What to actually do when a running injury shows up

Jacob Travis, a physical therapist in Nashville who posts as PT with JT, sees the same pattern over and over: a runner feels something off, tries to fix it themselves for weeks, and finally shows up once it's gotten bad enough that treatment takes twice as long as it would have otherwise. His advice runs counter to the instinct most runners have, which is to wait it out and hope it goes away on its own.

Here's what he actually recommends.

Don't wait more than a week. If a pain shows up once on a run and disappears, that's not a reason to panic. But if you notice the same pain, in the same spot, at roughly the same point in your run, more than once, that's the signal to act. Give it two to three days off impact, use ice to bring down inflammation and reduce pain (he's a fan, despite the ongoing debate about it), and retest with some light movement before going back to a full run. If it's still there after a week of that, stop guessing and get it looked at. "The sooner you treat it, the sooner it goes away," he says. Let it linger for two or three months before addressing it, and it can take two or three months to resolve.

Stop trying to self-diagnose everything as plantar fasciitis or shin splints. Those are the two conditions runners misdiagnose the most, mostly because they're the only two most people have heard of. Foot pain doesn't automatically mean plantar fasciitis, and JT says he's had to deliver the harder news of a stress fracture more than once after someone assumed it was something more minor. He's not against using something like ChatGPT as a starting point, but he's clear that it can't replace an actual evaluation, because there are usually multiple possible root causes behind any one symptom, and figuring out which one applies to you takes an actual assessment, not a symptom checklist.

Don't just treat the pain, figure out why it started. This is the part people skip most often. If you rest for a week, feel better, and go back to running with the exact same mechanics and the exact same deficits that caused the injury in the first place, it's going to come back. Manual therapy, massage, even a steroid injection can all reduce pain in the short term, but none of them fix the underlying cause. If you don't address that, the relief is temporary.

Take rehab exercises seriously, even the awkward ones. JT is upfront that PT exercises are often designed to target a muscle or movement pattern you haven't used in years, which is exactly why they feel strange and uncomfortable at first. That discomfort isn't a sign something's wrong, it's often a sign you found the actual gap. He's also honest that most people don't do their homework, and that physical therapy doesn't really work if you skip it. Manual therapy alone gives short-term relief. It's the exercises done consistently between sessions that create lasting change.

Most runners don't actually need to change their running form. This one surprises people. JT says the only time he wants to change someone's mechanics is if they have recurring pain tied to a specific pattern, or if there's an obvious inefficiency, like an upright trunk lean, that's costing them free performance. Outside of that, if you're not injured and you're hitting your goals, leave your form alone. Everyone's body is organized a little differently, and trying to force a mechanic that isn't natural to you can cause more problems than it solves.

Sleep is the most underrated recovery tool you have. When JT evaluates a new patient, one of the first things he asks about is sleep, and he says it's consistently the piece people are most honest about neglecting. His actual line to patients: he'd trade a week of doing their PT exercises for a week of consistently good sleep, any day. It's the single biggest lever for recovery, especially if you're actively working through an injury and your body needs every advantage it can get.

The bigger theme underneath all of this is one JT keeps coming back to: the sooner you actually deal with something, the less it costs you in the long run. That applies to the injury itself, the root cause behind it, and the boring daily habits, like sleep, that most runners assume don't matter as much as they do.

Hear the full conversation on the Maybe Running Will Help? Podcast here.