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In an ideal runner's world, every step of every mile would be 100 percent pain-free. No aches, no twinges, no lingering soreness from yesterday's workout. The reality is that many runners constantly deal with a slight (or not so slight) disturbance—a tender foot, a tight hamstring, a pain in the Achille’s tendon, a whiny knee. While these nagging issues often aren't serious enough to require a time-out, they are annoying, especially when they don't let you fully enjoy your time on the roads.

Think of running pains in terms of a spectrum. At one end you have severe, full-blown injuries—call it the red zone, which includes stress fractures that require time off. The other end, where you're in top form, is the green zone. Mild, transient aches that bug you one day, and disappear the next, sit closer to the green end. Unfortunately, many runners get stuck in the middle—the not-quite-injured but not-quite-healthy yellow zone.

Whether you land in the red, linger in the yellow, or return to the green end of the spectrum depends largely on how you react when that first stab of pain hits. Often it comes down to whether you take a little time off now or a lot of time off later. You can reduce your risk of ending up in the red zone if at the first sign of an issue, you back off your mileage, reduce the intensity of your runs, start a treatment program, and develop a proactive long-term injury-prevention strategy, such as strength training, stretching, and regular foam-rolling.  Therapy is like homework, none of us like having to do it, but if you don't do it, the issue will come back. And the more you learn about your body and how it feels, the better you will be at determining when you are approaching the yellow or red zone and when you need to get active treatment!

1. Runner's Knee
Patellofemoral Pain Syndrome (PFPS), or "runner's knee," is the irritation of the cartilage on the underside of the patella (kneecap). About 40 percent of running injuries are knee injuries. And 13 percent of runners suffered knee pain in the past year, according to 4,500 respondents to a runnersworld.com poll. PFPS typically flares up during or after long runs, after extended periods of sitting, or while descending hills and stairs.

Knee Check: How to Proceed
STOP!
Pain on the inside or outside of the knee immediately upon waking, which doesn't go away as the day progresses.
WITH CAUTION
Twinges early in run, dissipates, comes back after run. Bothersome after prolonged sitting.
GO RUN!
Completely pain-free even after sitting through a two-hour movie or after going on a hilly long run.

2. Achilles Tendinitis
The Achilles tendon connects the two major calf muscles to the back of the heel. Under too much stress, the tendon tightens and becomes irritated (tendinitis). It makes up 11 percent of all running injuries; and can also be affected by tight plantar fascia and by switching to a more minimalist shoe too quickly or without the proper intrinsic foot strengthening exercises.

Ankle Alert: How to Proceed
STOP!
Severe pain and swelling above your heel, even when not running. Standing up on your toes causes pain.
WITH CAUTION
Dull pain around your heel at the end of your run that lingers afterward but goes away when iced.
GO RUN!
No pain when you pinch the tendon, starting at the heel and working your way up toward your calf.
 

3. Hamstring Issues
The muscles that run down the back of our thighs bend our knees, extend our legs, drive us up hills, and power finish-line kicks. So when our hamstrings are too tight or weak to perform well, we notice it. Seven percent of poll respondents say their hamstrings have bugged them this past year.

Hamstring Signs: How to Proceed
STOP!
Sharp, sudden, strong pain and possibly even a snap or pop sound while running. The area is bruised.
WITH CAUTION
Chronic achiness and tightness that forces you to slow your pace and shorten your stride.
GO RUN!
Pain-free while climbing hills and doing speed work, even after long periods of sitting.

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