What hurts? Shins
You think: Shinsplints
But it could be: A Stress Fracture
The Difference: The pain strikes the same lower-leg area. However, shinsplints pain lessens as you warm up, while stress-fracture pain continues through the end of a run, says John DiFiori, M.D., team physician at UCLA. Stress-fracture pain often feels deep and radiates over a wide area, and weight-bearing activities increase the discomfort, says Clint Verran, a 2:14-marathoner and physical therapist in Lake Orion, Michigan. "If you're unsure, or if symptoms don't go away in three weeks, get a bone scan to rule out a stress fracture," Verran says.
What hurts? Knees
You think: "Runner's Knee"
But it could be: Iliotibial Band Syndrome
The Difference: The iliotibial band (ITB) is connective tissue that runs from your hip to your knee. "A tight IT band can cause friction along the outside of your knee, which is why it feels like a knee problem," Verran says. "I've seen people get surgery for a meniscus tear and the doctor gets in there and realizes there's no tear." If it's ITB syndrome, then running downhill, lengthening your stride, and keeping your knee in a bent position for extended periods will exacerbate your symptoms. Stretching to loosen the band can help resolve the problem.
What hurts? Lower Back
You think: Back Injury
But it could be: A Piriformis Strain
The Difference: "The piriformis muscle is deep in the hip region, next to the sciatic nerve," Verran says. "If it becomes strained and goes into spasm, it can mimic a lower-back injury." Often piriformis strains happen when you're putting in a lot of mileage on hard surfaces. The pain usually centers around the gluteal region and gets worse with prolonged sitting. A doctor or physical therapist can differentiate between sciatica and piriformis syndrome by stretching your piriformis muscle and conducting range-of-motion tests. The good news: Piriformis injuries tend to respond well to physical therapy.
What hurts? Sinuses, neck, random body parts
You think: A persistent cold or a few nagging injuries
But it could be: Overtraining Syndrome
The Difference: Push your body beyond its ability to recover, and it will start to break down, a phenomena that exercise physiologists call overtraining syndrome. The problem is that every runner's body has its own breaking point, and the warning signs are easy to brush aside. Look for a cascading effect, says Kristen Dieffenbach, Ph.D., an exercise scientist and athletic coaching education professor at West Virginia University. "It's a chain of events," she says. "You had one thing and now it's two and then three." Overtraining actually results from too little recovery, which can happen even at low mileage. "You're run down, so you keep getting colds and little aches and pains," Dieffenbach says. Other symptoms include moodiness, depression, a dip in performance, trouble sleeping, and persistent fatigue. The cure: rest and recovery.
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