Thursday, March 29, 2007
Torn Hamstring - Sara
I just got diagnosed with a torn hamstring (moderate) today. The orthepedic surgeon I saw says
no walking or running for 6 weeks!!!!!! This has me in tears. I've had pretty bad pain for about 3 months (have had the
overall uncomfortableness for 5 total monts), but have kept fast walking (5 mi/hr) and running through it. He said stationary
bike or elliptical are possibly okay as my feet will be stationary. I start physical therapy Saturday. I'm so scared I'm
going to lose so much muscle and fitness by the end of this. I've never gone more than 5 days without working out. Is
the elliptical really not going to hurt it? Any thoughts are greatly appreciated. Thanks.
Reply - Janet
Sara,
your injury is a serious one and was made substantially more so by your insistance on continuing despite the warning signs
your body was sending (pain). If not rehabilitated properly this injury has the potential to really end your running
days, so make sure to follow the PT's guidance and Dr.'s guidance to the letter! You'll need to be diligent
with core strengthening and lots of eccentric type exercises for your hamstring (your PT will guide you in this) and you'll
need to wrap your mind around the fact that getting well is more important than training right now! You want to have
your gift of running for years to come and the best way to do that is to get this injury FULLY rehabilitated before you resume
hard training. I'll be happy to guide you through the return to walking and running phase when your formal physical
therapy is completed. I've gotten many runners through similar (or worse) injuries and you CAN get back to running if
you do it right. As for the elliptical - you'll have to see how your body tolerates it. If it hurts (during,
after or the next day) then you're not ready for that. In addition you may be able to do the stationary cycle -
but again you'll have to experiment with some short sessions (5-10 minutes) and see how your body tolerates it.
For now, your focus has to be on healing - training will resume faster if you do that! Let me know if I can be of further
assistance and try to be patient - this one won't be a quick fix. Janet Hamilton, MA, RCEP, CSCS, Running Strong
coach
4:36 pm est
Wednesday, March 28, 2007
Ankle Pain - Nat
I've had recent ankle pain (interior, feels like tendons.) I thought I was overstretching
so I cut back and I also cut back on the elliptical. It took a while to figure out that the elliptical was part of the problem.
I've been running & spinning successfully for 2-3 weeks and decided to try the elliptical this morning. After a couple
of minutes, I felt a tweak in my ankle and am feeling it on and off now. Is it possible that the elliptical is my problem?
Reply - Janet
It is indeed possible that whatever you're doing on the elliptical isn't agreeing
with you right now. Have you experimented with lower resistance and incline? Have you played around with stride rate
on that machine? Perhaps your shoes are a bit old and not supporting you well? If you're new to running, then perhaps
it's just a case of building mileage too quickly. Back things off, take some time to work on hip strength and hamstring/calf
flexibility (gently) and make sure that your return to running (and the elliptical) is very gradual. If you continue
to have pain on the elliptical but not when running then you can probably say that you're not going to use that as a form
of cross training! Hope this helps - Janet Hamilton, MA, RCEP, CSCS, Running Strong coach
3:40 pm est
Tuesday, March 27, 2007
Knee pain - Lindsey
Hello, I am currently training for a half marathon and am 5 weeks away. I have been experiencing
pain off and on in my right outer knee as well as my inner quad (right leg). Usually bearable during running with alittle
Ibuprofen and TLC. However, Saturday I ran 11 miles for the long run and had to stop for many walk breaks due to pain and
fatigue. Up to this point we have not had to walk. Now two days out from the run, I am still experiencing quite a bit of pain
and not sure what to do from here. Any help would be greatly appreciated. Thank you so much. Lindsey
Reply -
Janet
You probably don't want to hear this, but I'm never a fan of running through an injury that is
significant enough to require Ibuprofen to be able to make the run "bearable". Ibuprofen is a powerful drug
and not only does it blunt your ability to feel pain, it also taxes your kidneys in such a way to possibly contribute to dehydration
issues. Without knowing more about your recent training history it's hard to know if there are training errors involved
-- have you added mileage too quickly? Have you been too focused on faster paces? Have you been adding too much focus on hills?
Are you consistent with your flexibility and strength work? Are your shoes too old or perhaps not a good match for your gait
pattern? The only thing you can do at this point is to back off a bit and let the tissue heal. If your issues
have been going on for awhile ( more than a couple of days) then perhaps it would be worth considering whether this race in
5 weeks is a good idea. You can train through and get to the start line but if you're injured your race won't
be what you wanted and you have the potential to cause other injuries in the process of continuing to train because you'll
alter your biomechanics and put abnormal stresses on other tissues in the process. You have the potential to take one injury
and turn it into several injuries! Perhaps you would consider switching to another race goal and take some time to work on
hip strength, calf and hamstring flexibility, core strength and do a bit more base building? I'd be happy to help with
this if you're interested... as noted on the home page I now have room on my schedule to take on a new athlete.
We may be able to get you through this pretty quickly if we get started on dealing with the underlying causes for the pain
rather than just masking the symptoms with ibuprofen. Janet Hamilton, MA, RCEP, CSCS, Running Strong coach
5:47 am est
Monday, March 26, 2007
Shin Splints - Elizabeth
I have invested in expensive sneaker as well as support banks for shin splint pain and nothing
helps what can I do its very discouraging and I love walking and dream of running one day
Reply - Janet
Elizabeth,
shoes are a good start, but they're only one piece of the puzzle when it comes to getting started in walking and running
injury-free. The unfortunate thing about shoes is that you can't equate the price you paid for a shoe with it's
correctness for your foot type. In other words, many of the most expensive pairs of shoes are very good at cushioning
a foot, but do less well with support - in other words the shoe you have may be too soft and cushy for your gait pattern or
it may not have the right foundation for your extra supports. As I said though, shoes are only one piece - look also
at flexibility issues (tight calves and hamstrings are common), strength issues (weakness in the lateral hips can contribute
to shin pain) and training errors - trying to build your mileage or speed too quickly. I've had really good success
getting people going and getting them through their shin issues - if you're interested in more detailed help check out
the services page of this website. As mentioned on the home page, I have room in my calendar at the moment to take on
new clients so I'd be happy to help you out. Best of luck in your training - don't give up your dream of running
one day. You CAN achieve it! Janet Hamilton, MA, RCEP, CSCS, Running Strong Coach
4:00 pm est
Runner's Knee - Robb
I have been diagnosed with runner's knee, PFPS, but not sure what caused it- potentially ramping-up
my distance too quickly. After a week of resting and quad strengthining and hip strengthening, the pain is gone. However,
I went for a short run today 3.5km and the pain returned at the end of the run. After I stretched my quads the pain is gone
and has not returned all day. Any info with regards to cause, expected recovery time, recovery techniques and focus, etc would
be great. This is a great site, keep up the good work!!
Reply - Janet
Cause - often the factors
that contribute to PFPS are related to lack of adequate flexibility (calves and hamstrings, also quads and hips), inadequate
strength (primarily hips and core, but also quads), biomechanical issues (wrong shoe, fatigued shoe, need for orthotics?)
and finally the big one --- training errors (too much too soon, too many hills, too much focus on speed, etc). Expected
recovery time - depends on how quickly you intervene and deal with the underlying causes. If you take a training break
early on and do the work needed to address these underlying factors you can be back on track relatively quickly (a couple
of weeks). if you ignore the symptoms and try to push through the pain - you'll turn it into a nagging chronic injury
that takes months to get through. The needed exercises vary from person to person and it may be that in your case only
one or two changes could make all the difference. If you're interested in more focused assistance, check out the services
page of this website. I currently have an opening in my calendar for another client and would be glad to help you out.
Regards - Janet Hamilton, MA, RCEP, CSCS, Running Strong Coach
3:36 pm est
Thursday, March 22, 2007
Morton's Neuroma & Hamstring pull - Carilyn
Two issues: I have Morton's neuroma on my left foot and a hamstring pull on my right leg (mid-thigh
area). I've been to PT and my PCP for both. Doing stretching exercises several times daily and taking anti-inflammatories
but still in a lot of pain -- especially the neuroma. (Also got wider shoes and orthotics in my running shoes.) I tried jogging
a couple of times but am now just doing the elliptical and some weights. Are there other things I could or should be doing?
I'd really like to get back into jogging and do a half marathon or 25K but just can't even get started with any kind
of training program because of the pain. (The hamstring injury was from Dec. 26, just standing and twisting; the neuroma has
been coming on since last summer.)
Reply - Janet
Has your PT or PCP emphasized any form of strength
exercise for the hamstring issue? If not - that's a HUGE missing piece in my opinion. Are they both confident
that this is truly just a hamstring strain? The mechanism of injury is a little odd for a hamstring - typically standing
and twisting isn't a common way to strain a hamstring. The neuroma thing - the wider shoes and orthotics should
help, but have you also been doing your calf stretching exericses regularly? If not - add those in several times a day (don't
do the one where you stand on a step and drop your heel off though - that will likely irritate the neuroma). Also keep
in mind that some people respond well to something called a metatarsal pad which is a teardrop shaped bump on the orthotic
that supports the transverse arch of your foot. You may want to talk to your podiatrist or pedorthist or PT (or whoever
built your custom orthotics) to see if they think that might help. Also keep in mind that the elliptical trainer is
great for maintaining cardio fitness but it works your body in a different way than walking and running so trying to jump
from the elliptical straight back to jogging may be a bit too aggressive. You may need to transition back to a walking
program and then systematically work back into a walk/jog and eventually back to a full running program. I would be
happy to help with this if you're interested, as well as guide you in some strength and flexibility exercises that might
help. Check out the services page of this website for more details. Hope this helps. Janet Hamilton, MA,
RCEP, CSCS, Running Strong coach
10:25 am est
Monday, March 19, 2007
Hip Flexor Pain - Chris
I have experienced Hip flexor problems for about 6 years. I tore my left Hip flexor when I was
younger and the problem pursists. I never have a moment when I am pain free, it feels better when I wear those heat patches
but yet it does'nt solve my problem. I stretch, work out, play other sports, I dont know what else to do.
Reply
- Janet
Depending on what you mean by "work out" - you may have missed some key strength issues. It's
probably not so much flexibility in that muscle that you need but rather a good deal of strength in the previously injured
muscle and even more so - in the region around your hips, low back and abdomen. No muscle functions in isolation, so
strengthening all the muscles in the region, especially the weak links in your chain may help. Depending on what other
types of sports you do and what stretching you're doing, you may be helping the issue or hurting it. Carefully rehabilitating
a torn muscle is vital. If it's not done properly, then over time compensatory patterns of movement take place and
muscle balance in the region is affected. Perhaps some focused attention on functional strength training will help bring
things back into balance. If you would like help with this - please see the services page of this website, or consult
with a good orthopedic Physical therapist for assistance. Hope this helps a little - Janet Hamilton, MA, RCEP, CSCS,
Running Strong Coach
6:00 am est
Snapping in Ankle - Jonathan
Over the last year or so, I've begun to get this snapping feeling in my ankle, as if a tendon
were being plucked upon. It's becoming more frequent and only happens when I use a longer stride (walking fast or running)
and happens specifically as I bring my foot forward.
Reply - Janet
There could be any number of
things going on here. Have you ever sprained your ankle? If so, perhaps you tore a sheath of tissue known as a "retinaculum"
that is responsible for holding the tendon in it's groove. It could also be that as you increase your stride length,
your biomechanics change and you pronate further or later than usual. Perhaps checking into different shoes would help?
The other thing to consider is flexibility - especially in your calf muscles. If you're tight there, that affects
your biomechanics more when you're taking longer strides. If you're not consistent with calf flexibility exercises
that would be something to add into your routine. Hope this helps. Janet Hamilton, MA, RCEP, CSCS, Running Strong
Coach
5:55 am est
Wednesday, March 14, 2007
Hamstring Issues - Carol
I have been running for just two years. The last few months I have been in physical therapy for
what turned out to be bulged disks caused from sitting too much at my job. After that healed I noticed the pain in my left
hamstring is worse. My PT said that I need to take 4-6 weeks off but has not told me what is wrong. The pain in my hamstring
goes away after a day or two but returns within 10 minutes of running. I'm hoping I don't really have to take 4-6
weeks off completely because that would have drastic mental and physical implications for me. Is there a way to recover a
hamstring injury while still running or at least shorten the time off to say 2 weeks? The PT didn't do a lot to figure
it out - just said stop running
Reply - Janet
The short answer is yes, it is possible to adjust
training in such a way that you can potentially continue to run. There's more to it than that though... what was the original
hamstring injury? Did you strain it? Or perhaps this "hamstring injury" is really lingering symptoms from your previous
low back disc issue? Am I safe in assuming that your PT emphasized exercise in your rehab from the bulging discs? If
so - those exercises should be on-going. If instead the PT focused only on symptom treatment (soft tissue massage, heat,
ultrasound, traction, etc) then perhaps there's a missing link in that your biomechanics are affected by weakened core
muscles. I'd be delighted to help you work through this - specific attention to flexibility exercises, strength
work to get your hips and lower back strong again, perhaps gait analysis to make sure you're in the correct shoe, and
detailed attention to proper progressions of training usually work pretty well to allow a runner to continue what they want
to do as they are healing an injury. If you're interested, you can log on to the services page of this website,
or you can send me an e-mail if you prefer. E-mail address is "janet at runningstrong dot com". Hope
this helps - don't give up the idea of running just yet! Janet Hamilton, MA, RCEP, CSCS, Running Strong coach
3:33 pm est
Tuesday, March 13, 2007
NASIR - treadmill running and knee injuries
Which action is less likely to injure knees? Running on treadmill at 10% incline with a speed
of 5 miles per hour or at an incline of 1% with 7.5 MPH speed? Thanks
Reply - Janet
This one is
hard to give a pat answer to. For example - if your issue is patellar tendinopathy or ITB syndrome, you may find that
uphill running at a slower speed is worse than more level running at a faster speed due to the length of time the muscle is
contracting being longer at a slower speed. If on the other hand your issue is patella-femoral syndrome you may
find that the slower speed is better. I think the issue is to specifically define what injury you're referring to
- and deal with that tissue issue from a standpoint of treating the underlying cause for the symptom. Also keep in mind
that treadmill running is by nature NOT the same as running on mother earth with it's regularly undulating surfaces, uphills,
down hills, slopes, etc. Why run on a treadmill when there is a much healthier option (outdoors!). My take on
this is that you need to not worry about the treadmill setting so much as you should concern yourself with WHAT specifically
is injured and then treat the underlying causes of that injury (flexibility issues, strength issues, biomechanics issues,
training errors, etc). Hope this helps a little. Janet Hamilton, MEd, RCEP, CSCS, Running Strong coach
9:48 am est
Donna - Numb ankles & toes with speedwork
My daughter runs track and is complaining of numbness in both of her ankles and toes when she
runs. She is okay when she runs a training run, but when she does speed work and sprints her ankles go numb.We got new shoes
2 weeks ago at the running store, and superfeet inserts. She had stress fractures 2 years ago, and those are resolved, but
the past two years she has mentioned the numbness in her feet. We have purchased Saucony shoes by the sales person each time,
but we are wondering if the back of the shoe is pressing on either side of her heel when she runs. The shoe has the two points
in the back on either side of where her heel fits into.Should she remove the superfeet or can you give us any suggestions,
this is slowing down her training and speed
Reply - Janet
That is a little odd that her symptoms
are absent with training paces but come on with faster paced intervals. Where were the stress fractures before?
Does she notice any difference in symptoms when she's running in the normal versus superfeet insoles? If she's petite
- perhaps the collar of the heel counter is contributing to the issue but that's not the most likely issue. Does
the numbness last throughout the speedwork and then resolve quickly when the pace slows or does it linger for a bit after
slowing? Has she been evaluated by an orthopedist? How old is she and how long has she been running? I'm
sorry - I seem to have more questions than answers for you! Janet Hamilton, MEd, RCEP, CSCS, Running Strong Coach
9:15 am est
