“You just fight with your brain, to get the body ready to fight against the illness”

I am not a big Formula 1 fan, but I do listen to a lot of radio at the moment. And so I came to understand a little more of the amazing story of Niki Lauda, who passed away yesterday, aged 70.

Niki Lauda was Formula 1 world champion three times (1975, 1977 and 1984).

“My brain was the only thing that I could control”

But in 1976 he had a crash at 150mph on one of the bends at the German Grand Prix and suffered third-degree burns on the majority of his body. He was rushed to hospital, technically ‘died’ twice before being resuscitated each time and had a priest read him his last rites.

His mental toughness is credited for not only keeping him alive, but also getting him onto the start-line at the Italian Grand Prix at Monza just 40 days later (in incredible amounts of pain, but still contesting the world title race which he had been leading by some margin).

You can hear about it in his own words on this video:

https://www.theguardian.com/sport/video/2019/may/21/niki-lauda-looking-back-at-the-life-of-a-formula-one-legend-video-obituary

“The mind leads and when it can the body follows”

For an injured athlete who is having a hard time, this may sound corny – like one of those motivational posters hanging on the wall of the gym such as “your attitude defines your altitude” or the like. But there is not only Niki Lauda’s inspiring story, but the increasingly considered ‘BioPsychoSocial Model’ in medicine which shows how interlinked all of these aspects are.

So even if your body is not responding to therapy for you right now, keep working on your mind. Amazing things are possible. You could be back in the fast-lane sooner than you think!

Good luck to all, and of course RIP Niki Lauda

When should pain stop my running?

Most of us have seen track athletes lying writhing in agony with the lactate in their legs, or even track cyclists suddenly vomiting from the amount of lactate that they have built up. And endurance runners always talk about it being painful and ‘pushing through the pain barrier’, so how does anyone know when they should actually stop, recover and rehabilitate? The goal of this is to help to create good training habits in terms of injury management and resilience for runners, triathletes and those who do a lot of running mileage as a part of their training (but it does not cover the impact of high lactate levels from very high intensity work using the anaerobic system).

The key is learning to understand the signals from your body

Development in training is built on the principle of progressive overload of the muscles, and so there is likely to be a level of soreness when you are training hard. This can be during and immediately after the run, or 12-72 hours later in the form of Delayed Onset Muscle Soreness (DOMS).

The reason that you get this muscle soreness is that exercise creates micro-tears in the muscle and with rest these recover and grow back even stronger, ready to do the challenge again. This cycle is called adaptation. You can help this process by doing a few good things:

  1. Getting some nutrition into the muscles within 30 minutes of finishing your workout. The muscles need protein to build the muscle and carbohydrates to replace the glycogen stores that you have used up. Testing of 4:1 ratio of carbohydates to protein have found these to be good at building lean muscle mass and restocking the glycogen – so things like chocolate milk can be very good (especially as liquids get into your system a little faster than solids)
  2. Giving your body enough time to recover with quality sleep and rest.
  3. Compression clothing on the legs has also been shown to have benefits immediately after exercise (as long as the foot is also covered), which is thought to be from reducing blood pooling in the leg muscles, and pushing all of the waste products out of the muscles and into the bloodstream.

DOMS is an additional level of soreness and lasts much longer. It is often characterised by agony going down stairs – check out the DOMS Stair Test within the Fellrnr wiki: https://fellrnr.com/wiki/Delayed_Onset_Muscle_Soreness.  Many people find that gentle movement is best – walking or very slow recovery runs on smooth, flat surfaces will help to flush out the toxins and let you recover. If you are routinely experiencing DOMS, then you are probably progressing the length and intensity of your runs too quickly, so scale back and replan your training.

But what about those pains that are not just soreness?

There is a different territory of pain: sharp, spikey pains with clear pain centres, or any pains that you would describe as burning, prickling, cramping or spasms. These words tend to match pains that go beyond the muscles, into the harder-to-repair areas of tendons, ligaments, joints and nerves.

I am in the process of writing other blogs on nerve pain, and reviewing some of the excellent material on the impact and treatment of nerve pain for runners and other athletes. But in the meantime the headline is that there are dimensions of pain that if you find yourself describing them with these words, the indications are that it is a lot more than muscle soreness.

This is where a good training logbook is worth its weight in gold

Hence these are all pains to take very seriously and get straight onto monitoring. If you keep a training logbook or diary, you should note down any level of aches and pains, so that you can look back and see when did you first have even a minor twinge in this area, how fast has it progressed, and is there is a pattern of low-level pains. For instance, is there a pain that you get only when running on certain surfaces? Or at certain intensities? Or distances?

In turns out that there is no measurable unit of pain

Whilst most things in life have a measurable scale, pain is sufficiently complex and individual that it has to be scored individually and subjectively. There are lots of different scales https://paindoctor.com/pain-scales/ but the most common one (and used by most UK healthcare professionals) is scored by the individual on a 0 to 10 scale, where zero is no pain and 10 is the worst pain that they have ever experienced.

It is really hard to think about this when you are in pain, so here are some words that might help:

Pain Level Description
0 No pain
2 Pain, but it can be ignored
4 Pain interferes with tasks
6 Pain interferes with concentration
8 Pain interferes with basic needs
10 Pain requires bed rest

But what does this mean for running?

I know how hard people find it to decide when to stop running, so here is my personal suggested scoring for pain:


My table of pain scale and what it means in running, with a suggested recovery action for you to take

I would suggest that whilst racing may take you to all of the way up to a level 5 (where in training you should stop immediately), you need to listen to your body and know whether this is a race that you should choose to DNF or ease back to simply make the line, vs hanging in there at all costs.

And I really hope that in training, at a 3 you would be walking and deciding whether to get your phone out and get a lift home to let your body recover for another day.

I always believe that the mark of a great training plan is the consistent build-up of sessions that progress you, but leave you ready to do the next session with quality, to get yet another progression.

Best of luck out there on the roads and trails! Make good decisions and look after your body!