I think I may have pulled something in my inner thighs. It started hurting on just one side now both sides are sore. Not sure if that would be a groin injury or not. I haven't had this type of injury before. I ran through the first two days of this pain thinking I was just sore from running. However, it is painful for me to go up and down stairs and I can feel a little pain when I walk. Today I have iced it for the first time and have been taking motrin. I feel a little better but it is killing me to take time off from running and I was hoping to do a half marathon right away in September. Do you think it is still posible for me to train for this marathon? Should I see my orthopedic? Is there any other training other than running I could try? Thanks for any help.
Reply - Janet
Rayna I really don't have enough info to go on with this one. It could be a strained muscle and if that's the case 3-4 days off running and allowing it some time to heal should help.  It could also be something much more significant - like a pelvic stress fracture.  If you're feeling pain at rest or the pain is very focal in nature... then perhaps a visit to your doc sooner rather than later is a good thing.  They won't be able to tell anything with an x-ray - but if it's a stress fracture it will show up right away on Bone Scan or MRI images.  As for your possibility of making your September half marathon... that all depends on what mileage you were up to when you got injured, and what your injury is. If it is a stress fracture, then your half in September is out.  If it's a muscle strain and you deal with it properly (rather than going out running on it) and your mileage was already high (35-40 a week or more) then there's a chance you can make it. As for other training - nothing trains you for running the way running does. In the world of long-distance events, nothing substitutes for training by running long distances. I can't recommend a different form of training without knowing what your injury is, and neither should anyone else.  Some forms of exercise might be OK while others have the potential to make things worse. Whether it is a slight strain or a significant injury like a stress fracture - it will be important for you to get to the "why" of this injury.  Factors to investigate as to why/how this occurred:
Flexibility - or rather lack thereof... look into hamstrings, calves and hip flexors.  You can't stretch away an injury but maintaining adequate flexibility is a good way to avoid them.
Strength - lack of adequate strength is a huge issue in most running injuries. Investigate low back, lateral hips and abs.
Biomechanics - shoe issues fall into this category, as do things like excessive or poorly timed pronation.
Training errors - this is perhaps the biggest category - building mileage too quickly, too many hills, too much speedwork, or simply going out the door at/near race pace on every run.
Best of luck to you - if you want more specific help with this, check out the "Services" page of this website and download and complete the coaching questionnaire and send it to me.
Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor

Hello janet, my name is jarrett and i am a 15 year old runner about 6'0 or 6'1 and still growing. I have a question about my legs, i have been training all summer pretty much because we are getting ready for the xc season and we started doing time trials, but what i noticed is that my legs ALWAYS feel fatigued. They might feel fine before a run but about 4 minutes into the run whether its an easy run or a hard run they feel like crap and like all the energy is gone. I drink lots of water about the daily amount i should drink for my age and i do not drink pop anymore, i do drink lifewater at times , which im not sure if it is good or not for me, but besides all that i just always feel fatigued. i had a time trial today and i ran around a 22:10 for a 5k but i just felt horrible like i couldn't run anymore about 4 minutes into it. Could there be any possible causes for why i feel so fatigued all the time? If you have any suggestions let me know ! :) thanks.
Reply - Janet
Well it could be as simple as over training or it could be more complex like a medical condition or disorder. Have you talked to your family physician to rule out things in the medical arena?  If not, then that's probably your first step.  If your blood tests are clear and there's no immediate cause apparent for the fatigue, then perhaps it is a simple issue of too many hard workouts back to back.  When designing your weekly training plan, think about doing a "hard/easy" schedule.  "Hard" can be defined as a long run (even at easy pace) or as a fast run (even if short in distance).  "Easy" can be defined as a short easy paced run, or even a rest day. If you're not taking rest days, or worse yet... trying to squeeze in two workouts a day, then perhaps just taking a bit more rest or an additional recovery day will refresh your legs. If all you're doing is hammering it hard day after day - your muscle glycogen is chronically depleted and you're basically tearing your muscles (and other tissues) down without allowing them the gift of time to recover!  Talk to your physician, and then get together with your XC coach to figure out if you might need a schedule tweak!  Best of luck in your upcoming season,  Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor

Approx 10 years ago I was hiking in and out of the Grand Canyon on a one day trip when I experienced profound pain in the outside of both of my knees directly between my upper and lower legs. I made it out on my own but both knees audibly squeaked and I could feel by touching the outside of knees the tension in the band as if a rubber band was being stretched between my upper and lower legs. I recently began to exoerience this pain in both legs while running and it usually starts at about 3 miles. i stretch, Ice, and take ibufrofren but it wont go away. What the heck is going on and why is it in both of my knees?
Reply - Janet
First off let me apologize for taking a week to answer your question - I've been traveling.
The location of your pain is consistent with iliotibial band friction syndrome, but of course it could be other things as well.  If we go on the premise that it's an iliotibial band friction syndrome then the things that need to be stretched include the calves, hamstrings and quads.  If you've been focusing your stretch on the lateral knee/hip then you may have been missing the perpetrator.  In addition, it might be worth it to see someone for a gait analysis - perhaps the shoes you're using aren't supporting your feet in their best alignment. This translates to a torsional stress on the ITB area. Finally -if your lateral hips are a little weak, or your core muscles (abs and lower back) aren't as strong as they should be - that could play into things.  Hope this helps.  Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor

Hi, I am 27 and have been a yr round runner since the age of 9. I ran and rowed in college. I am currently a personal trainer and coach, so the injury I have been experiencing is more than frustrating. While in highschool, I had some hip flexor pain. So I was given orthodics and stability shoes. About a yr later during the last 100m of an 800m final, I felt my hamstring pop. I took off for about 4 days and raced in Districts the following weekend. Up until March of 2006, I had no injuries. I competed in college, ran a marathon, taught spinning classes etc...Then in March of 06' my left hamstring started hurting. I kept pushing through, icing etc...June, I stared going to a Physical Therapist. We did ultrasound, massage, stim, etc...it alleviated the pain until I ran again. I got an MRI in Nov. of 06'. The Dr told me I had tendinopathy. So since then I was in physical therapy with 2 different people. I have been working on strengthening my hamsrings, I have cross-trained, but NOTHING is working. I recently went back to the podiatrist who originally made my orthodics, who is a distance runner. He checked my 3 yr old orthodics out and told me I didn't need new ones b/c I was not able to run high mileage over the last 3 yrs. I asked him to also check out the length of my legs/ hips, because I read that could be a source of injury. He said my left left WAS shorter than my rt and gave me a cushion for my left shoe. He also said I should probably see a chiropractor to see about the alignment in my hips. I haven't yet b/c I would like another opinion before I spend anymore $. I am so fed up. It has been almost 3 yrs and no answers that help. Iam so frustrated. I am 5'2", ranging between 110-115 lbs. I have very strong quads and not as strong hamstrings. I am pretty much at a loss...It is hard to be a trainer and not know how to help yourself. CAN YOU HELP???????

Reply - Janet

Tendinopathy is a tough diagnosis -- it's a degeneration of the tendon, not an inflammation and therefore it needs to be dealt with differently.  Most studies I'm familiar with promote eccentric functional-based exercises in a progressive manner as the eccentric load has been shown to stimulate collagen formation and muscle hypertrophy better than the concentric phase.  Did your PT evaluate your leg length difference?  If not, shame on them... you need to call that PT back and ask a few questions.  They may have evaluated it and not found one (likely).  If indeed you do have a leg length difference it needs to be determined if it's a TRUE difference in leg length (not so common) or a FUNCTIONAL difference due to pelvic or low back alignment issues (more common).  If you put a lift under a functional difference you'll make matters worse in some cases so this is an important detail to figure out.  

Keep in mind that all the "Cross training" you're doing may or may not be helpful as far as the hamstring tendinosis is concerned. It may be that the exercises given to you by the PT are fine and great but you're side-tracking yourself with all the other stuff you're doing in your spin classes, and other gym activities. I think it would be good for someone to take a good hard, overall look at your TOTAL training load and figure out what direction you need to go. Going after this piecemeal isn't working too well.  Let me know if I can help - you can feel free to e-mail me. Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor 

I am in search of some help, as you will see from the story below, my skier has tried everything we can think of to cure this problem but with no success. He has the ability to be world champion in our sport of water ski racing, if only we could beat the problem. All your comments and ideas would be greatly welcome. many many thanks. Robs (my skier) story and a brief description of our sport below: I started skiing when i was 6 and have always been passionate about it, i got into race at the age of 14, and won the national series for under 16 in my second year. i then went on to win two European champions ships and represent GB in my first world championship come 6th. I carried on skiing in the men’s events at the age of 19 i was also at the top of my game and looking forward to the European championships as part of the GB team. that was 4 yrs ago midway through the season I started to noticed a pins and needles sensation in both my feet. At first it was just pins and needles and I was able to complete a full race. Every race the problem got worse and the pins and needles turned into numbness in both feet and gradually worked up my legs to my knees. Every time I skied this sensation came on quicker and for the past 4 yrs I have not been able to ski for more than 20 mins. I have been to see various physio’s and chiropractors as initially we thought it was coming from my back. When nothing worked I went to see a sports doctor who suggested possible compartment syndrome. I had the operation on both legs on the compartment to the front of the legs outside of the shins. That was 2 yrs ago and the problem is still as bad. Having tried changing every piece of equipment i you whilst skiing to see if it is circulation and nothing has worked. I have the ability to excel in my sport but this problem and the drive to do train my heart out, but i can't beat this. can anyone help? Many thanks Rob.
Reply - Janet
Not sure I can add a whole lot of wisdom to this... but I'll pose a few questions.  Did the orthopedist who did the compartment surgery TEST the various compartment pressures before exercise AND within 5 minutes of an exercise bout that brought on symptoms?  If not -- perhaps they released the wrong compartment?  Has your athlete had nerve conduction tests done to rule out something bizarre like Multiple sclerosis or other nerve dysfunction?  Have they had doppler studies done to look at vascular health?  I'm not sure what practitioner to point you to.  Usually pins/needles sensations in an otherwise healthy athlete is related to nerve issues stemming from the low back and this would certainly be plausible in a sport like water skiing... but you've already checked that out.  Perhaps a vascular specialist or a neurologist is the next practitioner to see?  Best of luck to you - sorry I couldn't come up with anything more helpful than that!
Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor

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

I am just wondering, of course i am a distance runner, if i should run barefoot and what your thoughts on barefoot running would be. I have been wearing shoes a lot when i run and never have tried barefoot running, but i am told it helps increase your posture, calf muscles, foot muscles, and much more. I am thinking of starting but i am not sure if i should or not. Any suggestions and input on this?
Reply - Janet
Barefoot running is a great tool -- but should be approached with respect and caution. In our society we generally are in shoes for most of our lives and the intrinsic musculature of your foot is not as strong as that of a person that walks barefoot all their life.  Using short segments of barefoot running on turf is one thing... trying to run lots of miles is another thing entirely.  You might want to consider it the same way you do any new strength building activity -- start with small volumes and build very conservatively.  This is just another tool in your toolbox...like hill work and speed work and strength training, they can all be over-done! Keep in mind that if you're biomechanically challenged - (excessive or poorly timed pronation) then you'll nee to approach barefoot running with even more caution.  Hope this helps.  Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor

In January i had pain in the knee, which i, ignored because when i ran it eased. eventually it became unbearable and i went to a physio, who confirmed i'd torn my adductor and after treatment and 6 weeks of no running i slowly resumed training. everything has been going fine, running daily, x3 sessions per week, 50 miles a week, but in the last week, both adductors have been sore, although not at the same time and i have had to stop training. i cannot understand why this has reoccured, what is causing it and how i can prevent it ? please can you help.
Reply - Janet
it's hard to tell based on the info you provide.  If I understand your post correctly you're running daily? Why no rest days? Perhap you've been training at too high an intensity or doing too much running at/near race pace? Did you follow a sensible and slow build up to return to running? Have you kept with your PT strength exercises and flexibility exercises? Did the PT evaluate your gait pattern to make sure there's nothing going on there that might contribute? Has there been anything in the last week that has changed from your usual routine that may have set things off?  Lots of questions...   Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor
Follow up - Matt
Janet firstly.. THANK YOU for replying it is much appreciated. in response to your questions: i train everyday...over enthusiasm my running between training sessions is done at slow pace, no where near race pace after the initial injury i did build up slowly, but may have increased a little too much in the last 3 weeks ? my PT did not do a gait analysis or give me any strengthning exercises... this may be the problem?? 2 weeks ago i did some speed work.... main difference.... 10x300m in around 43 secs with 90 sec recovery... usually 49 secs with 60 sec recovery. i have been running for 3 years, but only training properly for a year, i do want to educate myself and want to understand why this has reoccured, what is causing it and how i can prevent it ?
Reply - Janet
Sounds like some big missing links to me. Strength work is super important when you're trying to recover from a "torn" muscle.  Speedwork is also likely an issue.  You did a high volume (3000m total) at a pace that was close to 30 seconds a mile faster that your usual (6 sec per 300 meter). It's likely that your symptoms recurred because you didn't fully rehabilitate from your previous injury and possibly because you introduced speedwork too soon, or perhaps too quickly ramped up the intensity of the speedwork.  The foundation of your training is the base building period... get solid with that foundation then introduce speedwork in a progressive and gradual manner.  If you'd like more help with this - please let me know via e-mail.  I have room on my calendar at the moment for a new athlete.  Janet Hamilton, MA, RCEP, CSCS, RRCA coaching instructor

I have had ITB issues for quite some time now. This began after a stint of not running for a few months and building mileage quickly. I realize I mad a mistake when he pain in my knee was severe. My knee would lock up while running. I consulted with a sports medicine doctor. He advised me to stop running and focus on only using the bicycle and stairmaster for six weeks. I stretch frequently and use a foam roller. I followed his orders and have begun running again. The doc advised me to start with 3/4 of a mile three times a week, building 1/4 of a mile per week. I have built to two miles, and I am experiencing slight twinges of tightness and pain in my knee and hip. I wear orthodics, I got a new pair about two years ago. I change my shoes more frequently than needed. I want to treat the problem, not just the symptoms. Please help! I would like to enjoy running in the beautiful summer weather! Any advise will be greatly appreciated! Thank you!
Reply - Janet
Well, the question that popped into my mind was: what sort of strength work have you done to deal with that part of the problem? You've stretched, but hopefully you've stretches something other than the ITB -- which is more often the victim and not the perpetrator. Hopefully you've been stretching calves, hamstrings, hip flexors and quads.  But you didn't mention any strength work.  Usually it's related to weakness in your core (lower back and lateral abs in particular) and lateral hips.  If you've not covered that base (core and hip strength) that would sure be a place to intervene.  It sounds like you've adressed the biomechanics issue with the orthotics and you've been relatively conservative on your build up.  Perhaps the strength work is the missing link?
Hope this helps.... Janet Hamilton, MA, RCEP. CSCS. RRCA coaching instructor