Injury Management: Bones vs. Soft Tissue

Injury Management: Bone vs. Soft Tissue Injuries

When faced with a new ache or pain, it is natural to try and figure out the cause. For runners, 90+% of the time it is due to some change in training load that likely was too much and/or too soon, and results in overuse type injury. One of the first determinations to make is whether you are dealing with a soft tissue injury or bone injury, because it likely changes how we approach managing it, especially early on.

In terms of the overuse injuries seen most often in runners, we are typically dealing with either bones or tendons. Tendon injuries, if managed correctly in the early stages, can often be controlled without significant loss of mileage/training or removing an athlete from participation. Unfortunately this is not often the case, as most of us try to “run through” an injury to the point where it does require a break or significant modification of running schedule to heal. Bone stress injuries, if ignored or allowed to progress, can have serious and long term (we are talking lifetime!) consequences for bone health, and should not be taken lightly!

Here are a few basics on differentiating bone vs soft tissue type injuries:


  • 🦴 Pain does not seem to “warm up” with exercise
  • 🦴 Pain that doesn’t get better with time off from running
  • 🦴 Pain both with putting weight onto the leg and again when you take it off
  • 🦴 If you have had a bone injury in the past

Soft Tissue: (especially tendons)

  • 💪🏼 discomfort with repetitive activities or that put the tissue on stretch
  • 💪🏼 feels better with rest (at least in the short term)
  • 💪🏼 stiffness with inactivity (such as with sitting or sleeping)
  • 💪🏼 follows the “warm up” phenomenon, where it initially feels better with exercise, but gets worse as you go or afterwards

Recognizing and managing overuse injuries early before they progress is key for minimizing time lost from running and other activities you enjoy. If you are dealing with symptoms similar to these, especially in the case of a potential bone injury, don’t wait to consult with a medical professional. More to come on how to start managing these types of conditions next week!