Janet, This morning I was running at a harder pace than usual. My intent was to run intervals. I'm not training for anything but just completed a marathon and half marathon recently. At 4.75 miles I experienced a shooting pain in my left buttock causing me to stop immediately. It's been half a day so far and my left buttock cheek is sore when I start to walk. I don't have any lower back pain. I have had some hamstring problems this year. Do I have a sciatic problem?
Reply - Janet
Michael, depending on how fast you were doing your intervals and what your recovery method/pace was... you may have strained a hamstring at it's insertion or you may have tweaked a facet joint in your lower back, leading to muscle quarding (and pain) in the buttock region.  Muscle spasm or guarding in the buttock region will compress the sciatic nerve and can resemble sciatica symptoms.  The fact that you've had hamstring problems before this year, and you were doing the intervals while probably not adequately recovered from your marathon and half marathon races leads me in the direction of a muscle strain. Take it seriously -- they can be a bear to heal if you bludgeon your way through them!  Obviously rest and possibly some ice are in order. A few days off, perhaps some not-too-deep massage work from a good sports massage therapist (don't let them work deep yet) and a little more recovery time from your recent racing schedule and all will be well.  Did you rehab the hamstring properly the first time?  If not - that would certainly be somthing to strive for!  Best of luck, let me know if I can be of assistance.  Janet Hamilton, MA, RCEP, CSCS, RRCA-Certified coach

I am 48 years old and first took up running 3 years ago. I got up to the point I could run 3 miles 3 times a week (although not in warm weather, I would lose my stamina in weather over 75 degrees). I thought my running was slow at about 10:30 a mile. Roughly 20 months ago I had a serious reaction to an antibiotic that impacted my health and have mostly recovered. However, I find some weeks I can run 3 miles and other weeks I can just barely do 2 miles. I run out of stamina. My running has also slowed down to about 11:00 to 11:15 a mile. I try to exercise 5 days a week with weight lifting and cardio (like a precor for 30 minutes if I am not running). Can you suggest anything to help my on and off stamina for running so I can consistenly run a 5K? My goal would be to eventually work up to running 5 miles, however, I have never been able to do that in the past. Thanks.
Reply - Janet
without knowing more about your specific situation, the solution that jumps to mind is to consider doing a run/walk combination.  Perhaps walking the first half mile for warm up, then alternating periods of running with periods of walking would allow you to build your distance back. If you've been doing continuous running for those 2-3 mile runs, perhaps try switching to 5 minutes running and 1-2 minutes walking?  The trick is to walk before you feel you absolutely have to, and begin running again when you feel recovered.  Most people are able to significantly improve their distance if they allow for walk breaks.  Hope this helps. Janet Hamilton, MA, RCEP, CSCS, RRCA-certified coach

Hey janet, this is me again. I got into a bone scan and got my results and it shows i have a long stress fracutre on my left tibia of my left shin. he said i have to lay off of it for awhile but i also need to keep my endurance up for running, how els can i do this?
Reply - Janet
Sorry to hear about the stress fracture! Talk to your orthopedist and ask about whether or not you can load the leg at all. Swimming might be your best option and if you use a pull buouy your legs float and you won't be working them at all.  If you're allowed to load the bone at all, then regular swimming, and deep water running (use a flotation device like a "wet vest") would be options.  If you're allowed a fair amount of loading, you may be able to use a stationary bike.  You have to ask your doctor though because the exact location of the stress fracture will determine what you're allowed to do.  Also make sure to take this time to work on the underlying CAUSE for your stress fracture - flexibility, strength, biomechanics... training errors... they all play a role.  Get to the cause so that when you do come back to running (very gradually) you won't have another injury.  Best of luck. Janet Hamilton, MA, RCEP, CSCS, RRCA-certified coach

Hi Janet, I wrote to you awhile back about having a bulging disc, but I guess it is a herniated disc on the right side. But most of my pain is on my lower left side of my back. Also, I noticed my legs have started to have an aching feeling-almost like I need to stretch them or move around. I have changed my routine a lot-I haven't been running, I used to wear heels all of the time, now I only wear flats, and I also got a new bed. Could this all be contributing to having more pain? I also received an epidural shot and the pain just seemed to move to a different place in my back. I am so frustrated right now and do not know what to do. I feel like I have tried everything-stopped running, ice my back, use heat on my back, take ibprofen, light walking. Am I ever going to be able to run again? Any information would be great! Please help! Thanks!
Reply - Janet
Valerie, a herniated disc is a serious issue and can present some pretty complex symptoms.  Rest is good, heat and ice are fine, but none of that addresses the underlying muscle weakness/tightness that is contributing to the pain.  Have you seen a good orthopedic physical therapist to get started on some exercises to address these issues?  If not -go to the top of this blog page and use the search engine to find an OCS (orthopedic certified specialist) PT in your state and when the list comes up, narrow your search either by geographic region or by looking for an OCS PT that specializes in lower back pain.  This will not be a quick fix.  You'll have to work on flexibility (calves, hip flexors and hamstrings most likely), strength (lower back and lateral abs and hips) and be patient as your body recovers from this. Walking is a great form of exericse - as is backwards walking for short distances.... 30 feet or so at a time... your sudden change of footwear may have contributed to your soreness, but it's a move in the right direction!  Best of luck
Janet Hamilton, MA, RCEP, CSCS, RRCA-certified coach

I have a tibial stress fx in my lower left shin. Here's the timeline: 6-7 weeks ago- started feeling pain in my shin at the start of a run but would go away. For a week or two, I ran my normal training volume (60-70 miles) tolerating the dull pain. Shortly after a 20 miler and some speedwork I was limping. I took 3 days off, felt a little better, and ran a Labor Day half marahton I had signed up for (9/2). Felt no pain in the race and ran a PR by over two minutes. I couldn't walk for 2 days. Tried to resume running later in the week but had three terrible runs w/ considerable pain. I threw in the towel right there (9/9). Knew I wasn't going to be able to run Chicago Marathon, 4 weeks away. I switched to xtraining (pool running, eliptical, biking) and had 2 acapunture tx's. Acupuncturist told me to try runnning again, so I went for 50 minutes one day which was awful (9/22). Then I went to see and MD who said stress fx, no running for 6-8 weeks (10/1). I started PT a week ago. My concern is that I stil have pain when walking? I'm spending a lot of time on the eliptical (1-2 hr workouts) every other day. Is that delaying my leg from healing? It doesn't feel much better than it did a month ago even though I've run just once in that time. What's the fastest route to getting this injury healed?
Reply - Janet
Dave - did your orthopedist who diagnosed your stress fracture OK the 2 hour elliptical workouts?  If so - I'm stunned! You have a broken leg.  Clearly - doing 1-2 hours of weight bearing exercise every other day is a HIGH volume and intensity for a broken bone to tolerate.  I think you should reconsider your approach to your health and training.  Running is a gift... one that can easily be taken away from you if you foolishly try to bludgeon your body while it's trying to work the miracle of healing.  Clearly listening to your body is a new thing to you since you continued to train despite pain.  Perhaps it's time to tune in to the signals your body is trying to send and give this injury the respect it deserves.  Check with your physician - I think they might consider your continued high intensity training to be a bit much.  One more thing, keep in mind that there are ares within the lower leg bone that don't have the best blood supply and therefore are more prone to a NON-UNION fracture... which requires some serious intervention in the way of surgery to repair.  You might want to consider backing off and letting your body heal! Janet Hamilton, MA, RCEP, CSCS, RRCA-certified coach

Hi ~ I started having pain in my right leg, in my groin area a few weeks ago. It was very subtle and just kinda nagging pain. Nothing major. I kept running and training (training for MCM) and over the last few weeks it became MUCH worse. I thought at first it was a groin pull, but now I believe it must be something diffrent. On some days, I am able to run, even got in a 22 miler on Saturday. Then Monday, went out to run an easy 5, and didnt make it 1/2 into the run. The pain was unbearable! I have a dull pain in my lower back, on the right side and a SHARP pain in my groin area of my right leg. My right leg is also VERY weak. If I put all my weight on that leg, I will almost fall over b/c the leg cannot support the weight of my body. Any help would be greatly appreciated! I'm nervous as I have the marathon in less than 3 weeks! Thanks!
Reply - Janet
Obviously you're not going to want to hear this but.... its time to see your orthopedist. The symptoms you describe are serious and in some ways sound like those that are similar to a stress fracture.  You must get this checked out now.  X-rays will likley not be the best diagnostic tool as they generally miss stress fractures.  Your orthopedist will likely do either a bone scan or MRI.  Get an appointment first thing tomorrow morning.  Do not wait. Janet Hamilton, MA, RCEP, CSCS, RRCA-certified coach

Hi Janet, me again one more time about the pelvic stress reaction/labral tear. Saw a new doctor who said the tear wasn't that significant and doubted it was the source of my pain and that lots of people had tears to the labrum. He thought hip impingement was the problem. He recommended a guided cortisone injection to relieve the inflammation and impingement problem. He also thought I would be OK with running in the future without any sort of surgery to fix the tear. Does this make sense? Anything I should worry about with getting cortisone for this problem? I have had two doctors look at the same MRI, one said to not run much ever again, the other said I should be able to have a productive running career, and neither seemed concerned about the tear so now I am slightly confused. The second doctor (who has recommended the cortisone and thinks I can still run) seems much more with it and attentive though.
Reply - Janet
Hi Jeff, a single cortisone injection, well placed (i.e. guided) isn't necessarily a bad thing, but it doesn't answer the question of why you have this inflammation in the first place.  If indeed the issue is inflammation and not due to the labral tear - this shot will prove that point.  Perhaps a third opinion is in order since the first two were such polar opposites in their approach? A labral tear may or may not affect your running - it depends on where the tear is.  Perhaps you could ask this second orthopedist (who you seemed more comfortable with) if he/she could recommend one more person for a final opinion.  Time consuming, but probably well worth it in the long run. Eventually though you've got to get a handle on the CAUSES - for that you may need to get with a good biomechanically minded PT or other specialist.  Janet Hamilton, MA, RCEP, CSCS, RRCA-certified coach