Where It Hurts Isn't Where It Started

The spot you keep rubbing

You know the routine. Something starts to ache, so you go straight to it. You roll it, stretch it, ice it, maybe pull the exercise that seemed to set it off. It calms down for a week or two.

Then it comes back. Same spot, same feeling, usually right when your training was starting to click.

That cycle tells you something useful. When an ache keeps returning to the same place after you've treated it, the sore spot is probably just where the problem shows up. The cause is somewhere else.

Symptom site, source site

I think about every recurring ache as having two addresses. The symptom site is where you feel it. The source site is the part of the system that stopped doing its job and handed the work to something else.

Your body is very good at getting the job done. When one link in the chain is weak or stiff, the load doesn't disappear. It gets rerouted to the nearest structure that can take it. That structure holds up for a while, then starts complaining. Treat only the complainer, and you calm the alarm while the rerouting keeps going.

If you work in rehab or healthcare, none of this is new. You probably explain it to patients every week. Here's the part I find more interesting: it's much harder to apply to yourself.

When it's your own body, you're busy, you're invested in the plan you wrote, and you already have a story for why it hurts. "I did too many split squats." "My shoes are worn out." Those stories are often true. They're also usually incomplete because they explain the trigger and skip why the tissue couldn't handle it.

That's where a second set of eyes earns its keep. A coach and a clinician look at the same body from different angles, and the overlap is where the useful answers tend to show up.

Tracing it up the chain

A recent client situation shows how this plays out. An experienced, self-coached athlete came to me with pain under the ball of one foot. It showed up during a block of heavy lunges and kept flaring on runs. She had already done the sensible things: backed off the exercise, rested it, and looked at her footwear.

When we tested her, the foot itself wasn't the main story. On that side, her big toe wasn't doing its share at push-off. When the big toe can't press and hold its position, the load shifts over to the smaller bones next to it, and those bones aren't built for that job. The ache was real, but it was the overflow.

Then we went further up. Her upper back rotated freely one way and felt sticky the other way, on the same side as the foot. I can't tell you that one caused the other. What I can tell you is that when rotation is limited up top, the body finds that motion somewhere lower down, and the foot often ends up there. Two findings on the same side were worth taking seriously.

So the plan addressed both:

• Big toe strength and control, trained directly and built into her warm-ups, so the foot can relearn how to share the load.

• Upper back rotation drills, weighted toward the stiff side.

• Heavy sled pushes and reverse drags, which load the foot and hips hard without the impact of running.

None of it ignores the sore spot. It just stops treating the sore spot as the whole problem.

Three questions before you treat the sore spot

1. Has this come back after I treated it? One flare-up after a hard week is normal. The same ache returning in the same place is a pattern, and patterns usually have an upstream or downstream source.

2. What is the joint above and below doing? Test the links on either side of the pain. Can your big toe extend and press? Do your ankle and hip move freely? Does your upper back rotate both ways equally? Write down anything that's different from one side to the other.

3. Does the pain match the side of the asymmetry? When a restriction and an ache sit on the same side, start there. It isn't proof, but it's a much better first guess than "I'll rest it and see."

Then train the source directly, and keep loading the sore area at a level it tolerates. The goal is to give the weak link its job back.

A second set of eyes

You can do this audit yourself, and you should. You'll also get more out of it with someone watching who has no stake in the story you've already told yourself.

If an ache keeps finding its way back into your training, book a call with one of our coaches at masterathletic.com. We'll look past the sore spot and build a plan around where it started.

Stay Strong,
Paul Oneid, MS. MS. CSCS
Founder and Head Coach