Talking about pain: describe it before you name it

Describe first, name later

Running pain is often called “runner’s knee”, “IT band syndrome” or “Achilles tendinitis”, but a label is not an assessment. The same pain can come from different tissues, and the same label can describe different presentations. In a consultation, the useful information is the phenomenon: where it hurts, when it started, what makes it worse, what eases it, and whether there is swelling or weakness.

Point to the most painful spot with one finger, then say whether the pain is superficial, deep or follows a line. Describe both sides separately if both hurt. If it moves, record where it started and where it travels.

A useful timeline

Put the events in order: when it first appeared; whether mileage, speed, hills, shoes or surfaces changed beforehand; whether it began suddenly or gradually; whether rest helps; whether it is stiffer the next morning; and whether there is night pain, swelling, heat, numbness or weakness.

Add the functional impact: can you walk normally, use stairs, stand on one leg, do a heel raise or squat? Which movements make you avoid loading the leg? What is the pain score from 0 to 10, and does it affect sleep or work? A number is only an aid; the trend matters more than one rating.

Bring your training record

A training log, watch data, shoe mileage and upcoming races help explain changes in load. Put the last four to six weeks on one page: weekly distance, longest run, quality sessions, races, illness and recovery. Do not offer only a total mileage figure, and do not treat watch data as a diagnosis.

If you have already tried an exercise or rehabilitation drill, record how long, how often and what happened. A clinician needs to know what helped and what aggravated the symptoms.

Red flags

Seek prompt medical care rather than watching and waiting, changing shoes or pushing through: inability to bear weight, marked swelling, a locked or deformed joint, fever, night pain that wakes you, progressive numbness or weakness, changes in bladder or bowel function, chest pain, fainting or severe breathlessness. After a head impact, worsening headache, vomiting or altered consciousness is an emergency.

The NHS advises not running while in pain and seeking medical or physiotherapy advice when pain is severe, persistent or accompanied by swelling. This page does not identify the source of pain and does not recommend masking it with painkillers to continue training.

Scope and limits

This page provides a consultation framework, not a diagnosis, imaging interpretation, medication advice or rehabilitation prescription. A qualified professional must assess the cause with an examination and any necessary tests. Pregnancy, surgery, chronic disease or neurological symptoms need the relevant specialist assessment.

Sources and scope

The advice not to run through pain, to seek help for persistent pain or swelling, and to use properly fitting shoes follows the NHS running-injury page. The pain-record and training-load framework is general clinical communication advice. Checked 2026-10-28.