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On this page, we'll try to answer your questions and provide some nuggets of wisdom. Keep in mind that diagnosis of injury is the responsibility of your physician.  Comments posted here should not be misconstrued as medical advice! 
Please refer to the publications page of this web site for informative articles on flexibility and strength exercises, common injuries, and other useful tips.
To find a certified specialist PT in your geographic region use the APTA specialist directory search engine or find a certified orthopedic manual therapist (PT) in your geographic region using the NAIOMT search engine or the search engine for the American Academy of Orthopedic and Manual Physical Therapists (AAOMPT)

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Thursday, September 2, 2010

P90X and running - Tim
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
6:08 pm edt 

Tuesday, August 31, 2010

Piriformis Syndrome - Kristen
Hi Janet, I have struggled with piriformis syndrome off and on for quite sometime but now it seems to have taken a turn for the worst. In addition to having pain in my rear and upper hamstring, I now have pain radiating down my leg on the outside of my knee and into the belly of my calf. Getting out of bed in the morning or out of a chair is not comfortable nor is sitting on the stairs to put on my shoes. :( I am not sure why all of sudden I am having these new issues. Thanks for your insight!
Reply - Janet
Kristen, it sounds like you've got a nerve root pretty irritated - perhaps the sciatic nerve.  It can easily cause the pattern of symptoms you've got.  It could be irritated up in the low back area where the nerves exit the spine, or it could be irritated as it transits through the region of the piriformis muscle.  I think you'd be wise to see a good orthopedic physical therapist who is trained in manual therapy techniques and see about getting this resolved. The fact that you've dealt with the issue "Off and on for quite sometime" means it's likely to be a bit more complicated to resolve.  You can use the search engines I've linked at the top of this BLOG page to locate a good skilled PT in your geographic region.  If you use the APTA search engine - search for an "orthopedic certified specialist" (OCS) and put in your city or neighboring towns to narrow it down.   Read their credentials and area of practice focus... you want one that is focused on low back and manual therapy if you can find one.  The other search engine is for the North American Institute of Orthopedic Manual Therapists (NAIOMT) and in this search engine you're hoping to find a "COMT" - which is the higher of their two credentials and stands for certified orthopedic manual therapist.  The CMPT is the first level of credentialling, the COMT is the higher of the two. Either way - if you can find a PT that has more than the standard skill set from their education it's not a guarantee of success, but it does indicate a good bit of devotion to learning their craft since any of these designations (CMPT, COMT, OCS)  are difficult to attain.   Good luck!  Let me know if I can be of further assistance.  I don't think this is something you're going to be successful with self-treating...   Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor
12:57 pm edt 

Tuesday, August 24, 2010

Burning/numbness in feet - Jessie
Hey, I have been having a terrible time with burning/numbness/tinglig on the balls of my feet while working out. This began happening when I bought new shoes. I have since changed shoes, even went to a place where they watch you walk and recommend the kind of shoes you should wear, and am still having issues. My concern is that, although the burning/tingling goes away when I'm done working out, my feet are starting to ache/tingle when I'm not working out.
Reply - Janet
It's hard to say based on this little bit of information - but perhaps you need to work a bit on calf flexibility? Are you stretching your calves regularly - if not - start doing gentle calf stretches several times a day.  Are you running on land or on a treadmill - if it's a treadmill are you putting it on an incline?  Run outside rather than on a treadmilll whenever possible, and if you must run on a treadmill, keep the incline flat most of the time, doing only shallow grades for short periods.  Are you running at appropriate paces? If you are trying to run too fast for your current fitness level, that might play into the mix.  Do you have any issues with your lower back? Sometimes low back issues can show up as numbness/tingling in the feet.   Hope this is some food for thought... Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor
11:33 am edt 

Saturday, August 21, 2010

Too big a shoe causing problems? - Kelly
Can someone run into foot issues when running a shoe too big/too wide for the foot? If so, what can some of those issues be?
Reply - Janet
I would think that too small or narrow a show would be far more problematic than one that's a bit too big - but if the foot is wallowing around in the shoe, then the shoe isn't able to offer the stability to the foot that perhaps is needed?  Also if your foot slides around in the shoe, perhaps this could contribute to blistering?  When you check the fit of your shoe - you should have about the width of your thumb between the end of your longest toe and the end of the toe box of the shoe - so generally speaking most runners wear a running shoe that is a size or two larger than their normal "street shoes". Hope this helps - Janet Hamilton, MA, RCEP, CSCS ,RRCA Coaching Instructor
6:38 pm edt 

Tuesday, August 17, 2010

Knee pain running downhill - Nikki
Hi there, So I have been to a Biokinetist and a Podiatrist and still when I run down hill below the knee to the right I get a funny pain and my knee goes funny I have to stop what I am doing rest for 2 min then carry on running. Any advice???
reply - Janet
Perhaps you still don't have the strength in your muscle/tendon to tolerate downhill running? Recent research has been showing real promise with the inclusion of eccentric focused exercise to help stimulate collagen repair in damaged tendons and it sounds like perhaps that would be a good thing for you.  You might ask your Biokinetist about single-leg decline surface squats.  Hopefully they're up to date on the most current treatments for tendinopathy and will know what you're referring to!  Wishing you speedy recovery - Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor
7:03 am edt 

Sunday, August 8, 2010

Heart rate for a marathon - Matt
What is an approximate average heart rate a runner can sustain for a marathon?
Reply - Janet
There are too many variables for me to give you a single number but perhaps a "ratio" or percentage would answer your question?  In a well trained athlete who has the endurance base needed to "RACE" the distance - perhaps running it at 85% of "maximum heart rate reserve" is a reasonable prediction.  This takes into account maximum heart rate and resting heart rate.  It's commonly referred to as the "Karvonen formula".  Keep in mind that if you do a prediction of max (220- your age for example) that the error range on this is +/- 10-12 beats.  Hope this answers your question.  Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor
8:32 pm edt 

Monday, August 2, 2010

Trying to lose weight training for Chicago - Thom
I am a 42 y/o guy, 5'11", 193 lbs. In the last 6 weeks I have run two half-marathons (1:57 and 1:53). I'm gearing up for the Chicago Marathon in 10 weeks and I need to lose 10-15 lbs safely without jeopardizing my training. Any suggestions? Thanks.
Reply -
Thom, this is actually a tricky thing to do... if you restrict calories while you're training a high level, you run the risk of not providing the metabolic capital your body need to repair tissue damage sustained in training.  Have you consulted with a Registered Dietitian who is sports-certified?  Keep in mind that someone who calls themselves a "nutritionist" may or may not have any college background -- but an RD (a Registered Dietitian) has the college background and the license to prove it.  If you find one who is sports certified (an additional credential that requires additional training specific to nutrition for performance) you've probably got a good person to add to your training team.  You can do a search for one in your geographic area by logging on to their website - http://www.scandpg.org  - they have a link on there somewhere that allows you to search for a SCAN member and I think you can do it by state or city.... go take a look and see what you can find.  In the absence of hiring a professional to give you expert and individualized guidance - you can pick up any number of books by sports dietitians (Susan Eberle, Nancy Clarke, etc) that have a wealth of information in them.  I recommend hiring someone for a few hours of consultation time -- it will probably net you a better result.  Good luck in Chicago!  Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor
8:54 pm edt 

Wednesday, July 28, 2010

High, rigid arch - Sam
I have a high, rigid arch and was wondering if it is even possible for me to overpronate? Just wondering because everything I read says "high, rigid arch = Neutral shoe with good cushioning but I have had a running store but me a stability shoe.
Reply - Janet
Sam I've seen high arched people who overpronate but they're usually high arched and NOT rigid.  It's not as common for a high arched rigid foot to pronate as a high-arched flexible foot, but I've seen it when the person had tight calf muscles.  Perhaps that's you?  Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor
7:53 am edt 

Tuesday, July 27, 2010

Marathon Training - Sumi
My marathon is scheduled on Oct 17th. I did a half marathon in May of this year, took rest for a week or so and then again started from 6 mile long run. Howver for the past month, I haven't been able to do the weekend long runs. I did 8 miles on Saturday while the others did 14. I was planning to increasing my mileage by 2-3 mi each weekend and catch up with my running team in a few weeks. However I woke up with fever the morning after my long run. I have been diagnosed with strep throat and am on antibiotics (amoxycillin) since Monday (for 10 days). I took complete rest on Sunday and Monday. Can I start running from tomorrow (wednesday)? Should I still go for the long run this Saturday? I was plannig to do 11. Should I cut it down? Any advice will be greatly appreciated. This sore throat has derailed my training schedule :( and I am nervous whether I will be able to catch up with the marathon training before it's too late. Thanks Sumi
Reply - Janet
Hi Sumi - with only 10 weeks to go before your marathon the time is pretty short.  It could be that your recent illness was brought on because your body was fatigued and unable to fight off the bacteria.   You may be able to resume training but don't be surprised if your body seems sluggish and fatigued... you've been fighting a battle on the inside!  I don't know that it would be wise to jump your mileage as quickly as you've outlined - you may set yourself up for an injury.  When you run and get fatigued, your "form" usually suffers and you place yourself at risk for a running injury as a result.  Perhaps you'd consider a later marathon which would allow you a bit more time to train properly rather than rushing to this one only a few short weeks away?  If you allow your body to fully heal from the infection, and then gradually rebuild your strength and endurance, you should be able to safely make a marathon in the December time-frame.  This would allow you a nice solid 20 weeks to train up from your current 8-mile long run to a point where your body can tolerate 20-mile long runs.  Is this your first marathon?  If so - I'd strongly recommend shifting goals to a later date!  Best of luck, let me know if I can be of assistance.  Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor
12:01 pm edt 

Minimalist Shoes for an overpronator? - Samantha
Hi, I am a moderate overpronater and was wondering if it would be harmful to incorporate running with the nike free (designed to simulate barefoot running) into my training. Would it hurt my form and my body?
Reply - Janet
Hi Samantha - as long as you're healthy and uninjured currently, you maybe able to incorporate some running in minimalist shoes like the Nike Free.  Be careful though - if you've run in relatively stable supportive shoes for a long time, you'll need to make any transition very very carefully. Perhaps incorporate some short segments at the end of a workout as part of your cool down?  I usually have people transition into barefoot or minimalist-shoe running by doing perhaps 400-800 meters of it at a time -- and only doing it perhaps a couple of times a week at first.  If there are no indications that your body is not tolerating it, then increasing the duration by 400 meters at a time is usually a safe progression.  The benefit you gain from running in barefeet or minimalist shoes is that you're likely to bring your cadence up (and therefore your stride length into a more optimum range) without really having to think about it.  The less you consciously think about your running form the better!  Running is largely driven by reflexes, and that happens really quickly at the spinal cord level.  If you start "thinking" about changing the way you run, you're bringing higher order brain function into something that should be a reflex. This is often counterproducitve. 
Good luck - make the transition very gradually and listen to your body!  Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor
11:51 am edt 

Friday, July 23, 2010

Where do I start? - Jade
I ran track and field all the way through college and high school. Got a full scholarship to college. Now interested in running professionally. Do you have any tips on where I can begin. Am now 27 yrs old, haven't run competitively since 2004. Don't have a coach. Use to having coaches and running on a team. Do not know what to do. Please help! Jade
Reply - Janet
Jade if you're interested in getting back into track and field sports - you may want to start your search for a coach through the USATF.  You'll want to interview potential coaches to see if they're a good match for you.  If it's distance running you're interested in - you can search for a coach on the RRCA website - http://www.rrca.org   You may also find it helpful to contact your local running club to see if they have regular group training sessions either in the form of a long run or track workouts.  I'd be happy to help as an individual coach but if you're looking for someone local to you or a group to run with - these other options may be best?  Good luck!  It sounds like if you have maintained good fitness through the years past college that you'll be in a good position to start!  Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor.
4:04 pm edt 

Wednesday, July 7, 2010

Racing at Altitude - Chris
I live in San Francisco and will be running the Leadville 100 in August. I read an article featuring your insights into traininig at sea level for high altitude events. You recomended arriving within 24hrs of the event rather than a few days early. I have an opportunity to climb Pikes Peak a week before the race and then hang out in Leadville for 6 days. Would this offer any benefit? Arriving a day before makes me nervous. Thoughts?
Reply - Janet
I'm certainly not the world's expert on altitude training, I'd have to say I think the true expert here is Jack Daniels PhD... however everything I've read says that your best performances are had either after acclimation (takes several weeks) or immediately upon arriving.  The period from 3-6 days after arrival is purportely the worst as far as performance is concerned.  The numbers I'm familiar with state that it takes about 3 weeks to acclimate to altitudes up to 7500', and an additional week for every 1000' above that.  Physiologically the adaptation to altitude takes time... and a week just isn't enough.   I don't think going there a week ahead of time, climbing Pike's Peak and hanging around for 6 days is going to offer any benefit for you.  Good luck, enjoy the challenge of the journey!  Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor
7:51 am edt 

Running with high arches - Julie
I have a question on high arches. I have them and have been told by a PT that they were surprised that I haven't had major issues with them thus far in my running career which has been 4 years. I have run 7 marathons and no major issue. Yes, I have had tight calves on and off, occassionaly shin splints but mostly due to training error or too much too soon stuff. But these comments have been wondering if you can be a successful ong distance runner with high arches???
Reply - Janet
I think you should rest assured that you can be a successful long distance runner with high arches. If the arch is high but the foot is flexible and the calf is flexible then there's usually not a problem.  If the ligaments in your foot are tigh (making for a rigid high arch) and your calf muscle flexibility isn't adequate - that can sometimes be cause for trouble.  Just relax and run - maintain good calf flexibility and wear footwear that compliments your foot.  Best wishes for many happy years of running! Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor
7:38 am edt 

Monday, June 14, 2010

Hip flexor strain - Kia
I had a mild hip flexor injury/strain about 6 months. Completely rehabbed it or so I thought until I attempted pilates. I didn't feel much until next day after the pilates class. I had felt 100% before the class even running on it for 2 months successfully with no pain. Now since the pilates class I feel like I am back to square one. Well it is not as bad as the originally injury but it feels very aggravated. Why would pilates exercises meant to strength this area aggravate the psoas/hip flexor? How long should I stay away from core work that cause you to recruit the psoas? I know I need to go back to PT but I was hoping some rest will help this time.
Reply - Janet
Perhaps you just re-injured it by doing more aggressive Pilates movements than your body was ready for? If you're new to Pilates, or perhaps have been off for awhile, it's important to start back with basic beginner exercises and work your way up.  If you do exercises that are beyond the muscle's capability - even though they're good exercises and meant to strengthen the area... if you're not ready for them, you'll end up injured! It would probably be worth it though to go back to your PT and inquire about what's going on.  Pain in the region of the hip flexor can be related to things other than a strained hip flexor (perhaps your SI joint? perhaps your low back?).  There are several things that your PT will help you rule out and they should also be able to help you determine which exercise set things off - and this will help in determining which way to proceed with your rehabiliation.  Rest is certainly a good first step - but you need to get to the root of the problem so a visit or perhaps two with your PT to do some specific troubleshooting is a good idea.  Wishing you speedy healing - Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor
11:05 am edt 

Friday, June 11, 2010

Running farther (and faster) - John
Second year runner, age 41. Usual run distance is between 2 to 3.5 miles. Iwant to run farther (& faster), but I sometimes struggle with my mindset. I'll think "it's too far" or think I need to conserve energy because "I have so much farther to run". Are there some tips that experienced runners use to keep their mind positive and enjoy the experience instead of self-talk themselves into either a weak finish or not attempt a challenging run at all?
Reply - Janet
John, most runners will tell you that they have good days and some not-so-good days.  One thing to evaluate is the pace you're running on your training runs.  If you're running at too fast a pace on your training runs (training at/near race pace) then you're pushing pace and making every training run a race!  To be able to run further, make sure you're running at an easy aerobic pace and take the occasional short walk break if needed. Try running different locations - trails and new terrain keep the environment fresh and stimulating. If you have a friend who runs your pace (not one that will push you) then sometimes having company on a run helps pass the time.   Building endurance takes time and consistency - running 4 or more times per week is good, and don't do the same distance every time out the door... some days are "easy" (perhaps 1.5 in your case) other days are medium (perhaps 2-2.5 in your case) and one day a week do a long one (in your case maybe 3.5 to 4).  When you're running adequate weekly mileage (20 or more) then you can work on speed!  Endurance first, then speed.  Good luck, relax and enjoy the journey!  Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor
8:44 am edt 

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Running Strong* 191 Crossing Dr* Stockbridge, GA * 30281
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