When to Stop Walking It Off: Recognizing Sports Injuries That Need Treatment

By Mark Howlin

Associate Physiotherapist, Musculoskeletal & Sports Injuries (BSc, MSc, GEMt) · Registered with the AHPRA (PHY0004060355)

Mark Howlin is an Associate Physiotherapist at Physio K, with a focus on sporting injuries and post-operative rehabilitation, with advanced dry needling training from Ireland and Sydney. Across six years of clinical practice in Ireland and Australia, he has developed particular experience in chronic conditions such as anterior knee pain and Achilles tendinopathy, and acute lower limb muscle strains, using an integrated approach combining manual therapy, dry needling, and progressive rehabilitation. He has also served as team physiotherapist to elite GAA athletes, including during a championship-winning run at Croke Park

Read more about Mark →

Last reviewed: 8 November 2026

Stop walking it off when pain is sharp, worsening, or changes how you move. Limping, avoiding weight on one side, or losing strength are signs the injury needs assessment, not more activity. Seek urgent help for deformity, severe swelling, numbness, weakness, or a cold limb, and arrange physiotherapy review when pain persists, recurs, or limits your normal routine.

Key Takeaways

• Sharp, escalating or compensatory pain that changes your movement pattern requires assessment, not more activity

• Emergency signs include deformity, inability to bear weight, severe swelling, numbness, weakness or a cold, pale limb

• Gradual injuries from repeated training deserve attention too, especially when pain appears earlier, lingers longer or wakes you at night

• Pain settling temporarily doesn't mean the problem has resolved, tissue may still be far from tolerating the demands that caused it

• Professional assessment identifies whether you're dealing with a load problem or something more serious, and guides safe return to activity

When to Stop Walking It Off: What It Actually Means for Your Body”

Walking it off usually means continuing to move or play despite pain, in the hope it will settle on its own. Mild discomfort that eases quickly and doesn't alter how you run, land or push off may sometimes be monitored with modified activity. Sharp or building pain is different. When you start limping, changing your stride, favouring one leg or losing strength, you're shifting load onto other tissues to protect the painful area, and that compensation can create new problems while the original injury worsens.

I see this pattern often in people training for a specific event, a first marathon, a triathlon, a cycling race. They've put months of effort in, the event is weeks away, and pain starts creeping in. The instinct is to push through because stopping feels like losing all that work. Behind the question of when to stop is usually a lot of frustration and doubt about whether they'll still be able to participate.

The "No Pain, No Gain" Trap

The phrase "no pain, no gain" treats all pain as the same thing, which can be harmful. Everyone experiences discomfort or stress on their body during intense exercise, that's normal. But that sensation is very different from tissue pain, the sharp, localised ache that signals something is being overloaded or damaged. Exercising through tissue pain doesn't build resilience, it usually leads to more pain with a lower threshold, or an acute injury that forces you to stop completely.

"The myth I find myself correcting in almost every appointment is the belief that once the pain has gone, the problem has gone with it," says Mark Howlin, Associate Physiotherapist at Physio K. "The tissue may still be some way off tolerating the demands that caused the problem in the first place. If someone returns to their previous running volume at this stage, assuming they're back to normal simply because it doesn't hurt, the pain will often return within a matter of weeks."

When Pain Is an Urgent Warning

Some injuries need immediate medical assessment, not a wait-and-see approach. Seek emergency care for visible deformity, an open wound over the injury, suspected dislocation, severe pain out of proportion to what happened, or rapidly increasing tightness and swelling. A cold, pale, numb or weak limb is also an emergency. Inability to bear weight after an acute injury, particularly with focal tenderness over bone, warrants prompt assessment because fracture is possible. If a joint is hot, red and swollen alongside fever, urgent medical review is needed to rule out infection.

The Ottawa Ankle Rules, validated in a 2003 systematic review published in BMJ, help identify who needs an X-ray after an ankle injury. The rules are highly sensitive for clinically important fractures when applied to appropriate patients, meaning they reliably pick up serious injuries while reducing unnecessary imaging.

Gradual Injuries Deserve Attention Too

Not every significant injury announces itself with a sudden pop or fall. Repeated impact, rapid increases in training volume, inadequate recovery between sessions, disrupted sleep and low energy availability can all contribute to stress injuries and persistent problems in tendons or muscles. Pain that is becoming more frequent, appearing earlier in your run or session, lingering after you finish, occurring at rest, or waking you at night should not be dismissed as normal training soreness.

In clinic, I often see people who have been training intensely for a specific event. One woman training for her first marathon had been running six days a week and came in with knee pain a few months before race day. She'd run ten days straight before the pain started, which immediately stood out. We developed a plan that included an initial period of reduced running volume, some targeted exercises, then a gradual reintroduction of running guided by her pain levels. The key was helping her see pain not as damage, but as information to guide her sessions.

What the Research Shows

According to the 2021 Clinical Practice Guideline for the Management of Lateral Ankle Sprains published in the Journal of Orthopaedic & Sports Physical Therapy, recommended care includes early protected loading, meaning you start moving and bearing weight in a controlled way soon after injury, alongside therapeutic exercise and rehabilitation tailored to the severity of the injury and your functional goals. This approach applies to many sports injuries: early, carefully progressed movement usually beats complete rest.

A physiotherapist can assess how you move, your strength, how much load the injured area can tolerate, joint stability and any nerve-related symptoms. They can also identify when medical review or imaging is needed. Suspected fracture, major tendon rupture, dislocation, vascular compromise (reduced blood flow) or compartment syndrome (dangerous pressure build-up in a muscle compartment) requires medical management, not routine exercise-based treatment.

What You Can Do

Stop the activity if pain is sharp, worsening, causes a limp, or changes your running or playing technique. Continuing can increase the load on other areas and make it harder to work out what's actually wrong. After an acute injury, check whether you can bear weight normally. Don't keep walking on a limb you can't load properly, particularly if there's tenderness over bone, deformity or rapid swelling.

Seek emergency care for numbness, weakness, a cold or pale limb, severe pain that seems out of proportion, an open injury, suspected dislocation, rapidly increasing tightness in a muscle compartment, or fever with a hot swollen joint. Arrange a physiotherapy assessment if pain persists beyond a few days, keeps recurring, causes weakness, affects your sleep or work, or hasn't clearly improved after a short period of modified activity.

Return to sport gradually, using your symptoms, strength and function to guide how quickly you progress. Don't jump straight back to full training volume simply because the pain has temporarily settled. Pain is there for a reason, and it rarely disappears on its own without something changing. A full assessment and a structured plan give you the best chance of getting back to what you want to do, and staying there.

Common Questions

When should I get an X-ray?

You should arrange an X-ray if you can't bear weight immediately after an ankle or foot injury, if there's tenderness over specific bones (the back edge or tip of either ankle bone, or certain midfoot bones), or if pain and swelling are severe. The Ottawa Ankle Rules guide this decision and have been shown to reliably identify fractures. Your physiotherapist or GP can assess whether imaging is needed.

Can I keep playing if I can still walk?

Being able to walk doesn't mean the injury is minor or safe to play through. If you're limping, changing how you move, or experiencing sharp or worsening pain, continuing can overload other areas and make recovery harder. I assess movement quality, strength and load tolerance to work out whether modified activity is safe or whether you need to stop completely for now.

Why does it hurt more the next morning?

Pain often worsens the morning after activity because of inflammation and stiffness that builds overnight. When tissue is irritated or damaged, fluid accumulates and muscles tighten during rest, which is why the first steps out of bed can be the worst. If this pattern is happening regularly after training, it's a sign the tissue isn't coping with the load you're giving it, and the plan needs adjusting.

Will resting make me lose all my fitness?

Complete rest is rarely the answer. Most injuries respond better to modified activity that keeps you moving without aggravating the problem. I work with you to find what you can do safely, whether that's reducing volume, changing intensity, or switching to a different activity temporarily. Structured, graded return beats stopping everything, both for your fitness and for your recovery.

If a sports injury is affecting your training, book an assessment with Physio K or contact the clinic to talk it through. If you have any of the warning signs listed above, seek urgent medical care first.

Reviewed by Kenny Merlevede. Kenny Merlevede is a Senior Physiotherapist with 18 years of experience in private practice, with a focus on complex cervical presentations and persistent musculoskeletal conditions. Registered with the Australian Health Practitioner Regulation Agency (PHY0002060505).

This article is for general information only and is not a substitute for personal medical advice. If you have concerns about your health, please consult a qualified clinician or your GP.