I have been training for the Disney Marathon which will take place on January 13th. This past Sunday I suffered a back injury while lifting something, I believe it is a lower back strain. It was quite painful on sunday and monday but has been feeling better, but still tight, since then. I have not run or exercised since then, and have been taking NSAID's. I had built up to 60 miles with my longest run at 20 (12/16) and a 15 mile goal marathon pace run (12/09) at a 6:40 pace which felt comfortable. I had planned on doing 22 miles on monday and starting to taper the last 3 weeks. I'm not quite sure how to approach my training from this point, my goal now is to recover from the injury and get to the starting line healthy...any suggestions?
Reply - Janet
Sounds like your training up to this point was pretty solid so you might be wise to just back off and make your taper a week longer than planned.  Muscle strains take time to heal and hopefully that's all you injured in your back.  Several days off running, using ice and walking to help alleviate muscle spasms is a good first step.  If you've not seen a massage therapist, that might also be something to consider.  If symptoms don't improve with several days of rest and some help from your massage therapist, then perhaps a visit to the doc is in order to rule out something more than a pulled muscle.  Walking is a great form of rehab for back injuries because the low-load, rhythmic movement helps promote blood flow. I don't think doing a 22 miler a week after a back injury is a great plan.  Listen to your body -- if you're still having symptoms, don't push it... let it heal!  Good luck, hopefully you'll make it to the line healthy.  Janet Hamilton, MA, RCEP, CSCS, RRCA-coaching instructor.

I am a 25 year old female distance runner and was just diagnosed with an ischial stress fracture. I was underweight for the last 6 years and competing in marathons and ultras, and in the past 6 months gained 50lbs. I also suffered from some unexplained muscle injury in my legs (burning and redness that wouldn't go away) and finally got back to running for 3 months until this happened. I had groin pain all of a sudden, and they thought it was a groin pull. It took a month to get to see the Dr. and get a bone scan. Luckily I can walk without pain and even stand on the affected leg and hop up and down. I wanted to know what the best thing to do right now would be- I feel that the weight gain (too much for my frame) put extra strain on my body too. I would really like to at least do some exercise like elliptical or bike, as these don't hurt at all. I will listen to the doctor but want to hear your ideas. Thanks!
Reply - Janet
Kris I'm not sure I've got the time table right but if I understand your question, you gained the weight before you got the stress fracture? Were you running during this period of rapid weight gain?  I would think that as long as the activity does not cause you discomfort, you're probably going to be cleared by the doc to go ahead and do it.  I prefer to have athletes cross train using several modes rather than just using one or the other (bike or elliptical).  If you are cleared to walk, that may also be a mode of strength building and cross training for you.  Your case seems kind of complex and I would really need to know more about the time line and other details to offer more specific guidance. I'll be happy to help -- I just need to know more.  If you're interested in this, log onto the services page of this website and download and complete the coaching questionnaire and send it do me either in the body of an e-mail or in a word attachment.  It sounds like there may be several things that need to be worked on!  Hope to hear from you. Janet Hamilton, MA, RCEP, CSCS, RRCA-coaching instructor

In an un-running related accident I broke my 5th metatarsal (undisplaced, proximal end). My podiatrist have been really good getting me basically healthy, but now I need a plan to get running again. Prior to the injury I was training for a 1/2 marathon (not my first) and I am hoping to be able to run another soon. How do you start training again after a broken bone, are there specific work outs avoid (or do more of), is the advice for a non-running related injury different than a stressed induced injury?
Reply - Janet
Meera, the bone has to heal whether it was broken in training or by kicking a coffee table! You're wise to have sought the assistance of a podiatrist with this.  If you've only been off running for a few weeks, start back with a walking program for a week or two and evaluate how you feel. If you can walk painfree with no limping then you'll be able to make a transition to walk/jog and eventually get back to training.  There's a chance that while you were off training you may have lost some flexibility and strength so make sure to do your homework there. Also, as you get back to running, remember the cardinal rule - build mileage first, not speed. Keep your pace easy and build your endurance. I'll be happy to help you through the process. If you're interested, either send me an e-mail or check out the services page of this website.  Good luck on your return, make sure to discuss footwear with your podiatrist if you haven't already.  Hope this helps. Janet Hamilton, MA, RCEP, CSCS, RRCA-coaching instructor

Hi, Last night I did a track session of 5 x 1km. After the third rep I did a stretch where I rested my right ankle and knee on a bench at a right angle to my body. I pushed down on the knee to get a better stretch and my knee let out a MASSIVE crack. I got a sharp pain on the lateral side of my knee and hamstring. It was quite debilitating. I finished off the session but could feel the back of my knee, lateral hamstring and top of my calf siezing up. The pain on the lateral side of my hammy got worse during the night. I iced it a couple fo times. This morning I cant flex my hammy without severe pain. I get no pain when my leg is straight. I get the pain mainly behind my knee and in the large tendon running into my knee (next to the ITB). Any ideas on what this is? Can I strap it and keep running? What sort of treatment woudl you recommend? Thanks heaps.
Reply - Janet
No you can't just strap this and keep on running. In fact, trying to complete your intense workout despite "debilitating pain" wasn't such a good idea -- but we won't go into that.  Let's get to the queston of what this might be.  You might have pinched your meniscus or perhaps partially torn a muscle (strain) or tendon.  I think at this point your best bet is to take 4 days completely off running (even the easy pace stuff) and REST in hopes that whatever you've damaged can heal.  I think it would also be reasonable and wise to make an appointment with your orthopedist to get this checked out. Posterior knee pain (back of the knee) and "massive crack" and "debilitating pain" all point to something more severe than just a strain.  Get it checked out.  When you're cleared to run again, be cautious. You may also want to reconsider your flexibility exercise form -- sounds like you were going WAY too far... sort of applying "more's law" (if a little is good, more is better).  Best of luck - get that appointment with the doc.  Janet Hamilton, MA, RCEP, CSCS, RRCA-certified coach