5 Steps to Take for a Nagging Pain

By Dr. Michael Cerami

As an athlete, when pain starts to get your attention, you should:

    1. Ignore it and toughen up
    2. Ask your friends for advice
    3. Start taking lots of pain medication
    4. Stop all activity
    5. Stay up all night worrying about it
    6. Ice constantly
    7. Heat constantly
    8. Talk to your doctor
    9. Schedule surgery
    10. Give up your sport because “You’re not a runner”

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As ridiculous as these suggestions sound, almost everyone has done them when they start hurting. I think a lot could be gained by getting a better perspective on what’s actually happening when you’re hurting and developing a treatment plan prior to the injury.

Throw out those Top-10 Should-“Nots” and Hone in on my Top 5 ‘To-Do’ Steps:

#1) Pay Attention- Ask yourself these questions:

  • Has this happened before?
  • What could this be? What ELSE could this be?
  • What have I done new?
  • What does it feel like?
  • Is the pain showing up predictably?
  • Repeat question- Have I had this before?

#2) Check your Database:

One of the biggest challenges patients face when they are hurting is not having enough history to reference their experience. For example, if you’ve been a Mom for 15 years, your children have probably thrown enough challenges at you (health and otherwise) that you have some pretty good ideas on how to handle things. If you’re a new Mom, you might be freaking out at every new sniffle your child gets. Try and put some perspective into better understanding what exactly MIGHT be going on.

#3) Don’t Overdo or Under do It

Some patients I see totally ignore their problem until it incapacitates them. Other patients can behave like a Woody Allen character and think the sky is falling. Just because your shoulder hurts doesn’t mean it’s a Rotator Cuff tear. All pain in the knee is not caused by a torn meniscus. Your Psoas is not the root cause of every hip and back pain.

#4) Have a Plan and Try Something New

This should be normal for most athletes. First rest, then ice, then try compression and elevate. Don’t repeat the same activity or exercise that caused the problem until you have at least 48-hours of no pain.  The only way you’re really going to be able to tell if it’s a complicated problem on your own is to go through and test a variety of options.

I personally have had two experiences with my left knee in the last year that I found interesting. Seven years ago I had ACL reconstructive surgery so the left knee is a little weaker than the right knee. I solved one problem by ‘training’ to change my foot strike and cadence to alleviate the strain on my knees, which took a solid training block to correct safely. The other problem took a quick decision when I stopped 1-mile into a 10-mile planned run, and took a week off.  You don’t know what’s going to happen until you try it.

#5) Have Plan B

When you run out of self-treatment options, it’s time to make a decision. Do you want to learn to live with pain and wait for it to eventually leave on its own, or do you need to see a professional?

If you seek the help of an expert, who can best help you? Patients should make this decision based on their personal philosophy; there is no RIGHT choice. I remember bike riding with a physician years ago and we found out that we had both experienced Plantar Fasciitis in the past. I asked him what he did to treat it. He told me he got a cortisone injection. I treated mine with FSM and orthotics as my personal philosophy steers clear of drug injections.

Two people, same problem, different choices. One’s not right or wrong, they are just different for different people. The spectrum of options runs from medication and injections of all sorts to massage and ointments. Which approach resonates best with you? There’s also the time and financial part to consider. Do your research and be vigilant. Call the office and ask questions. It’s your body, and no one cares about it more than you do.

I firmly believe there’s almost always an answer to help you. Follow these steps and you’ll get there quicker.


Dr. Michael Cerami owns Utah Sports and Wellness and has been a competitive triathlete for over 18 years. He is available for a no charge consultation one Saturday per month at The Salt Lake Running Company (700 East store) by appointment. He can be reached at 801-486-1818 or online at www.utahsportsandwellness.com

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