“From Pain to Performance: Essential Guide to Treating Acute Injuries in Runners”


Running the London Marathon is a challenge on so many different levels. It’s not just about the obstacles you face on the day of the run. As the event day gets ever-closer, the training becomes more physically challenging, but also starts to test you psychologically and emotionally too. By this stage, you have already put in a lot of hard work. With each mile you run in training your determination to complete the challenge at the end of April grows ever greater. So one of the most emotionally challenging setbacks at this stage, can be developing an injury.

Naturally, you will want to get over this obstacle and get back to training as soon as possible. But we need to add a word of caution. Running with an injury (acute or chronic) can have serious long-term implications to your health. The old adage of ‘no pain, no gain’ does not apply to injuries! So don’t be a martyr to your cause or you may have to defer to next year.  

That said, many minor injuries incurred in the coming weeks can still be effectively treated before race day. If you are unlucky enough to get injured, below is an explanation of some of the most common treatment methods and why they are so effective. 

Acute Injury Treatment  



The first step to treating an acute injury is getting it properly diagnosed, either by your GP or a professional sports injury specialist (such as a physiotherapist, sports & remedial therapist or osteopath). The sooner the injury is treated and the symptoms addressed, the quicker the rehabilitation process can start, and the more effective the treatment will be (also, to avoid it becomes chronic).

PRICE Protocol to treat acute injuries

The term ‘PRICE’ is an acronym for a procedure that is regularly used to treat more minor injuries such as strains and sprains, as well as closed fractures. The individual letters stand for protection, rest, ice, compression and elevation. The objective of PRICE is to reducing swelling, alleviating pain and speeding up recovery. 


For many years this protocol was referred to simply as the RICE method. The recent addition of the “protection” element was made as a common-sense measure. Aimed simply at avoiding aggravating the injury further, it refers to the use of props such as crutches, walking canes, splints, braces or slings. The objective is to immobilise or reduce activity in the affected area. 


This is a crucial element needed to allow time for the body’s natural healing process to kick in. Depending on the extent of the injury, however, the recommendation may vary between complete rest or active rest. Some movement is often beneficial. Gentle and pain-free movement can often help to restore range of movement in a joint. And regular isometric exercises can often help maintain muscle tone and guard against muscle atrophy (when muscles waste away from lack of use).


Crushed ice wrapped in a paper towel, or frozen peas wrapped in a thin tablecloth, can act as a makeshift icepack for applying to injuries to reduce swelling. The ice is usually applied for 10-15 minutes at a time roughly once every two hours. Applying at intervals in this manner is considered more effective than a long and continuous application. 


This involves wrapping the injured area in an elastic bandage. Again, the goal is to reduce swelling. It is imperative that the bandage is not too tight because that can actually increase swelling and reduce blood circulation! You’ll know if the bandage is too tight because you’ll probably experience numbness or tingling sensations in, or around, the affected area.


This involves raising the injured area above the level of the heart. The goal is to prevent the pooling of fluid at the site of the injury and, again, to help reduce swelling. Elevation is most effective 24-48 hours directly following the onset of the injury.

The need to reduce swelling seems intuitively the right thing to do. However, inflammation is part of the body’s natural immune response to injury. There is growing evidence from within the Sports Science community that there are benefits to allowing some level of inflammation to persist in some instances. 

This brief outline of the PRICE protocol is intended as a guide for treating more minor complaints. If you are unsure as to how to deal with an inflamed injury, it is always advisable to seek professional guidance.

Heat and Cold 

As mentioned, cold treatment is a good way to help combat inflammation. This is especially so in the 48 hours immediately following an acute injury. Cold treatments work by decreasing blood flow. 

However, in many situations it can be beneficial to promote blood flow by dilating blood vessels. In this instance, heat treatment can help. It also has the useful side-effect of helping to relax sore and tightened muscles. Often, electric heat pads or heat wraps are used for treatment, but a hot water bottle can substitute as an easier alternative.

Typically, heat treatment is used for stiff tendons and conditions such as osteoarthritis. It can be used during a warm-up to help alleviate stiffness in muscles. It has also been used to help relieve muscle spasms (especially in the lower back), as well as helping with some strains, sprains and tendonitis.  

As if to further complicate the matter, there is a type of therapy that alternates between the use of both hot and cold treatments. As a simple explanation, it is a good way to trick the body into boosting circulation but also helps to release extra nutrients into the muscle. This can be very beneficial in speeding up muscle repair. Combined hot and cold treatment is therefore a popular treatment in helping to reduce the impact of DOMS (delayed onset of muscle soreness).

Knowing whether to use hot, cold or both types of treatment can sometimes be confusing. If in any doubt about what works best in your specific circumstances, contact us directly, or your own GP/specialist for further clarification. 

Depending on the type of injury,  Sports & Remedial massage could help to speed up recovery, but we will recommend to wait 48 hours to receive one. Do your research and make sure  your  Sports Massage therapists has experience and knowledge on treating running injuries.

What type of Massage is Sports & Remedial Massage? 

 Unlike many “relaxing” forms of massage, Sports & Remedial Massage is a massage modality specialised in treating sports injuries , muscle imbalance and muscle pain affecting joints and tendons.  It tends to be firmer and deeper. It has some broad health benefits such as improving blood pressure, lymph flow and circulation. But crucially, it gets right to the heart of the issue when rehabilitating muscles and joints from injury. 

The underlying goal is to counteract the stress and tension that can build up in soft tissue during strenuous exercise. It is a sophisticated and specialist modality that borrows many techniques from Physiotherapy and Osteopathy. Treatments within the remit of Sports & Remedial Massage include soft tissue release, neuromuscular interventions, fascial and positional release. 

Used in combination, the above-mentioned treatments can help reduce pain and tension, stretch and restore connective tissue and help relax over-active muscles. Sports & Remedial Massage is not appropriate for all running related injuries, but in can be hugely beneficial in the vast majority of cases. 

We hope this information is useful for you. If you need advice or have any questions about our treatments, please contact us. You can find us in Mill Hill Broadway and Islington. We are always happy to help. If you like this blog, please share!

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