Deciding When Not to Run

Nearly every injury starts as a minor concern. For many motivated trail runners, the most important workout is deciding not to run.

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For many motivated trail runners, the most important workout is deciding not to run.

Nearly every major injury or setback starts as a minor concern. Like a leaking ceiling, it’s a little drip you can ignore. Let it drip for too long, though, and the whole ceiling could come crashing down.

Stress fractures are the best example of what can go wrong from a persistent drip. A 2002 article in the Journal of Athletic Training provides a comprehensive overview of all the research up to that point. Bone endures stress from activities like trail running, remodeling itself from that stress “to more efficiently endure external forces.” So running actually makes your bones stronger … to a point.

A little too much stress can cause the bone to deform slightly. At this point, the bone might be mostly fine structurally—a few days off could heal it. But continue pushing, and it progresses to a stress reaction, or damage similar to bruising on the bone surface. Stress reactions take longer to heal. Wait even longer, and it’s a stress fracture, which could take six weeks to several months to heal, depending on the location. A similar progression of maladies can happen with upper respiratory illness if you train through chest congestion, or over-training syndrome if you train through severe fatigue.

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So the key is to stop early, guided by the principle that a few days off is no big deal, a few weeks off is frustrating but manageable and a few months off is worse than a caved-in ceiling.

This cautious approach will be over-inclusive for many injuries or illnesses. Sometimes, you’ll be taking time off when you’re totally fine. But just because five of the chambers are empty doesn’t mean you should play Russian Roulette with your health.

Here are the questions to ask yourself each day before you hit the trails:


Fatigue is normal, especially if you have kids and/or a busy job. But if you feel like a low-energy Jeb all the time, something more worrisome could be going on, like iron deficiency or the presence of abnormally high levels of stress hormones like cortisol. Unchecked fatigue can culminate in over-training syndrome, which has the potential to take you off the trails for months or even years. But even if it never reaches that point, persistent fatigue is probably a sign that your lifestyle is not healthy. It’s important not to push through chronic tiredness without a strategy to get better.

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“Injured or Sick”

I have a tongue-in-cheek rule with the athletes I coach: if the first time I hear about a stress fracture is when they are going to a doctor, they owe me $500. The idea is that most injuries like stress fractures start out as a minor annoyance. Stop while you can still run, rather than waiting until you’re at Rite Aid buying crutches and checking the status of your health insurance.

The same goes for sickness—a surefire way to turn an innocuous sniffle into a bout of bed-shaking bronchitis is to run hard while sick.

If you are both tired and injured or sick, even in small doses, the most strenuous thing you should be doing is watching Netflix.

No runner has ever regretted taking an extra rest day or three when dealing with an injury, illness or fatigue. When in doubt, ground yourself now so you can fly later.

David Roche partners with runners of all abilities through his coaching service, Some Work, All Play. With Megan Roche, M.D., he hosts the Some Work, All Play podcast on running (and other things), and they wrote a book called The Happy Runner.

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