The pain traffic light: when to stop and when to carry on

With a niggle, almost everyone does one of two things: stop completely until it passes, or grit their teeth and carry on unchanged. Both are bad. The first detrains you and heals nothing on its own; the second turns a niggle into an injury.

The rule that was tested in a trial

A study in patients with Achilles tendinopathy compared six weeks of rest against carrying on running and jumping guided by pain. Those who stayed active did no worse: they ended up the same as those who stopped.

The criterion they used is the one you can use, and it’s three conditions at once:

• During the run, the pain doesn’t go above five out of ten.
• When you finish, it doesn’t clearly rise above where it started.
• By the next morning it’s back to where it was.

What this traffic light doesn’t cover

Let’s be clear: the trial was on the Achilles tendon, not on “any pain while running”. The rule has been adopted fairly broadly in clinic because it makes sense and works, but that’s professional consensus, not a trial for every kind of pain.