Lydia Keating: “When should a runner heed discomfort?”

Words by Lydia Keating. Photography by Seung Lee.

January 31, 2024: New York City. Three months before the marathon in London.

I sit in a room on the fifth floor of a tall building on the Upper East Side. At least four television monitors are turned on, each flashing scenes from different cable programs. The volume is low on each, and garbled murmurs fill the space. The only clear, crisp noise is the receptionist’s voice when a new person walks in. “Name?” and “You can take a seat” are mostly all she says. 

The room is labeled as the Pain Management Center. I know it isn’t quite the right place for me, but if I wait for a sports medicine doctor or an orthopedic surgeon, it’ll be another month before I get an appointment. An older woman holding a cane sits a few seats down from me. I’m staring at the carpeted floor when a little white pill rolls into my periphery. 

“Honey,” the woman says. I look up, and she’s smiling at me, but her forehead wrinkles with concern. “Could you please get that?” she asks. “I dropped it, and I just can’t bend over that far.” “Of course,” I say. I stand up and pinch the tablet off the floor. She extends her arm and smiles again when I place it into her hand. I see deep creases in her palms, the type my middle-school friends would run their fingers across at recess to predict things in my future (I would live a medium-long life, I would be rich, I would one day be very smart). 

“These are my magic pills,” she says, placing one onto her tongue, which gleams with saliva under the fluorescent lights. She takes a swig from her plastic water bottle, nearly empty and all bent. “That’s what I call them,” she continues. “Because they make my pain vanish. Magic.”

I sit back down and carry on filling out the questionnaire the receptionist gave me. The room smells vaguely of rubbing alcohol. The form lists questions about my previous medical conditions. Have I experienced pain here before? Have I ever fainted? Am I depressed? Have I ever been depressed? Have I ever had surgery? Did the pain ache, or did it throb? Was it sharp or piercing? 

In the past two weeks, I’ve seen a physical therapist, an acupuncturist, and a sports masseuse. Each of them required me to fill out iterations of the same questionnaire. All asked me to describe my pain in detail. I write with a dull yellow pencil:

Describe the pain? It’s in my lower back. It is usually dull and achy and is only sharp when I run. 

Does it affect your day-to-day life? Yes. I can’t run.

December 29, 2023: Tennessee. Five months before the marathon in London.

Just before the New Year, I feverishly write down goals on my phone’s notes app. I craft a perfected version of myself, the one I promise I will be in 2024—the final year of my twenties. 

I separate my goals into distinct categories: writing, running, content/career. My running list goes as follows: 

1. Complete 10 MARATHONS BEFORE I TURN 30. That’s three final marathons this year: London (April), Berlin (September) and Pikes Peak (September)

2. Get a running coach

3. Get back into a lifting routine. Lift 3x a week

4. Organize a monthly Fruit Gang community run like the one I did before the NYC marathon 

5. Create a running community and/or get more involved in the NYC running community

When I look at my five-item list, it excites me. I’m nervous, of course—I know it’s ambitious. But I’m invigorated by the challenge.

January 2, 2024: New York City. Four months before the marathon in London.

After the holidays, I fly back to New York and hire a run coach. We devise a plan. I tell him about the three marathons. I explain that the major race in London, the first one (only four months away in April), is the most important to me because I want to go for a personal record.

He emails me my marathon training plan the following day. Reading it, I feel giddy—a sensation of limitlessness. If day by day, I stack the bricks of hard work, anything is possible. 

The following day, on the second day of the New Year—a crisp, cold, bluebird morning in New York—I drive to Prospect Park to run my first workout of the training block. It’s a workout consisting of a generous warm up, ten alternating one-minute intervals, and a cool down. During the final mile of the run, as I take on the undulating hills of that iconic loop, I feel a dull aching in my back. 

I push through the pain because so much of running is that: pushing through thoughts, sensations—physical and emotional signals—that tell us to stop. It’s one of my favorite parts of running—how it teaches us to embrace discomfort, a lesson that somehow never gets old or stale. Discomfort should be welcomed, running tells us, because it’s an indicator of change, of improvement. At its core, that’s what running is all about: a way of showing ourselves we are capable of change, that if we want to, every day, we can choose to become better versions of ourselves.

The obvious conundrum is then, when should a runner heed discomfort? It becomes a complicated negotiation.

February 14, 2024: New York City. Two and half months before the marathon in London.

Two weeks after my initial visit to the Pain Management Center, I return for an MRI. The nurse asks if I want to listen to music, but I decline. I’m in one of those periods of life when all music—no matter the genre—makes me sad. I stay as still as possible as the large, cylindrical machine churned, clicked, and buzzed.

Later that evening, the doctor calls me with the imaging results. I have a sacral stress fracture. The sacrum, at the very bottom of the spine, sitting between the hip bones, is shaped like an inverted triangle. It will take eight to twelve weeks to heal, and I have to stay off my feet as much as possible. 

My physical therapist tells me that sacral fractures are becoming increasingly common with runners but are often misdiagnosed. When people ask me, “What happened? Are you still running London?” They aren’t always familiar with the term sacrum, so I say, “I fractured my back.” It sounds unnecessarily dramatic, but it’s true. 

February 20, 2024: New York City. Two and a half months before the marathon in London.

When I share with my online community that I’m struggling with a running injury, there’s an influx of messages from people sharing their own experiences. I speak directly with a few: 

Billie ran the marathon last year. A month after London, she experienced pain in her left knee. It was a stress fracture in the bottom of her patella; she was in a brace and crutches for eight weeks. While healing from this injury, she also moved from Boston to New York. “I’ve experienced a lot of anxiety from the injury,” Billie says. “And moving was a stressful period. I felt—and still feels—like I am missing out on building a new community in New York because I can’t run.” She tells me when she returns to running, she will be “a lot more mindful and really respect [her] body for allowing [her] to run.” She has a bib for the 2024 Chicago Marathon. 

Natalie ran the Grandma’s Marathon in Duluth, Minnesota, in June, 2022, and then the Twin Cities Marathon the following October. After finishing Twin Cities, Natalie experienced leg pain and numbness in her foot. Several doctors and physical therapists later, she discovered she had run both races on a torn meniscus—a twelve-centimeter tear. She had surgery this past June and began jogging again in January, 2024. Natalie tells me that recovering from her injury has been a meditation on grief. “Because it is a loss,” she says. “It’s a loss of self and identity. I’ve been coping with the mental health struggles that come with that.” When she asked her surgeon if she would ever run again, he told her to consider racing other distances. “That was a stab in the heart because I’ve always felt like, well, if I’m not a marathoner, then I’m not a real runner,” Natalie tells me. We talk about how that’s a fallacy—how any distance, even just a minute of jogging, is a worthy distance. I tell her that I want to lean into the recreational track racing scene once I’m back running. That 26.2 miles is undeniably a sizable accomplishment, but there are many other ways to challenge yourself as a runner that are just as (if not more) impressive.

Lauren, a new mother, speaks to me about her experience recovering from childbirth and its effect on her running. She ran at the very beginning of her pregnancy but stopped in the first trimester. Pregnancy exacerbated a muscular imbalance in her pelvis. “More force, more weight, more of a load,” she explains. “Pregnancy made the injury more prominent.” She still hasn’t been able to run since having her baby, but she craves it. “Even if I could run just three miles, three times a week, that would make me happy.” She is optimistic that, with time, she’ll be able to get there. “As a mom, I realize more than ever how important it is to…be healthy and have a clear mind.” For now, yoga has been her running substitute and living in Denver, it’s got her through the cold winter months.  

March 7, 2024: New York City. Two months before the marathon in London.

I’m now in week nine of my recovery. It’s getting warmer in New York. I no longer feel pain when walking. When the temperature goes above fifty degrees, I find myself consumed by impatience and a yearning to run. The injury  causes me to have some bleak days. Historically, when my mind goes dark, I turn to running. But that’s not an available option right now. Healing is confusing—I’m constantly asking myself whether I’m doing too much or too little.

It does, however, feel like there’s something karmically significant afoot. I planned out this ambitious year of three marathons to hit a shiny goal of ‘Ten Before Thirty’, and on the first day of my first training cycle, the universe said, “no.” I’ve finally reached a point where I can gracefully part ways with this goal. I can, of course, complete ‘Ten Marathons Before Thirty-One’ or ‘Ten Before Thirty-Two’—it doesn’t sound as punchy, but now the accomplishment will be that much more triumphant and meaningful whenever I get there. 

Before my injury, I looked at turning thirty as if it were this static, daunting finale of something. Now, I look past it and I’m filled with a jittery, excited anticipation for what’s to come in my next decade: adventure, friendship, good food, returning to my regular runs in Prospect Park, and, most certainly, a marathon in London.