Hi Janet, Thank you very much for answering my question. I will definitely make an appointment with my orthopedist. Hopefully its not the meniscus. It is a strange problem as it hasn’t really hampered my running at all (except for those occasionally sharp pains) and I am actually running faster now than I have in the past three years (I’ve set PRs in 6 races since January). I do strongly believe the injury stems from the skiing trip, and I certainly don’t want to make the condition worse though. Although again, the problem does seem to be slowly improving. Thanks again for your advice and for providing the motivation to see an orthopedist. Brian
Reply - Janet
Brian, once you've cleared yourself of any joint issues (meniscus), then we can move forward on dealing with the other factors that might be contributing to your symptoms. Things like hip/core  muscles that aren't quite up to the speed you're putting on may be an issue.  As you have worked on getting faster, if your core and hip muscles aren't quite up to the task then as they fatigue your biomechanics may falter and that alteration in your movement pattern may be contributing to the intermittent pain.  Likewise if you're doing too much intensity training, you may be just working your way into an overuse training injury.  First things first -- make sure you're not dealing with a meniscal injury, then the rehab path can be determined!  Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor

I sometimes experience a sudden sharp pain in my left knee (in the center just below the knee cap) while running. I believe this pain stems from when I twisted (or perhaps hyperextended) my knee in December 2007 while downhill skiing. The pain is sudden and sharp and causes me to slow down and alter my gait for a few seconds, but then the pain will go away just as quickly and I can continue running with no problems. If it happens, it usually only happens once during a run (sometimes 2x). Some other phenomenon associated with the pain: 1. The pain occurs unpredictably, but it seems to happen more when I am running downhill or if I happen to land funny on my left foot. 2. It happens more when I am running fast than running slow (e.g., it hardly ever happens on 10+ mile easy long runs; it is more likely to occur when running fast downhill). 3. Exception: It has never happened during a race (10K to half marathon). Just while training. Regarding the ski injury: 1. There was some mild swelling for a few days. 2. I stopped running for 2 weeks. 3. My knee would buckle slightly if pushing off laterally (for about a week or so). 4. I can still not completely assume a full squatting position (especially if leaning forward, into the squat) without some tightness/pain in my left knee. This has improved greatly since December and it appears to be improving still. Overall, the condition seems to be improving, but I would feel better knowing the cause of the pain and any exercises to improve/strengthen the knee. Thanks, Brian
Reply - Janet
Brian, with the description of your injury, the immediate post-injury swelling and buckling and the ongoing issue with difficulty squatting down I'd be suspicious about your meniscus being injured.  Have you seen an orthopedist to have some diagnostic imaging done?  Perhaps an MRI or CT scan would reveal what's going on in there. If the meniscus comes up clean, the next thing to rule out would be patellar tendinopathy.  I think your first step (if you've not already done so) is to schedule an appointment with an orthopedist (your general doc should be able to refer you).  Once you know what you're dealing with it's much easier to plan your rehabilitation path.  Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor

I've came up with what I believe is a case of runners knee in my left knee. I hurt it in late March, and was running on and off with it, but not giving it enough rest to heal. So I decided to rest it all Summer, and do alot of swimming, biking, and the elliptical machine to stay in shape for the time off. Even though I do this my knee still gets alittle tight, but not nearly as much from running on it. I was wondering if this is the right plan, and is that okay? Also about how long is the healing process, or about when would be okay to try to start running again?
Reply - Janet
Although the biking, swimming and elliptical will keep your cardiovascular system in shape for running, none of those things directly deals with the underlying factors that caused your knee pain in the first place.  This is probably why your symptoms are not resolved (though with the different forms of stress, they apparently are getting a bit better).  Have you dealt with the underlying flexibility and strength issues?  Have you had a gait analysis done to see if your shoes might have played a role?  "Runner's knee" is a complex issue and usually has several things that need to be addressed.  Some to consider include:
1) Lack of adequate flexibility - especially hamstrings and calves but also hip flexors and quads may be tight.
2) Lack of adequate strength - usually it's core muscles in the lateral hips and lower back that need work - don't bother with the knee extension/curl machine at the gym it will likely make things worse not better
3) Biomechanical issues -perhaps your shoes are worn or aren't correct for your gait pattern?
4) Training errors - too much mileage too quickly, running at too fast a pace all the time (very common), too many hills, too much speedwork, etc.

Hopefully this is food for thought.  If you'd like specific help rehabilitating from this injury and getting back to running I'd be happy to help.  Please see the coaching/services page for more information or feel free to contact me directly by e-mail.  Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor

I HAVE A TORN HAMSTRING, NOT TO BAD BUT CANNOT RUN ON IT. IS IS OK TO BIKE? I HAVE BEEN INVITED ON A 30 MILE BIKE RIDE ON SUNDAY?
Reply - Janet
I don't think a 2+ hour bike ride on a torn muscle is a good idea.  Is this a "self-diagnosed" tear or have you seen a doctor and had some form of diagnostic testing to confirm a tear? If it's a mild strain, that's one thing... if it's a tear (severe strain) that's another.  I'd still think that if this is a recent injury you'd be better to NOT do that 30 mile ride.  That's a pretty long/intense workout for an injured muscle. Just my 2 cents worth.... Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor

Janet, many many thanks for your reply, I certainly took your advice to heart. I've been off running for 6 weeks now and will hold off at least another 2. The PT I've been working with is terrific; he's (thankfully) familiar with EDS and has given me great - as in easy to remember and not agonizing to do - strength-building exercises for the calf, foot, quad, the whole shebang after the therapeutic work we've been doing. He's even agreed to work with me off-site to help with race training. I'm not calling off the fall marathon just yet, we're going to continue working together and see how it goes. If it turns out not to progress as smoothly as hoped, I'll just focus on halfs and 10Ks, as you suggested. I've been really cautious in my non-running training and am taking this very seriously, and your advice was very much appreciated.
Reply - Janet
That's great news Jessica! Sounds like your PT has taken a good "whole body" approach to integrating strength from above to assist your posterior tib.  Hopefully your PT is as good a running coach as therapist and you'll have good success in your future race plans.  Glad to hear it all worked out well.  Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor

I have a pain localized at the toe next to the big toe and the pad underneath it. This has been gradually getting worse over the past few months, with it occuring more a few hours after a long run. It also always seems to be worse in the morning, getting better later in the day. I use an orthotic and have not changed it. I have been running for many years and this is a new injury for me. Any suggestions would be appreciated. Lou
Reply - Janet
How old are your orthotics?  Could they be fatigued and no longer supporting you the way they used to? Have you changed your training in any way (more miles, more hills, more speedwork?). Sometimes if you ramp your training up and don't do some flexibility exercises to maintain adequate flexibility then things start to tighten up.  Usually with forefoot symptoms I look to the calf muscle as the culprit.  Perhaps you can make a visit to the practitioner who made your orthotics originally and have them checked for signs of material fatigue.  One other item to look at is your shoes -- are they old? are they a different model than you were wearing before?  Hope this helps a bit. Feel free to e-mail me directly if you have more questions.  Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor

I run track and cross country. Im trying to shave time off my mile and two mile and I hear that if you shave your legs that you get less resistance and therefore a better time. Is this true?
Reply - Janet
I'm not aware of any research that bears that out -- but if you want to experiment on yourself you can sure give it a try.  It's hair... it will grow back.  Seriously, for the amount of wind resistance that might be encountered, I think we're talking about a pretty small change.  Doesn't seem worth it to me.  Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor