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RATE THE PAIN: ONE TO FIVE

RATE THE PAIN: ONE TO FIVE

RATE THE PAIN: ONE TO FIVE

 Every time we go to a medical or health expert with an injury or a sore body part, we are asked to rate the pain on a scale of one to ten.  Ten is a nice round number, and we all like round numbers. The scale, however, is not ideal for runners since it lacks specificity.  What, for example, is the difference between a six and a seven, or a two and a three, and what exactly does each number mean.   

 Decades ago, when I first began competitive running, I learned the value of keeping a daily log of my runs and documenting any injuries or nagging physical problems.  It was then that I developed a very simple and usable scale that would have real meaning and allow me to look back and know exactly how a problem area was doing over time.  Each of the five numbers had a specific and defined meaning. 

 ONE:  This is your first indication that something unusual is going on in a part of your body. It is not yet a pain at all.  It is a sensation, which calls your attention to that area.  I liken it to the feeling you have when the inside label of a shirt collar is twisted and irritating your neck.  You keep thinking about it and wish it would go away, but it persists in calling your attention to that area. The body part giving this signal is usually totally silent and out of your awareness, but now it keeps calling to you.  Something is going on, but since you can’t even label it as painful, you ignore it and hope tomorrow it won’t be present.

 TWO:  Now the area can definitely be labeled as painful.  It is not just an awareness; it is a pain.  The pain, however, is very minimal and not a big concern.  You have had minor pains like this many times and have been able to push through them easily.  Yes, it’s painful, but so minimal that it hardly registers, and it’s easy to ignore.

 THREE:  Now the pain is no longer minimal or minor.  It is big-time real pain.  You no longer have a problem wondering if this is pain or not.  It’s impossible to ignore.  You know something serious is going on.  This is the real thing.

 FOUR:  This is the most severe pain you can tolerate and keep running.  If you are in a race when this happens, you may keep going, but your better judgment tells you it is foolish to keep it up. If you are doing heavy training, it is definitely time to quit.  You have a big and serious problem now.  

 FIVE:  This is the dreaded one.  It totally stops you in your tracks.  You can’t run another step, no matter how much you want to.  Hopefully, readers have never hit number five or even number four.   I reached five once when suddenly a meniscus in my knee tore and folded up on itself.  I slowly walked home limping all the way.  Fortunately, I was only a mile away.  An orthopedic appointment the next day was in order.

 I still use this scale on a daily basis.  If nothing is bothering me, I write “OK” in my notes.  If something is starting to be problematic, I give it a number.  If a serious injury develops, I can look back in my log and see exactly when and how it progressed.  I find the five scale much more meaningful, manageable and useful than the ten scale, and I hope you will as well.