I have been an injury free runner for 20 years. I am 37 and training for my 3rd marathon. During my last 20 miler I began to have pain on the outside of my knee. At mile 10 it was so incredibly painful and stiff. I finished the run and was not able to walk for the rest of the. I took 5 days off and have R.I.C.E. Will it be possible to run through the pain again for the marathon in two weeks without doing irrepairable damage?
Reply - Janet
Pain is your body's way of signalling you that there is something wrong. I'm not a fan of trying to ignore the body's attempts to keep me from hurting myself further. You've started off on the correct foot to rest this and ice it, hopefully whatever you've injured will heal quickly but two weeks is a really short time to hope for a full and complete recovery.  You'll be tempted to take over the counter anti-inflammatory drugs to make it feel better but I'll caution you to make sure you're not running with those drugs in your system. They are analgesics (pain killers) in addition to being anti inflammatories. If you mask your body's ability to sense pain, then you run the risk of doing much more damage by running through an injury that would have otherwise stopped you.  This isn't your first marathon... you know what's coming... and it just doesn't make sense to push through pain and risk further injury for the meager rewards of a medal a shirt and some bragging rights. Perhaps you can put this marathon on hold and schedule another one in a few months - and in the meantime get well and work on the underlying reason for the injury (training errors? shoes? strength imbalances? flexibility issues?).  Wishing you a speedy recovery -- Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor

On June 8, 2008 I had an accident in which I broke my tibia, tore my ACL and my medial meniscus. After the leg healed and I had therapy to bend the knee again, surgery on the knee was performed on 8-4-08 in which my OS did a hamstring repair on the ACL and was able to repair the meniscus. I was 6 weeks non-weight bearing but did start therapy at 5 weeks post-op to begin bending the knee. Prior to all of this I was a runner - ran 3-5 miles 5-6 times a week. OS says that the repair is the best thing for me. I'm 38. Right now I'm very nervous as I don't feel I'm coming along as well as I should. I'm in my 3rd week of therapy and I'm still using a cane with the leg brace and it hurts like crazy to put weight on it most days. Bending is fine - I can get it to 105 degrees. I know I still have a ways to go as my OS told me to expect 3 months of therapy. My main question is, when can I expect the pain to go away and at what point will I feel normal again? Also, do you think I'll ever be able to run again like I used to? Thanks!
Reply - Janet
Hi Michelle - sorry to hear about your accident and the surgery. You've had a long path so far and your orthopedic surgeon is right... you've got a long way yet to go.  The good news is that the meniscus was repairable - and although that means a MUCH longer rehab time, it will probably mean a better long-term outcome for your knee over your lifetime.  Meniscal repairs are much slower to rehabilitate because the meniscus doesn't get much (if any) blood supply so it's VERY slow to heal and regenerate tissue.  For this reason you have to be a bit conservative in how you approach this rehab.  Talk to your PT -- ask them how many meniscal repairs they've worked with (hopefully many) and ask them what their experience has been.  In my experience it's a long road.  I wouldn't rush back to running until you're walking painfree up to 12 miles a week.  You need good hip strength, normal joint mobility, good quad and hamstrings strength, and a nice patient approach to your training when the time comes.  I do think you'll be able to return to running like you used to -- but it's going to take some time.  You can't bludgeon your body back to fitness... you're going to have to finesse your way back to where you were before.  Be patient. Talk to your PT and if you don't sense that they have enough experience in rehabilitating meniscal and ligament repair surgeries... seek out a more experienced PT!  Hang in there - I predict you'll run again!  Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor

I was running everyday for a while when I first started and started off slow about 5.0 then as time went by got to like 5.5 or 6.0, but that was really taking time and working my self up there. I had not ran for a while and now when I do it hurts when I go anywhere past 5.3 or 5.4 mph. It has a slight pain right where my pelvic and hip meet. It goes away once I rest and comes back if I run a little to hard, but it's really not to hard for me. I like running about 5.5 mph. Do you know why this is?
Reply - Janet
Melissa, there are several variables to consider.  Are you doing ALL your running on a treadmill (hopefully not) and if you're doing any running other than on a treadmill - does it bother you the same way? If you run on a treadmill exclusively, it may be that the pace and incline you're selecting are not appropriate for you.  If you've been keeping the TM inclined the whole time, try doing a rolling hills type or flatter incline (vary it from 0% to perhaps 4 or 5%).  Are you consistent with stretching your calves, hamstrings and hip flexors?  Are you running in a shoe that's appropriate for your foot type and is the shoe in good shape or perhaps it is fatigued and old? Pacing - most people select a pace that is too fast for their current fitness level when running on a treadmill.... because running on a TM is much easier than running a similar duration or distance over land.  You might try  easing your pace or better yet -- go out side and run on mother earth...  you may find that your hip/groin pain is improved.  Finally - if you're already good about your stretches, know that you're in the right shoe, and know that you're pacing properly... it might be worthwhile to have someone evaluate your lower back.  Sometimes low back issues can refer to the region you're having symptoms in.  Best of luck, hope this helps.  Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor.

I am a 50 year old woman and have been running for many years. Over the past 2 years every 5-6 months I have been getting tendonitis in my calf. I can run about 5-6 miles and then I have to completely stop and am down and out for a week or two. Today I had to drop out a half marathon because of the pain. I have tenderness with pressure at the site and I feel it going up and down stairs. What would you suggest to treat and to not have this happen so often to me. One other thing, I have noticed that I have hip pain the day before this tendonitis really kicks in. Could it be due to weak hamstrings????
Reply - Janet
Well, it could be issues related to weakness in your hamstrings... it could also be issues in your lower back that are referring the symptoms to your calves. Without knowing more about your training it's hard to speculate as to a cause.  Some things to look into:
1. Flexibility -are you consistent with general flexibility exercises after you run? Areas to pay particular attention to include the calves, hamstrings and hip flexors but don't forget spinal flexibility and perhaps your quads as well may be playing a role.
2.  Strength - are you pretty consistent a couple of times a week with some general lower body and core strength work? Perhaps if you're weak in your lateral hips or lower back this could be placing a greater load on the smaller muscles downstream?
3.  Footwear - are your shoes correct for your gait pattern? Are they relatively fresh (not fatigued)? Do you wear orthotic support and if so, are the shoes correct for your orthotics (i.e. they should compliment each other, not work against each other)/
4.  Training - have you been conservative in your build up of mileage? Do you do most of your runs at the proper easy pace? Going out and running at/near race pace is a common training error, make sure you're not doing that!
5. Have you been seen by a doc to make the diagnosis of tendonitis or are you self-diagnosing?  If you've not seen someone, don't assume that this is an inflammatory process.  As for how to treat - ice is usually generally recognized as helpful but it depends on exactly what tissue is symptomatic. Work on hip/core strength, maintaining or regaining lost flexibility, and train smart.  In order to give you more detailed assistance, I'd need to know a lot more about your specific recent training.  It sounds like it's something that is relatively easy to resolve if we get right to it and don't let the symptoms linger.  Feel free to e-mail me directly if you have more questions.
Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor

i started back power walking/jogging about a month ago. i stopped during my menstrual and the bad weather in florida. about three days ago i felt twitching in my left knee and my knee would buckle at any given time when standing. i dont feel anything when sitting but i have to stand at work because i am a hair stylist. i was told that it could be a lack of potassium, calcium, magnesium, but i take a daily vitamin everyday. im 35 years old.
Reply - Janet
Wow... lots of variables to consider here.... Had you been having any pain or symptoms with your running (prior to your layoff?).  Have you ever had any injuries to that knee in the past? The more serious things would be meniscus or cartilage damage but that isn't really likely since you didn't mention any pain... just a twitching and sense of buckling.  Taking a multivitamin is fine, but you may still be out of balance in your nutritional and electrolytes status.  If you've been doing dieting and trying to restrict certain food groups or avoiding salt, or drinking lots of water -- these things can throw your electrolyte balance out of whack and lead to symptoms such as you describe.  Perhaps spend a little time looking at your nutrition and hydration status, makind sure you're balanced in your nutrition and not over-hydrating or under hydrating. If there was no prior injury, and you know you're eating and drinking well, then if the symptoms don't resolve in a day or two - it would be worth it to see your doc to check this out.  Best of luck to you - Janet Hamilton, MA, RCEP, CSCS. RRCA coaching instructor