Overtraining Syndrome - the Pinch Test

In his book Lore of Running, Tim Noakes MD provides a simple test that runners can use to detect potential injuries before they become problematic. He call's it the "pinch test." This is something I have been doing for years without thinking about it. It involves pinching certain muscles or tendons and noting any pain or discomfort. Invariably, pain is a sign of an impending injury.

Some areas that runners should "pinch" regularly include the achilles tendon, the tendon on the outside of the knee joint, the patellar tendon, and the front of the shin. If you feel tenderness when pinching these areas, it is time to pay more attention to them and to rest if necessary.

Identifying nascent injuries is easy to do. Knowing when to stop running is more difficult. Noakes offers a simple way to grade injuries and provides advice on when to rest.

A grade 1 injury is one with discomfort or slight pain that occurs with the onset of running but goes away. For grade 1 injuries, treat them with ice, anti-inflamatories, and possibly stretching. Definitely check your shoes to see if you need to change them up.

A grade 2 injury is one with pain that persists after the beginning of running, but does not effect your performance. These are injuries that we all have, where we can put up with discomfort and keep training and racing. Grade 2 injuries can quickly escalate. Noakes believes that most running injuries are the result of training errors. A grade 2 injury means that you need to change your training. Go back to what you were doing before the injury escalated. Usually this means cutting back. Also intensify treatment with ice, etc.

A grade 3 injury is one that is effecting your performance. You cannot train effectively, and you certainly cannot race competitively. Noakes strongly suggests immediate rest and intensive physical therapy for this type of injury.

A grade four injury is one where you cannot run at all. You may not be able to walk without difficulty. At this point you may need surgical intervention or total immobility.

The trick is using the pinch test to keep any injury from escalating past grade 1. That takes discipline.