Warning Signs You Should Never Run Through

Running through pain is often seen as strength — but for diabetic runners, it can be dangerous.

In this episode of The Runner’s Sole Podcast, Sharon Miller explains the critical warning signs runners should never ignore. From swelling and warmth to subtle color changes and hidden infections, small symptoms can quickly become serious complications when diabetes affects foot health.

You’ll learn why pain is not always a reliable signal, how neuropathy can mask injuries, and why early action is the key to preventing long-term setbacks.

Through real patient stories and practical clinical guidance, this episode helps runners understand how to recognize red flags early, respond correctly, and continue running safely for years to come.

Whether you’re living with diabetes or supporting someone who runs with it, this episode gives you clear, science-based strategies to protect your health and stay active confidently.

🎧 IN THIS EPISODE YOU’LL LEARN:

✅ Warning signs diabetic runners should NEVER run through
 ✅ Why pain may be absent even during serious injury
 ✅ The meaning behind swelling, warmth, and color changes
 ✅ Early signs of infection and foot complications
 ✅ What Charcot foot is and why early detection matters
 ✅ When to stop running and call a podiatrist
 ✅ Daily monitoring habits that prevent long downtime

👣 WHY THIS EPISODE MATTERS

For diabetic runners, ignoring small symptoms can lead to infections, ulcers, or long recovery periods.

Recognizing warning signs early allows you to act quickly, avoid complications, and continue running safely — not just today, but long-term.

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🏃 ABOUT THE PODCAST

The Runner’s Sole Podcast is where running meets science, stride by stride.

Hosted by podiatrist and runner Sharon Miller, the show helps runners understand foot health, prevent injuries, and build sustainable running habits — especially for those managing diabetes while staying active.

Transcript

SPEAKER_01 0:18

Welcome back to the Runner Soul. This is the place where running meets science stride by stride. And as ever, I'm Sharon, your resident podiatrist. I'm also a runner and an unapologetic foot nerd. So today is episode 5. And we'll be talking about warning signs you should never run through. So for normal healthy people, if you feel a little twinge or a little pain, then it's okay to run through and you know push yourself a little further at times, depending on what pain is and what's causing the pain. But if you are diabetic, then there are certain warning signs you should no way ever, never run through. So we'll be talking about that. And in the last episode, we talked about the toenails, calluses, skincare. So today we'll be talking about the very very important word warning signs not to ignore while you're running. So swelling, redness, warmth, color changes, and drainage are all signs that your feet are in trouble. Especially if you're running with diabetes. Because of course, we want you to be fit, we want you to be active. That's very, very important. And in order for you to be able to do that, we have to recognize any symptoms early so we can save you from long time, downtime, serious complications, infections, discomfort, and just any kind of we don't want any irritations. So by the end of this episode, you will know what are red flags and what to watch for. How to act before small little issues can become major setbacks. And exactly when you need to call your podiatrist for an appointment. As we all know, runners are very stubborn people. And diabetic runners even more so. Because diabetic runners they don't want to be held back, they don't want to look like they're making excuses, and they want to be healthy and active, the same as everybody else. So the mentality of I'll deal with it later can be dangerous. Because you might look down and think, oh, I've got a little bit of blood, huh? I'll be alright. Or you'll see your nails falling off and you just stick a plaster on it. Forget about it. And we can't always rely on pain when you're diabetic to let you know that something's wrong. Because as we know, pain may be absent. You may have some neuropathy, which can mask issues that would normally hurt. Because when your nerves are not working properly, then the messages going from the brain down to the area like your feet, those signals get interrupted. And so if you're diabetic, we can't we just you know, we just can't trust those signals. So that's why we are trying to encourage you to be extra alert, and then small problems can really escalate quickly. So just a little bit of redness, a bit of swelling, minor blisters may seem harmless, but they can develop into infections or ulcers if they're ignored. Also, all the above are definitely breathing grounds for infections, even cellulitis. Because if your skin is red swollen, there's a little bit of a break, then that is perfect conditions for cellulitis. And here's a practical tip. We want you to adopt a proactive mindset at all times. So if it looks unusual, please, please pause and check. Because a few minutes today can save weeks of downtime later. And we want to keep you on your feet, keep you in the green. We don't want you going in the amber, we don't want you going in the red, we want to keep you in the green, keep you moving, keep you going, keep you healthy, keep you active. Let's talk about what the red flags actually are. So, what are red flags? What are the red flags in particular that every diabetic runner should know and should look out for, and should know that when they happen, it's something they need to take action. So, one of the main things I would say, the top things um would be swelling without pain. Well, that could indicate lots of things, it could indicate inflammation, fluid buildup, and it's also going to make it harder for you to walk. It's going to be harder to get your shoes on, and even wearing clothes, you know, putting on trousers and stuff, you might find that everything just feels so much tighter. So you might have that swelling, and because you don't have the pain, you just think, huh, I'll be okay. Then the other signal is warmth. Now that's very important. It's always good to check the temperature of your skin, especially if you find that one part of your skin is warmer than the other. And a good way to do this is even check it with your elbow or the back of your hand, and just make sure that the temperature is the same throughout, because if you find that one bit of your foot is warmer than the other, or even on the legs, it could signal infection or early stage charcoal changes. Now, you might not have heard of charcoal changes or charcoal, but that is basically when the foot becomes deformed, um, usually when you're diabetic, because what happens is all that inflammation, all that swelling will make changes in your foot. So where the bones are, then inflammation could maybe make your ligaments and your muscles maybe change the shape of them or put them in a different place, and then the bones will start dropping because they're not been held in place properly. So you might have say your navicular, that might that's a very important bone in your foot, and then you might find, oh, lo and behold, that has fallen, it's dropped, and now it's actually hitting the ground, which means you have created a high pressure area, in which case that bone will keep bashing on the on the ground as you walk, and then it'll build callus, and then it could build corn, then it could go on to an ulcer, and then once that ulcer forms, it could get deep, deep, deep, deep, and it might be hard for it to heal, especially if your circulation isn't very good. So please do pay attention to the warmth. So we're not talking about warmth that you know you've been out running and you you feel a little bit hot because you know your temperature has risen naturally, we're talking about having one particular area in the body or one foot or one leg, that's clearly a little bit different to the rest. And then on to color changes. So if your skin seems to have a sort of a red or a purple or white areas that can signal pressure. And if you've got pressure, then you may have some bruising, you may have circulation issues, tissue breakdown, and in cold weather and your circulation isn't working too well, we have to look out for chill blades. Now, chill blanes are a tiny little red, or they can be like little purpley, and almost looks like little dots, or almost like the start of a rush. And the most prominent places you get them would be on the tips of your toes. So we've seen a lot of chill blades this year because we are in Scotland and we are in winter time, so a lot of people have very cold feet, and of course, if you're diabetic, you may not even know that you have cold feet because I'll notice my patients and like, oh, your feet are so cold today, and they say, Really? No, no, my feet don't feel cold, but the temperature doesn't lie, and then we move on to drainage or odor. Now, this is very important. Yellow, green, or fowl-smelling liquids could be infection. So if you do find that there's any kind of you know, a fluid coming out of the area or what we call pus, or just even if it's just like clear water, then that's a bad sign, and that's definitely a warning sign that we have to do something. And then we'll talk about persistent sores. So, do you have any sores on your skin that just doesn't seem to be healing quickly and it needs attention? Look for areas of redness around this. I mean, you may have it for weeks and weeks, and you'll think, oh, it's crusted over, it's not a problem, but it is. If it's not healing, then we are in trouble. So, practical tip inspect your feet before and definitely after every run. And it's a good idea to use a mirror, just you know, a little mirror, a little handheld mirror or mirror that you use for your foundation, your compact. And if you're a man and you don't put makeup on, then you can borrow it from your lovely wife or your dear girlfriend or your partner. And it's a good idea to use this mirror to be able to see Aries on your feet, because of course my patients will say, Oh, I can't reach my feet, I can't look down there, I don't live with anybody, there's no one to help me, but the mirror never lies, so always keep a small mirror handy. Now, another tip which is good is taking photos. So if you take photos weekly, then you can track any subtle changes because again, our memory, you know, you think, oh, you know, it's fine, it looks better, better than it was. But if we have pictures that we can compare by, then we are definitely on the right track. As I mentioned, shark up foot earlier. I would just like to just take a little bit more time to talk about that subject by itself because it is very, very important and it's very serious. Now, shark foot doesn't happen overnight. You don't just wake up and it's there, and that is why we are encouraging you to check for any changes, you know, know the signs, you know, know your feet, know your body, know if anything has changed. And it's often overlooked, not just in diabetic runners, but in the wider diabetic public. So what is it? Well, to explain it in more detail, it's the bones in the foot which weaken and shift without causing pain. And one of the things that cause it is that warmth, the higher temperature, the swelling, inflammation that will cause a lot of changes in your foot that you just cannot see, but then it means all those things in your foot, like important things like ligaments and um tendons and muscles, they're there. Everything in your foot and your body is there to play a particular important role. And so if those things are not able to work like they're supposed to, then your bones will change, they'll they'll drop, they'll move, they'll go in a different direction, and you know that shift is what causes the problem because then your bones are on the ground and not in your foot, so you find then that your your foot is like really, really flat, and then it becomes deformed and hard to get shoes to fit, hard to get your shoes into any kind of you know, training shoes might be too tight, normal shoes might be too tight, and then you'd have to go into a sort of a custom-made shoe to protect the foot. So, why do runners miss it? Well, because of reduced sensation, and anyone can have reduced sensation, not just diabetic people. If you have the reduced sensation, it means that you you'll keep on running even as the damage occurs, because there's no messages, those messages from the brain are being interrupted and hidden, and so the signals are not going to where they need to go, and so you are not getting the message. And so, why does early detection matter? Well, as we said before, treating early prevents the deformity and the long-term disability, because it will cause you disability and in some cases amputation. So if you have to have your foot amputated, then it will definitely affect your life in a big way. So please, please pay attention because there's just it's just like small, tiny, tiny little changes over time, and those tiny, tiny little changes, we can fix them if we notice them early enough. So, you know, if it's just a little bit of redness or you know, a little bit of inflammation, if we take action, then it won't have the same impact. So, practical tip if you do notice any kind of swelling, redness, warmth, or anything that doesn't resolve quickly or kind of looks like that's a bit odd. I don't recall it being like that before. Please do call your podiatrist immediately or see your GP because early intervention is so critical. Let's look at an example of one of my patients. We'll call her Maya. Now Maya was a type 2 diabetic runner. She loved running and she just wanted to be active and she had put on a lot of weight in the past, and she just wanted to, you know, keep that weight down, maintain that weight. Because of course, if you can exercise and maintain a stable weight, then that has a very positive effect on your pancreas and your insulin. So it's very important that you keep active. Well, when Maya was running, she did notice a slight redness under her big toe. And she didn't feel any pain with it, like it wasn't bothering her or anything like that. So of course she ignored it because if it wasn't bothering her, it wasn't a problem. And after one call to me, she received some guidance on rest, footwear adjustment, monitoring, and I also gave her some advice about keeping the area clean. Reminded her to clean her feet every day and put some antiseptic on it, and lo and behold, the issue resolved quickly. It was there and gone, over and done with. And it meant she avoided infection, downtime, inconvenience, financial burden of having to go see somebody, pay to see a podiatrist. It could even mean time off work. So the lesson is early attention beats waiting for pain because you know that pain may not come. I hope I'm getting the message across that diabetic runners cannot afford to ignore any warning signs. If you want to stay fit and healthy, you want to stay on the move, then please look out for any swelling, warmth, color changes, drainage, anything at all that seems odd on your skin, because these are your body's messages. So listen, act, and prevent setbacks. And please do join our Facebook community to share your stories, ask us questions, let us know what your problems are, and I'm sure we can solve them. And it's also another good way of connecting with other runners. So the link is in the show notes. At the end of the day, if you've been dealing with foot pain and you're not sure whether to rest, change your shoes, get professional help, go see a doctor, we've put together a free runner's foot pain checklist. And you can get access to that through the link in the description. So do make good use of that. And in our next episode, we'll be wrapping up season four with running for life, not just for miles. So please do tune in for that one. It'll be good. So, how to build a sustainable running routine. And we'll be working with your medical team and how to create habits that keep you running safely for years and years and years and years. Plus, one last patient story that shows how consistent care and smart habits definitely pay off. So remember, your body is communicating with you all the time. It's just sometimes we don't listen. So your body talks, especially your feet, and don't wait for pain to come before you take action. Watch out for those small warning signs that tells you something's changed in your body. If you act early and every step you take becomes a safer step towards running for the rest of your life.