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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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Friday, July 11, 2014

Tips on Pace
Though I don't agree with the part about using a treadmill for speedwork, this article on Fix.com has some good tips on how to work on improving race times.  Remember though, one size does not fit all! Generic advice here is solid but not appropriate for everyone.  Stepping up the pace
10:50 am edt 

Thursday, July 3, 2014

Coming back to running after 5th MT fracture - Richie

67 male running for 30 years (5-8 miles). This was to be my first marathon year (NYC 11/14)Broke right 5th metatarsal on 5/29 and should be off boot/crutches by 7/18. I know marathon is probably out this year and that's OK. Once I'm cleared for running how far should I go and what frequency? Thanks

Reply - Coach Janet

Your long history of running will do you well as you come back. The type of tissue strength that you get from that many years of running is a wonderful gift!  I recommend that when you're cleared to be off crutches and the boot that you spend a couple of weeks (at least) transitioning through a walking program and make sure your foot feels 100% symptom free.  I like to have people accomplish about 10 miles a week of walking with no symptoms before they transition into running again.  The transition phase also should start conservatively - perhaps only including 1 minute of running every 4 minutes of walking at first.  As your body consistently proves it's tolerating the run segments (symptom-free during the workout as well as afterwards) then you can gradually bring the run segments up in duration and gradually shorten the walk breaks.   How quickly you move from one stage to the next really depends on your body's response.  No two training plans are created equal and this is especially true when we're talking about a return to running program.  When in doubt - hold stead and don't increase the run segments -- you'll never hurt yourself by giving your body a little moe time to adapt to the training load.  Good luck -- please let me know if I can be of assistance  - you can always reach out to me via email at janet at runningstrong dot com.   Janet Hamilton, MA, RCEP, CSCS

11:12 am edt 

Sunday, June 29, 2014

Sharp knee pain, training for first half - Melody

I just started training for my first half marathon ..up to only 41/2 miles but I am having sharp stabbing pain on the inside of each knee. I thought I could just shuffle but even that I can't do without pain. I what can I do? I've had my running mapped and have had shoes fitted to me. Help! And thank you :-)

Reply - coach Janet There are a few things to think about here -- first of all, how long have you been running?  Were you already running some solid mileage before increasing your training?  Second thought - are you training at the proper pace for your current fitness level?  It's important to realize that training is training and racing is racing -- and you shouldn't do all your training at race pace.  Third thought - what terrain are you traning on?  If you've added hills or perhaps transitioned from a treadmill to out door running then that may be factoring into it.  It's important to listen to the symptoms and not force things.  If you can walk without pain, then perhaps you can use walking as an interim activity while things settle back down.  Typically knee pain like you describe is related to the following:  lack of adequate hip strength, lack of adequate core strength, inadequate flexibility in the calf and hamstring muscles, lack of adequate support from your current footwear (even if it's been fit to you -- perhaps it's still not the right match?), adding mileage too quickly, adding hills too quickly, training at the wrong pace.    Look over that list and see if there's anything that rings a bell with you.  If you're not already doing it, get consistent with calf and hamstring stretches and also with some strength work for your hips and legs. Work in a pain-free range of motion on all exercises and gradually increase that range as your symptoms permit.  I'll be happy to help with more specific details but I'd need to know a lot more about your specific injury and training history as well as a whole host of other things.  If you're interested in that, check out the "services" page of this website or simply drop me an email to janet at runningstrong dot com.   Hope this helps!  Janet Hamilton, MA, RCEP, CSCS, RRCA certified coach 

6:30 pm edt 

Monday, June 16, 2014

Follow up to hip flexor question - Jan

Hi Coach, Thank you so much for insights about my hip flexor issue. When you mentioned the low back, I remembered that I hurt my SI joint this winter doing forward bends in yoga - perhaps it isn't completely resolved. I also remember doing the clam shell exercise and feeling a sudden painful pull in my inner thigh on one leg. Maybe that's partly to blame as well. I've incorporated calf stretches and the reaching lunge exercise into my routine, and am searching for a PT to check out my low back. Thanks again!

Reply - coach Janet  Glad to help!  Use the links in the information above to get to a couple of search engines that might help you locate a good skilled orthopedic PT.  The APTA search directory will let you narrow it by location (state and city) as well as certification -- you'll want to narrow it to "OCS" (orthopedic certified specialist) and then look at the stated practice focus of the therapist.  If you can find one that's focused on manual therapy and lower back issues, you may find you get a much better result with their expertise.  Good luck!  Janet Hamilton, MA, RCEP, CSCS 

3:43 pm edt 

Friday, June 13, 2014

Sore Hip Flexors - Jan

Hi Coach, For the past month or so, my hip flexors on both legs have been very sore after I run. When I do squats or lunges, I feel them in my quads rather than my glutes. I do isolated glute exercises (bridges, band walks, clams, leg lifts). It seems like I just can't get my glutes to take up their share of the work, even though I do the recommended strengthening exercises. Any suggestions? Thanks!

Reply - Coach Janet 

There could be a couple of things going on but the first thought I had was - I wonder if something is going on in her lower back?  One of the two dominant hip flexor muscles attaches to your spine - and so if there's any dysfunction going on there it can certainly contribute to a sense of tightness there. In addition it's not unusual for people with low back dysfunction to have inhibition of the gluteal muscles.  Even if your back doesn't hurt, it might be worth checking in with a good PT to have an evaluation.  Another thought -- do you stretch your calves on a routine basis?  If not, that might be something to work on. It seems unrelated but it's not -- when your hip flexors are being stretched to their longest length in your gait pattern is the same time that your calves are being stretched to their longest length (the push off phase of gait) so tightness in one often results in tightness in the other.   Final thought I had was: Are you training at the right pace?  If you're running at a pace that's a bit too fast for your current fitness level, you may be taxing your muscles a bit too much.  I think you're doing a lot of good isolated gluteal exercises but you might try to incorporate some balance and reach exercises.  See this page for a picture of a diagonal backward balance & reach exercise that targets the gluteals.  Good luck, hope this helps!  Janet Hamilton, MA, RCEP, CSCS

7:24 pm edt 

Wednesday, May 28, 2014

Competitive racewalker with Left side issues - Karl

As background, I am a semi-competitive racewalker (8 half marathons since May 2012, plus a lot of 5K, 8K, 10K, 15K races, etc. I try to train, race, or work out 5 days a week, unless I am tapering for a long race (or recovering). MY PROBLEMS: I have noticed that my left leg (and the left side of my body, generally) doesn't even seem to be "engaging" at all when I walk. My right side seems to be doing all the work. I don't know if these other symptoms are relevant, but I have battled with an elevated right hip, plantar fasciitis in the right foot, a fallen left arch, and shin splints in both shins. Any ideas - either from a posture/alignment standpoint or a stretching standpoint? (Or any other "standpoint" you think might be helpful!)

Reply - Coach Janet  If you have an elevated right hip, perhaps you have a leg length discrepancy?  In my experience, the long-leg side (in your case perhaps that's the right leg?) tends to be more likley to get plantar fasciitis.  There are two types of leg length discrepancy:  Structural and Functional.  Structural leg length discrepancy is when one set of leg bones (femur and tibia) is longer than the other side.  In cases like this, the only "solution" is to use a small lift in the shoe of the short leg.  What's more likely the case is a Functional Leg length discrepancy caused by a spinal/pelvic misalignment.  This can be resolved with spinal mobilization and then follow up with exercises to strengthen the area so that the proper alignment is held.   If it's an issue that's been going on a long time, it may take awhile to realign and to get your strength back.  I'm thinking with your sense of "lack of engagement" on your left side that this is what you're dealing with because if your back is out of alignment it can cause nerve root impingement which would result in a decrease in strength on the involved side.  If you have any symptoms in your butt or down your left leg, this would be even more likely to support the spinal alignment theory.  If you can get in with a good orthopedic PT that has manual therapy skills, or perhaps a Chiropractor who has skills in not only manipulation but also exercise prescription -- you should be able to get this resolved.  Good luck, hope this helps! Coach Janet Hamilton, MA, RCEP, CSCS 

9:36 am edt 

Saturday, May 24, 2014

Help for a 100m sprinter - Juliette

My daughter is a spinter and runs flat footed her feet ankles lean inwards. She rounds a fast 50 m and than last 50 slower. Can you help?

Reply - Coach Janet   

There's a lot going on in that short distance of 100 meters but the quick answer is that the stronger your daughter becomes the faster she'll be in that last 50 meters.  Sprinting success comes from being able to produce a lot of power, so perhaps you could consult her track coach about helping her with some strength training exercises.  The second piece of the puzzle is stamina.  That comes with aerobic training -- which comes from training distances much longer than the 100m.  Hope this helps? Coach Janet Hamilton, MA, RCEP, CSCS

8:24 am edt 

Friday, May 16, 2014

"Best" strength training for runners? - Janet

Hi Coach Hamilton, I loved your resistance band workout in the latest issue of Runner's World! I've done it several times, and I feel it in all the right places. I have quite an assortment of bands and have always enjoyed using them for strength training. I've been reading quite a bit lately about how runners should focus on heavy weight, low rep training rather than lighter, higher rep training. What are you thoughts on the best way to strength train for runners? I have a home gym and don't have anyone to spot me for really heavy lifts, which is why I've always gravitated towards tools like resistance bands to really work my muscles. Is there really a "best" way to strength train, or is just doing it the most important factor? Thanks!

Reply - Coach Janet  I love using resistance bands for strength work because they're portable and can easily be used for a variety of exercises.  However, they're not the only tool in the toolbox.  There's a fair amount of research that shows that heavy resistance exercises are better when it comes to improving running economy.  So your question is a valid one -- which is better?  Like most things... it depends.  It depends on what you're trying to accomplish.  If you're working on general strength improvements or trying to balance out areas of strength deficits or recovering from an injury and trying to rehabilitate -- I'm a fan of moderate resistance and using body weight and resistance bands.  This allows you to focus on form and technique and really refine the movements so that you're doing them well.  If on the other hand the athlete is healthy, already has good strength that is well balanced (no major weak areas) then focusing on heavier resistance or even plyometric type exercises might be the right choice since they're more likely to be associated with an improvement in running economy and race performance.   So -- the answer to your question sort of lies within you... what are you trying to accomplish?  General strength and/or muscle balance?  Perhaps rehab?  Then body weight resistance and resistance bands are a great place to start.    Hope this answers your question!  Coach Janet Hamilton, MA, RCEP, CSCS

10:13 am edt 

Saturday, April 26, 2014

Resuming running after neck surgery - Traci

Hi Coach, I'm testing the waters after being away from running for two years. Last year I had an artificial cervical disk and fusion surgery, and have just recently been given the green light to do impact activities. I asked my doctor if it was ok to run, and he said yes that we have to test my neck. That being said I've decided to do your learn to run program to ease into it. I'm worried though.. do you think running has more impact than most sports? I sure do miss it, and want it back in my life.

Reply - Coach Janet -  Traci I think as long as your orthopedic surgeon has given you the green light you should be fine to start the process.  I think you're wise to start with a walking program and gradually progress through a run/walk regimen... being willing to adjust as you go based on how your body is responding.  The impact forces of running are gradually absorbed all the way up the chain from the feet to the head... and once the forces get above the lower back region they're probably a good bit less intense than they were in the lower region.  Still - you're wise to build gradually. Muscles are the best shock absorbers in the system so being as strong as you can be will work to your advantage.  Good hip and leg strength allows the legs and core to absorb and dissipate forces.  Running on groomed turf or packed dirt will also generate less force through the bones, but you need to be aware of your footing so you don't trip or stumble and fall.   Take it slowly - listen to the feedback from your body and best of luck on your return!  Let me know if I can be of assistance (janet at runningstrong dot com).   Hope this helps -- good luck!  Coach Janet Hamilton, MA, RCEP, CSCS 

1:14 pm edt 

Tuesday, April 15, 2014

Training for 5k/10k - Jan

Hello Coach Janet, This question resulted in quite a discussion with my running friends, and I'd love your opinion. If a runner wants to run, say 25 miles per week and is training for shorter distance races (5-10k), what is the best way to distribute those miles throughout the week? More frequent, shorter runs or less frequent, longer runs? Thanks so much!

Reply - Coach Janet this is a classic question and the answer isn't as straightforward as you might think!  Each athlete is a unique individual with unique areas of strength and weakness -- and if you train based on what your weak links are, you'll improve.   The bottom line in my mind is this - the event has a certain demand for endurance - you must be able to complete the distance if you intend to RACE the distance! So for that I always look at the big picture and make sure that one of my workouts is addressing the distance question.  That's usually the longest run of the week and I usually keep the intensity of that run fairly low.  For good results in shorter races (5k and 10k) I like to work up to a long run that's substantially longer than the race distance -- for a 5k, working up to 6 or more miles, and for a 10k working up to 10 or more.  Keep in mind though that your  longest run shouldn't be more than about 35% of total weekly mileage -- so if youre goign to do a 10 mile long run, you should probably be logging at least 28 (preferably 30) miles per week.  

So - that leaves the athlete with another 18-20 miles per week to distribute on the other days.  I like two days off per week but some athletes can get away with just one.  So -- for my routine, those 18-20 miles will be distributed over 4 days.  I pick two of them to be easy days -- perhaps running only 3 miles those days.  That leaves me with two other days that I can work on moderate distances (perhaps 6) or if I'm in a race-preparation phase I could use those moderate overload days to work on higher intensity stuff like hills, intervals, longer race-pace specific runs, etc.

You see this is the fun part of training plan development -- it's not the same for everyone and it won't be the same from one phase or period of training to another!   This is why "canned" training plans often fall short of more personalized and customized plans.  Hope this is food for thought!  Best regards - Janet Hamilton, MA, RCEP, CSCS 

1:57 pm edt 

Monday, March 31, 2014

Calming nerves before a race - PT

Coach, I get super nervous before highly competitive track races. I think it affects my performance because of my mental state going into the race. How can I calm pre-race nerves? (Directly before the event and even the days leading up to the event)

Reply - Coach Janet

There are several good books that might help you, but it also might be worth your while to consult with a sports psychologist for some guidelines and mental exercises you can practice.  Simplified version is that learning to reframe negative thoughts and emotions into positive ones will be immesely helpful in terms of your performance.  One book I've referred to in the past is "In Pursuit of Excellence" but Terry Orlick.  I think you can get it from Human Kinetics publishers.  Best of luck to you! Coach Janet Hamilton, MA, RCEP, CSCS 

9:09 am edt 

Saturday, March 29, 2014

Adjusting a "canned" half marathon plan - Melissa

I'm running my first half marathon in 7 weeks. I started running again this past week. Not ideal, I know, but I'm generally pretty active, lead a healthy lifestyle, and have ran cross country and track in the past. I've been looking up training programs online, but they don't fit well with my schedule. Can you make any recommendations for tweaking them? Most generally seem to have you do longer runs on Tuesdays, Thursdays, and Sundays, but Tuesdays, Thursdays, and Saturdays my schedule is the busiest. If I shift everything forward a day, then the longest runs are on Mondays. Will movings the schedule forward have an impact on my race day? That is, will my body get settled into this schedule and be thrown off if I'm running the race on a day I'm not used to running a long day on? Thanks so much for your input!

Reply - Coach Janet - I don't think your body is going to be thrown off by running your event on a day other than your typical long-run day. This is one of the challenges of using a plan that's not been customized for you -- the days don't match with your life, and the progression may or may not be apppropriate for someone who's only got 7 weeks to train!  Look at your life - pick the day of the week that works best for your schedule for the long run.  Then pick two other days during the week (hopefully not back to back, and hopefully not the day before or after the long run) and put your medium distance days there.  For example if Sunday works better for your long run - then perhaps Wednesday and Friday would work for medium distance days and you could do shorter runs on Tuesday and Thursday or Tuesday and Saturday.  Remember, training is a process -- you've only given yourself about 5.5 weeks to train.... the last 10-14 days should be a gradual taper so that you toe the start line with legs that aren't totally exhausted from training.  My best advice though, since this is your first half marathon, is to give yourself more time to train! Injury risk goes way up when you try to "cram" for a test like this!   If you'd like a plan thats fully customized to YOU, your schedule, your fitness level, your goals -- get in touch!  Coach Janet Hamilton, MA, RCEP, CSCS 

9:28 am edt 

Thursday, March 27, 2014

Persistent ITB issues - Janet

Hi Coach Janet, I get frequent bouts of ITBS and patellar/quadriceps tendonitis. I've seen both a sports doc and PT, was told I over pronate and probably have weak hips and glutes (structurally my knees are fine). I wear stable running shoes with a Superfeet insert, and religiously do all the hip strengthening exercises prescribed for me. I incorporate cross training, I lift weights, I try to be smart about my running...everything that's supposed to prevent my issues. Yet I seem to continually get them. In your opinion, is there anything I'm missing as far as cause or treatment? I would really like to get rid of these things once and for all. Thank you so much for any insight you're willing to provide.

Reply - Coach Janet  

It sounds like you're doing all the right things but perhaps a progression of the hip strengthening exercises would be worthwhile if you've been doing the current ones for awhile? Maybe you're ready for the next level of challenge?  If your PT feels that you're already doing all the strength work they can give you then it may be that orthotic support would help.  I don't generally jump to those right away, but if you've addressed the weakness and any lingering tightness issues -- then it might be an avenue to explore. Generally hip and core weakness is the biggest issue in my experience so lots of attention there is usually the best resolution.  Strength work 2-4 times a week.  Also - make sure the training plan you're following is appropriate in terms of pacing, overload/recovery, and progressions and intensities.  Hope this helps!  Coach Janet Hamilton, MA, RCEP, CSCS 

5:14 pm edt 

Monday, March 24, 2014

Training faster than goal pace - PT

Do you believe that to run a specific goal time in, for example, a mile race, that you need to run slightly FASTER during reps than goal pace because you have rest in between?

Reply - Coach Janet  It's common when you're training to achieve a new PR to so some intensity work at paces slightly faster than goal pace, but this is not something I'd recommend for a beginner.  I've had good results using shorter intervals at slightly faster-than-goal pace in well seasoned and experienced athletes. You always have to consider the risk/reward.  Hope this helps.  Coach Janet Hamilton, MA, RCEP, CSCS 

10:23 am edt 

Friday, March 14, 2014

Icing prior to a workout or race - PT

What do you think about icing 6-8 hours before (the morning of) a hard workout or race?

Reply - Coach Janet I am not sure what you're trying to accomplish with that?  There are some studies that show that cooling the body temperature prior to running or racing in a very hot environment may improve time to exhaustion but I would think that it would need to be closer to the time you're running than the 6-8 hours you mention.  Some believe that icing may improve recovery from hard bouts of exercise, but that would occur after the event so I'm not sure what you're going for with an ice treatment 6-8 hours prior.  Perhaps you can provide some insight? Coach Janet Hamilton, MA, RCEP, CSCS 

Follow up - PT -- By the 6-8 hours prior for icing, I'm meaning as far as recovery goes? Say you're still sore coming into it. Is it too late to recover slightly the morning of a race? Can it relieve soreness during the day or do you need to sleep for best recovery? Thanks. 

Reply - Coach Janet -  In my opinion if you're still sore the morning of a race you've failed to follow good basic training guidelines which usually include some sort of planned recovery or taper period in advance of your race.  To my knowledge, there's no way to substitute for that.  I don't think the ice treatment 6-8 hours prior to the event is going to to much of anything.  Recovery and tissue repair is a physiological process that takes time... you can't magically speed it up with ice.   Your best bet is to plan your training around your key races and include a taper phase so that you toe the line with well-rested and refreshed legs.  Coach Janet Hamilton, MA, RCEP, CSCS 

3:09 pm edt 

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