Running with pain – should you push through or stop?
It’s one of the most common questions we hear in clinic:
“I’ve got a bit of pain… should I keep running or rest?”
Most runners are given one of two pieces of advice:
Push through it
Stop running completely
Neither is particularly helpful.
In reality, the answer sits somewhere in the middle and depends on how your body is responding to load.
After recently completing the West Highland Way, I was reminded how quickly even well-conditioned bodies can start to feel overloaded. Sore feet, tight hips, niggling aches—it all adds up when demand increases.
The same applies to running.
The key isn’t whether you run or rest.
It’s understanding how much your body can currently tolerate, and how to build from there.
If you’re currently dealing with a running-related injury, our physiotherapy service in Exeter can help you work out exactly where that starting point is.
Why running injuries don’t improve (even when you’re trying to do the right thing)
Most runners fall into one of these cycles:
Pushing through pain
Feels manageable during the run
Worse later or the next day
Gradually becomes more persistent
Stopping completely
Pain settles
Return to running
Pain comes straight back
Following rigid rules
Fixed percentage increases (10% rule)
“No pain allowed” approaches
Plans that don’t reflect individual capacity
The problem is that none of these approaches consider your individual response to load.
The 4 key factors we use to guide return to running
At Quay Kinetics Physio in Exeter, we use a simple framework to guide decisions around running with pain.
1. Irritability – how sensitive is your injury?
This is the starting point.
Ask yourself:
Do you have pain at rest?
Does walking or climbing stairs aggravate it?
Does it worsen throughout the day?
High irritability
Pain at rest or with basic activity
Symptoms easily aggravated
Running is unlikely to be helpful at this stage.
Moderate irritability
Pain comes on with activity
Settles relatively quickly
Running may still be possible with modification.
Low irritability
Minimal day-to-day symptoms
Only noticeable under higher load
Running is often appropriate with structure. If you’re unsure, it’s worth getting this properly assessed rather than guessing. You can read more about what to expect from an appointment on our physio treatment FAQs page.
2. Run tolerance – how much can you do right now?
Most runners ask:
“Can I run?”
A better question is:
“How much can I run without making it worse tomorrow?”
Run tolerance is the amount of running you can currently do:
with minimal symptoms
without worsening your baseline
Start simple:
Short, easy run
Flat surface
Comfortable pace
Then assess your response.
3. The 24-hour response rule
This is one of the most useful tools in managing running injuries.
During exercise
Mild discomfort can be acceptable
Significant pain usually indicates overload
The next day
Symptoms should return to baseline
If they are worse, the load was too high
This helps you adjust early rather than waiting for a full flare-up.
Understanding pain and exercise
A simple way to think about this is:
Stay within a manageable range (safe zone).
Avoid sharp increases in load.
Look for gradual improvement over time.
Sleep well, eat well and remember to rest.
4. Risk vs reward – what are you training for?
There is no one-size-fits-all answer.
If your goal is general fitness:
Lower risk approach
Gradual progression
If you are working towards an event:
You may accept slightly higher risk
Load needs to be managed more strategically
Your plan should reflect your priorities.
Common mistakes runners make
Doing too much on a good day
Symptoms improve, so you increase everything at once.
Ignoring next-day symptoms
The delayed response is often more important than how it feels during.
Stopping completely when not necessary
This reduces your capacity and makes returning harder.
Neglecting strength work
Running alone does not address underlying deficits.
A simple return-to-running framework
If you are unsure where to start:
Find a manageable starting point
Keep symptoms within a tolerable range (2/10 max ideally).
Review how you feel the next day
Progress one variable at a time
Build consistency before intensity
When should you not run?
Seek advice if you have:
pain at rest
night pain
significant swelling
worsening symptoms despite reducing load
Why a personalised plan matters
Generic plans do not account for:
your injury
your history
your current capacity
A tailored approach helps you progress with confidence rather than guesswork.
Need help getting back to running?
If you are:
unsure whether to run or rest
stuck in a cycle of flare-ups
not seeing progress
Our physiotherapy team in Exeter can help you build a clear, realistic plan. If you’re unsure which appointment to choose, our treatment price & FAQ page explains everything clearly.
Frequently Asked Questions: Running with Pain
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It depends on how your body is responding. Mild discomfort (2/10 or less) during running can sometimes be acceptable if it settles within 24 hours and does not worsen your overall symptoms. However, if pain is present at rest, worsening, or affecting daily activities, it is usually better to reduce or stop running and seek professional advice.
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In many cases, running with low-level discomfort (around 0–2 out of 10) can be acceptable, as long as symptoms do not increase significantly during the run or worsen the following day. Monitoring your 24-hour response is key.
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The 24-hour rule involves assessing how your symptoms respond the day after exercise. If your pain returns to baseline within 24 hours, the load was likely appropriate. If symptoms are worse or more persistent, the load should be reduced.
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Start with a short, easy/internal style runs and assess your symptoms during, after, and the following day. This helps establish your current tolerance. From there, you can gradually build your running volume.
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You should avoid running if you have pain at rest, night pain, significant swelling, or symptoms that continue to worsen despite reducing your activity. These may require further assessment.
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If your symptoms are not improving, keep recurring, or you are unsure how to safely return to running, physiotherapy can help. A personalised plan can make a significant difference to your recovery.