Hi Janet, I'm just returning to running after almost 12 weeks off after a stress fracture in my left tibia. I've been running lightly every other day, alternating with walk breaks. The running itself feels pretty good, however my calf/soleous tighetens up afterwards. My tibia feels completely healed, I still do have some spot muscle tenderness if I really press. Aside from strectching, icing, and PT- what else can I do about this calf tightness and the slight muscle soreness? Is it OK to continue with running?
Reply - Janet
have you had any follow up diagnostic imaging to confirm that you're fully healed?  It would be unlikely that you weren't... but there are areas in the tibia that are very slow to heal so if this trend continues you might want to discuss it with your orthopedist if you haven't already.  With that said, the tightness in your calf/soleus is probably not just lack of adequate flexibility but also a strength deficit.  You have to come back from this very slowly -- walk more than run for a bit.  Walking will help develop the strength in those muscles as well as your hips and this should help when it comes time to run.  Stretching gentlly several times a day should deal with any true flexibility issues, but the strength stuff is going to require perhaps a bit more focus.  Doing the walking is the most specific way to train, but you may also want to do a few other functional exercises like squats and lunges and balance/reach type exercises to get your other muscles working and get them all working as a team (as opposed to the machines at the gym that tend to work them as individuals and not as a team).  You can find some good examples on the publications page of this website in an article entitled "FUNctional strength training".    Finally, make sure the paces and distances you're doing are appropriate.  Your pace should be very easy effort - and your distances should be short for now.  Follow a run/walk routine that has you walking more often than you think you need to, then when the calf settles down you'll know you can start to transition to shorter and less frequent walk breaks.  Good luck!  Let me know if I can be of assistance with your return to running.   Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor

how much running should you do every other day and still maintain and increase strenght in the rest of your body. What I usually do is warmup with running first, then I workout. When I run during the winter, it is on a treadmill, and I am bulding up to no more than 30 minutes. I do my weight training right after that, and then stretch and do abs at the end of my workout. My running pace on the treadmill, right now, is between an 8:30 and 8:00 minutes mile pace. I am at about 60-70% effort at this point.
Reply - Janet
Max, it's hard to say how much running is right for you - it depends on your goals.  If you have a goal of just maintaining cardiovascular fitness while focusing more on building muscular strength and size (body building) then running 30 minutes 3-5 times a week will work well for you.  If your goal is to complete a fun run like a 5K, 10K, or half marathon... then obviously the amount you run needs to increase to help you reach your distance goals.  As a general rule, running at a conversational pace correlates to about 70% to 80% of heart rate reserve.  This number is calculated by taking into account your maximum heart rate (either known max or some prediction of max) and your resting heart rate.  I'm assuming that your reference to 60% effort is not a heart rate effort but rather how the run "feels" to you.  Bottom line - pace should be easy enough to carry on a conversation, and distance or duration should be consistent with your overall goals... general fitness - 30 minutes 3-5 times a week is great... got a race in mind?  Probably need to adjust your training to match it.  I'll also encourage you to transition off the treadmill any time you can -- it's a much different world running on the treadmill than it is running on mother earth.  Good luck with your fitness pursuits! Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor

Hi Janet, Really appreciate your responses to my problem. This is a weird injury as recently the pain has been more in the sole of my foot.....a constant aching whilst I walk which then seems to progress up my calf and sometimes into my thigh. I purchased running shoes which had increased protection around the arches but this happens when I am doing the weekly shop with my wife (much to her annoyance...thinks I do it on purpose!!) in a normal pair of shoes?? Its an annoying injury because it affects my normal everyday life without even trying to run etc Paul
Reply - Janet
Paul this is sounding more and more complex.  It's not usual for pain to radiate upwards if it's related to nerve root issues in your back - so perhaps you've ruled that out.  The previous foot injury and surgery... perhaps there is scar tissue in there that's interfering with normal function? It sounds like your pain happens when your foot is unsupported (normal shoes, shopping activities).  If support seems to help (i.e. less symptoms when you wear your running shoes) then perhaps a visit with an orthotist or podiatrist or pedorthist to evaluate you for custom molded orthotics would be a good idea? The fact that this is such an odd presentation of symptoms really points to the need for you to find aomeone to evaluate your situation.  Perhaps a good orthopedist or physical therapist can help? I know you said it is difficult to get in - so perhaps if you make the appointment now you can be seen within a couple of weeks.  I think this one deserves some investigation... Best of luck! Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor

Thanks for your input... I was fitted for the sneakers I have now and they fitted me with an 8 1/2 and I wear a 7 1/2 or 8 shoe...I am going to try those socks that you recommended and see how that works otherwise I might be fitted with a different shoe... It's so aggravating when this happens and makes it painful to continue other than that I have great runs... Maybe I should just cut the toes off and call it a day!! LOL! Thanks for your help...Leslie
reply - Janet
If the toe socks don't do the trick, definitely look into a different manufacturer of shoe - perhaps the shape of the shoe just doesn't match your foot.  If that doesn't work - it's probably time to see your doc to rule out circulatory or nerve related issues.  Best of luck.  Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor

I am training for two half marathons, and everytime I am doing my long run when I hit mile six my toes get numb and make it hard to continue it's very aggravating and hurts...I was fitted for Asics 2140's should I consider some sort of compression sock I find that when I run without socks it gets better but then I get blisters! HELP!
Reply - Janet -
Since it feels better without the socks it makes me wonder if you perhaps bought your shoes a half size too small? When you stand in your shoes with socks on, you should have space beyond the end of your longest toe equivalent to about the width of your thumb.  Another test is to take the insole out of the shoe and place your foot on the insole - there should be a good 1/2" or more of insole visible beyond your longest toe.  Second thing to look into - perhaps the shape of the Asics last isn't working well with the shape of your foot?  Perhaps switching to a different manufacturer (Adidas? Saucony? Nike? etc) might be a better shape match for your foot.  Finally - if the shoe fit and shape are good - trying different types/thicknesses of socks is an option.  I have friends who do ultra-distance running and swear by the "toe socks" (socks that look like gloves for your feet) as a base layer with a second sock on top to avoid blisters on long runs of 30 miles or more. If you go this route you'll most likely need to up-size a bit to accomodate the extra layer.  If the sock and shoe changes don't work, look into seeing your physician for some tests for other (less likely) problems like exertional compartment syndrome or even nerve root irritation in your lower back. Best of luck! Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor