Minor knee pain, stiff hips, a sore shoulder… What’s an athlete to do?

Small niggles: those little irritations and tiny pain points that crop up during the course of training/everyday life. They’re pretty much unavoidable. A sore shoulder here, a twinge in your hip there, a feeling that something is clicking weird in your ankle. The little stuff that is annoying and maybe a bit painful, but it doesn’t scream “get help NOW!”

I wanted to re-post this (originally from 2002) article after writing about a crappy experience I had with a pushy massage therapist who was trying to convince me that my minor soreness was cause to instantly book 12x sessions with them. This article is the reminder that sometimes, you do need the help… but from the right person.

So, what do you do about the tiny pain points?

Over the years, I’ve been a big fan of the ‘ignore it til it stops’ school of thought, which worked pretty well in my twenties. But in my mid-thirties, well, let’s just say it’s not quite as easy to bounce out of bed anymore. These days, I’m a firm believer in treating things properly when they first come up.

I specifically say ‘properly’ because 10 years ago, my inclination when something was aching or sore would have been to pop some ibuprofen and get on with it. Pro tip: This is a terrible idea. (I’m still furious with the doctor who didn’t understand what Ironman training entailed and told me that if my legs were sore before any run, I should just take Tylenol and go. Not ideal for kidney function.) So when I say ‘proper treatment,’ I mean figuring out the root cause of the issue, not just numbing the pain.

For example: I’m in the middle of another big training block, and it’s generally going well. Except for the fact that a couple weeks ago, I started to have a twinge in my shoulder/neck area. No major impingement to my range of motion, just a tightness and a tension that I couldn’t get rid of. As a runner, this doesn’t affect my day to day training in any obvious way… But it does. For one thing, I run wearing a pack most of the time, so even though it wasn’t bothering me during runs, I knew the pack weighing down on that shoulder could be making the situation worse. I also know that the minute you’re training with some kind of imbalance, it’s likely to throw off everything else eventually.

Now, I’m not saying you should call a chiropractor the minute something starts to twinge. But if it’s clearly not vanishing in a day—meaning it’s definitely not just because you slept wrong and needed to stretch it out—but if something is continuing for a few days, even if it’s not getting worse, it’s probably time to check in. So, after a week of this funky sensation in my shoulder, I booked in with a massage therapist and an osteopath I know and trust.

Tip: I’ve noticed that most of the best experts in the physical therapy world are super booked up right now. If you’re trying to book a session and can’t get in for 6 weeks, I suggest emailing them and asking to be put on a wait list. If you have a flexible schedule, often you’ll be able to snag a last minute appointment pretty quick. (That’s what I had to do!)

Both of them confirmed that there was nothing structurally wrong or concerning (phew) but that there was a lot of knotting/tension and not enough movement in that particular joint. There wasn’t a ‘this is what you did, this is how to fix it’ diagnosis, but I did get some homework. And to be honest, the biggest thing for me was ruling out anything more serious. I’ve seen way too many athletes push though a small niggle that eventually revealed itself to be a much bigger problem than they had realized.

While I’m all about taking care of the little stuff before it becomes big stuff, there is a large caveat here: Don’t Panic. A little twinge in your hip doesn’t automatically mean you have a torn tendon or a stress fracture, it could be as simple as sleeping in a weird position. I’m all for taking care of small issues as they arise, but I definitely have to remind myself that none of them are the end of the world. Don’t ignore things, but don’t make mountains out of molehills either.

You do have to have some level of understanding of your Operating System, so to speak: Are you the kind of person who freaks out over everything? Maybe give yourself an extra day or two of easy training or rest before seeking a professional opinion. If you’re the kind of person who ignores everything, be quicker to call for an appointment. (And for the self-proclaimed hypochondriacs out there, sometimes there actually is an issue! I wouldn’t say I’m a hypochondriac about myself, but I am about DW, our dachshund. Last week, I took him to the vet because I thought he had a tick head stuck in his belly. The vet thought I had mistaken his nipple—the dog’s, not the vet’s—for the tick, but it turned out I was right, and they did have to pull out a tick head. It’s that whole ‘even a broken clock is right twice a day’ thing.)

Bottom line: Don’t ignore funky feelings or little twinges. Don’t freak out, but don’t sweep them under the rug by ignoring them or medicating them either. It’s much better to check in and find out that you’re totally fine than to ignore something for months and realize you’ve done a lot of difficult-to-repair damage!