Dear Janet, I have been running for 10 years+ and am turning 48 this October. I alternate my running with spinning and swim 1/week. I had been having on and off left hamstring issues that started about 2.5 years ago and in May a orthopedic surgeon recommended the Graston Technique to get rid of the scar tissue. I had this done over a 10 week period and I believe it made a difference. At the same time I was having weird knee pain...same left side on the outside of my knee. The chiropractor who did the Graston work told me it was a bursa and he basically took one of his tools and rubbed it out. I gradually made progress running with a few set backs here and there mostly due to over-doing it. A couple weeks ago the knee pain seemed to surround my knee sometimes. No matter what I do or don't do I feel like it pain either in my knee or hamstring. I went back to the same orthopedic surgeon and he said I have tight ITB and showed me some stretches. I have been doing them everyday (I'm on day 5). My concern is that my issues are always on the left side and the hamstring thing still comes and goes. And now this. I stretch everyday after I work out, have been trying various strength/functional training, and cross-train, but can't seem to feel better for more than a day at a time. This all started in March and I'm still only able to run 4 miles. I used to run 8 miles 3/week. Any advice would be appreciated. Thank you for your time.
Reply - Janet
It sounds to me like everyone is focusing on the "victim" (symptoms) rather than looking for a "perpetator" (the underlying causes).  Iliotibial band pain is pretty much never caused by a tight iliotibial fascia -- that fascia is supposed to be nice and tight... it's a fascia, not a muscle! It connects your butt to your knee and if it were loose it would not be able to transmit the forces generated from above.  Most of the studies on ITB issues point to core and hip weakness rather than lack of adequate flexibility as being a key issue.  If it's flexibility that's playing into the issue, it's more likely tight calves or hamstrings. Still... the first place I'd look for an underlying cause to address would be your strength - glute medius, quadratus lumborum, glute max, lower back, etc...  Another issue to dig into would be your training.  You used to run the same distance 3 times a week... perhaps a little variety would be something to consider? What about pacing - most runners, left to their own devices, run almost every run too fast.  Perhaps your pacing wasn't right?  Gait pattern - if you are biomechanically challenged as a result of your muscle weakness or skeletal alignment then that can play into things.  Sometimes it's a simple matter of getting strong enough, other times you have to play around with different types of footwear or supports to compensate for skeletal alignment things that you can't straighten out with muscle training.   I'd be happy to try to help - if you're interested, take a look at the "Services" pace and then send me an e-mail (janet at runningstrong dot com) and I'll be happy to answer any questions you have about how virtual or in-person coaching might be of use to you.  Best regards - Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor

My marathon is November 14th and I got sick a week ago with a really bad upper-respiratory infection. Because of my asthma, I have not been able to run for seven days and hopefully will be able to at least knock out a few this evening if I take my nebulizer. Is it still feasible to run it at this point? I am freaking out because this is my first one.
Reply - Janet
Amanda, since you have a known respiratory condition (asthma) I'm assuming you're under the care of a pulmonologist or at least under the care of a general practitioner who deals with respiratory problems.  I think you'd be wise to set up an appointment with the doctor to get a better handle on how well your lungs are functioning.  If you didn't have asthma as an underlying condition it might be a bit more clear cut - basically you can usually listen to your body's feedback and you'll know when you're ready to resume running.  The time between now and your marathon is short so it would be a good idea to get a consult with your physician as soon as possible.  No marathon is worth compromising your long term health over! You can always back up and do a later one!  Trust me - running a marathon with your respiratory function compromised is NO FUN... and your results will be less than you had hoped for. If you're healthy and well trained, then run the marathon. If you're not healthy or not well trained, then put it off for a later one!
Hope this helps - Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor

I have been finding my training hard to balence in terms of training volume, intesity/ type etc. I am a club runner age 19 years old, i have been running since primary school, and have competed in various cross country races/ track/road races and have completed 2 marathons. I would like to increase my speed over shorter distances like the 5k, however it seems the further i ran the weaker the performance in terms of age graded %. I usually train about 5-7 days a week if i dont rest i run a slow paced effortless workout just keep moving on days off. typical week of mine is: MON- 6-7 miles- 7:30sm/m road TUE- usually a speed session/ intervals: 10x 400meters with 1.30 min recovary jogs between WEDS- 6-8 miles @ 7:25 off road THUR- tempo run 1 easy 5 miles at 5:57-6.10 m/m 1 mile cool down FRI- rest or easy cross training 45 mins at the gym, and also inculde strength training upper body at any gym session. SAT- usually a local 5k time trial race or easier workout 5-6 miles at 7:50m/m SUN- uasually a long run of 10-12miles at roughly 7.50m/m my recent pb times are- 1mile- 4:44 5k -16:21-TRACK RACE-16:56-ROAD RACE 10k-37:02 half-01:21:24 marathon- 2:58:39 any help in terms of training routines and workout schedule would help alot thanks.
Reply - Janet
Just looking at the data you provided - you're running pretty much the same distance every day except your long day -- and totaling about 40 miles a week.  That's adequate base to support a strong 5K, but perhaps you're overtraining or over-racing?  I encourage athletes I coach to take a minimum of one day totally off each week, and really most perform better with two days off.  As for your PB times - your 5K PR predicts a faster 10k, 1/2 mar and marathon than you've done so that makes me wonder if you're not pacing correctly on your tempo run or perhaps not doing appropriate speedwork on your interval day.  Have you ever experimented with anything OTHER than the 400's?  Perhaps doing some 800's or maybe doing a variety of drills.  The one thing that jumps out at me is the lack of true recovery days in your week.  I'd be happy to help with a more detailed training plan - check out the "Services" page for more information or feel free to e-mail me directly (janet at runningstrong dot com).  A well designed, personalized training plan requires far more information than you've provided here.   Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor

Hi...I'm a 37 year old female runner just diagnosed with a hip stress fracture. It took me about 3 weeks before I realized I needed to see a Sports Injury Doctor, but did, and had an MRI which confirmed the injury. Crazy thing is that I was still trying to workout (resistance training-no running), while awaiting the results. Obviously, I will not run until I'm given a green light, but the Dr. said it is okay to use an aqua jogger to run in the water. I'm on crutches for 4-6 weeks, as long as healing is good at the follow up appointment. When is a good time frame to start Water Jogging? I've been stretching, but that seems to aggravate the injury, so I'm now afraid to do anything, even run in the water. Should I wait until all the pain subsides before trying to run in the water? Or is there going to be pain associated with this type of injury for a while, even if I'm not making it worse? I don't want to rush the rceovery, but I'd also like to do something while I'm sitting around waiting for it to heal. I've never had a broken bone in my life, so not sure, if nagging pain is just normal. Any recommendations on avoiding water jogging, or if you think it would be beneficial would be appreciated. Thank you!
Reply - Janet
I am assuming by "hip" stress fracture you mean a stress fracture of the neck of the femur bone? Perhaps it's a pelvic stress fracture? Either way, the fact that you're to be on crutches for 4-6 weeks minimum points to the serious nature of your injury. It's good your doc is going to allow you to workout in the pool but you'll need to take things gradually.  I would not recommend you do a lot of focused "stretching" as this is not an injury that was the result of poor flexibility - most of the time it's more an issue of inadequate strength.  Stretching may be placing undue stress on the healing bone so it might be worthwhile to back off on that stuff.  You may be able to do a variety of things in the pool - lap swimming with a buoy held between your legs will enable you to do fairly vigorous aerobic exercise without stressing the legs at all.  You may be able to do a little bit of easy-effort aqua jogging  but I'd recommend you wear a flotation vest of some sort (aqua jogger or "wet vest") so that you're bouyant enough to do the activity at a low intensity without fear of sinking.  Start gradually - perhaps alternating 5 minutes of lap swimming with 3-5 minutes of deep water jogging... listen to your body. If the deep water running is uncomfortable and the swimming with a pull-buoy is not... then stick with swimming for a few workout and then try it again. If your doc cleared you to do this, he must feel that the fracture is relatively stable, but listen to your body just the same and back off if things don't feel OK.  Good luck - you have a long journey ahead of you in this recovery so try to be patient and keep your eye on the prize - returning to running eventually.  Take some time during the recovery to look back at your training and see if you can find the underlying causes that might have contributed to this injury.  It may be related to nutritional stuff, overtraining, too much speedwork, inadequate strength, sudden increases in mileage, biomechanical factors, etc.  Focus on dealing with as many of the causative factors that you can so that when you get the green light to resume walking and eventually to resume running you'll be able to come back stronger and wiser.  Here's wishing you a speedy recovery! Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor

Thoughts on incorporating P90X into running periodization program for overall strength training? Thanks
Reply
Most runners benefit from functional strength training done in a weight bearing mode that also has an element of balance challenge to it.  I think if P90X is a workout you enjoy and it keeps you motivated that's a good one to consider incorporating into your running routine. I wouldn't do it in conjunction with a harder run day (intervals, pace runs, long runs) since that might be a bit too much overload.  I guess it depends on what motivates you to actually do the strength work that will benefit you. I'm not sure that P90X is any better than any other strength training routine that utilizes body weight, free weights, bands, etc., but it's probably at least as good as the standard routines.  Basically if you're doing something other than the isolation-type machines at the typical gym, you're probably doing yourself a favor.  Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor