagler [00:50:07]: It sounds so simple, in terms of how to respond. If if if you're panicking, you might have an injury. The it's just Yeah. Don't panic. But easier said than done sometimes. Said

Coach Hayley [00:50:17]: than done.

Cory Nagler [00:50:19]: Yeah. Exactly. Hailey, thank you so much. I think we sought out today to kind of help runners distinguish and niggle from an injury and how to respond. And, ultimately, I think this classification of it

Finn Melanson [00:50:28]: all is a discomfort and

Cory Nagler [00:50:29]: of it all is a discomfort, and and how to really approach that for healing is gonna be really useful. So, hopefully, if you're listening to this, you've up some good insights to really make sure that you can stay healthy and, you know, continue on with your training. So thanks for joining me, Hayley.

Coach Hayley [00:50:44]: No problem. It's great to be back on the forecast.

Cory Nagler [00:50:47]: Awesome. Loved having you here. And to everyone listening, happy running. Thanks for listening to the Run to The top podcast. I'm the showrunner at Runners Connect, where as always, our mission is to help you become a better runner with every episode. You can connect with me on Instagram at Corey underscore Nagler. Birth your Strava by searching Corey Nagler, and please consider connecting with the rest of our team at runnersconnect.net. If you're loving the show, you can help us reach more runners by leaving a rating on Spotify or Apple Podcast.

Cory Nagler [00:51:29]: Lastly, if you want bonus content, behind the scenes experiences with guests, and premier access to contests, and consider subscribing to our newsletter by going to runnersconnect.netforward/podcast. I'll see you on the next show, but until then, happy running, everyone.