ASK the Running Coach! 

We'll try to answer your running related questions and provide some nuggets of wisdom.  Keep in mind that diagnosis is the responsibility of your physician.  Comments posted here should not be misconstrued as medical advice!

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Thursday Feb 26th, 2015

Returning to running after a hamstring injury - Allyson

I've been a distance runner for several years now, running anywhere from 42 - 64 miles per week. In June 2014, I was in terrible pain and went to see ortho. I was diagnosed , by MRI, as having a tibial stress fracture. I was out for six weeks due to the fracture in my left leg. When I returned to running, everything was okay. I was back up to seven miles per day within a few weeksonly to suffer some kind of hamstring injury that profusely bruised the entire back thigh of my right leg. During this time, I ran/ walked with a friend in order to heal the hamstring......about 8 weeks. Now, I am having more difficukty running than I did when I first began years ago. I am landing hard on the ball of my right foot and appear to be shuffling that foot. I also can only run a half mile, stop for 1 minute, repeat. My legs feel so very heavy and my attitude is growing skeptical of ever running again. This used to be so easy but now I can't get my pace or gait back. I work out religiously at very hard cardio at gym. Daily.... 40 mins stair machine at 102 steps per minute, 1 hour of elliptical average 10 miles when finished. Cardio never bothers me until I run. I have noted that. Even when walking breaks are added, I am still averaging nine minute miles......meaning I am speeding up very fast, then needing to walk. Any suggestions? I am totally exasperated and do not usually quit.

Reply - Coach Janet

Hi Allyson - that must have been a pretty bad injury to your hamstring to show up as "profuse bruising"... did you fall?  Did you see your orthopedist for that injury?  Your question is eerily timely... I just posted an article today on the rather uncommon injury of a traumatic hamstring rupture. You can read it HERE.  Bottom line - from your description it sounds like you may have injured the hamstring more severely than you first realized.  Your comment about having trouble getting your gait back and feeling weak and not balanced would make me suspicious.  If you didn't get some form of diagnostic imaging (MRI or Ultrasound) to rule out a partial or full hamstring tear - I think you'd be wise to discuss that option with your orthopedist.  Trust me - you can still have some level of function even if one of your tendons is pulled off the bone.  Read my post linked above and you'll see what I mean by that.   If you find out that all is well and everything is intact - then perhaps the issue is that you're trying to run your typical training pace (the 9 min miles you refer to) and perhaps you just need to take this a little more slowly.  Not all injuries heal at the same rate -- you managed to come back quickly after that 6-week layoff for the stress fracture but this recent injury is muscular and may take a bit longer to rehabilitate.  At the very least - some visits with a good Physical Therapist to give you some specific rehab guidance would be a good thing to consider.  Good luck - hope you're back to your old self soon!  Coach Janet Hamilton, MA, RCEP, CSCS, RRCA certified coach

Monday Feb 23rd, 2015

Running a marathon with back pain - Laurene

I have been running for a couple years and ever and 2 half marathons this past year. This year I decided I wanted to do a full marathon next month. I have been training for the last 5 weeks, my last run last week was 15 miles. A few days later I have been I have been down with lower back pain, I havent ran in the back is starting to feel better. My question to you is, is it possible to still try to run a marathon and three and a half weeks?

Reply - Coach Janet

It's hard to tell from your question if this is your first marathon or not but either way - it's important to respect the distance. In my humble opinion it's never a good idea to run a race injured or just coming back from one - and it seems that you've certainly got something going in your lower back.  It would be my recommendation to take this race off the books and instead focus on getting well, and getting to the root of the underlying cause for your back pain.  If you've only 3 weeks to go - you should be starting your taper phase and with a long run of only 15 miles that's inadequate mileage in my opinion.  The question shouldn't be can I run a marathon in a little over three weeks.... but rather should I risk running a marathon in a little over three weeks?  Think about the risk-reward on this one.  The best case scenario is that you survive the marathon and you're no worse off when you finish than when you started.  That's not likely to be the outcome, especially if this is your first.... the outcome could be far worse, with a worsening of your symptoms and a miserable experience on race day.  It just makes more sense to me as a coach to have you step back, get the issue fully resolved, deal with the underlying causes, and then train properly for the next marathon attempt.   I hope I have interpreted your question properly - good luck with whatever you decide to do!  Best regards, Coach Janet Hamilton, MA, RCEP, CSCS, RRCA-certified coach

Thursday Feb 5th, 2015

Pain in right hip - Dawn

I have been running for about 10 years. I usually run about 20 miles a week, mainly on tracks. Recently I have been suffering from pain in my right hip which is deep and feels like i should be able to stretch it out but can't seem to. My left foot has also recently become slightly misshapen at the the big toe joint, like a bunion. At the weekend I was running on a treadmill and noticed that I am landing much heavier on my left foot. I then tested my legs and my right leg seems to be slightly shorter than my left. I am just wondering what you think?

Reply - Coach Janet

Perhaps you'd consider transitioning off the track and doing some/most of your running on more varied terrain?  Always running in circles tends to lead to overuse issues and asymmetries and it sounds like you're describing just that! Leg length discrepancies come in two general forms: structural - the bones of one leg are physically shorter than the same bones on the other leg, and functional - one leg "appears" shorter but it's due to asymmetry in the spine or in muscle strength/flexibility.  The way you describe your hip pain and your history of running 20 miles a week in circles on a track for 10 years makes me think that perhaps you've become imbalanced in your back or imbalanced in your muscle strength/flexibility.  Perhaps a visit with a practitioner who can fully evaluate your spine and biomechanics would shed some light.  At the very least, you'd probably be wise to seek out a place to train other than on a track.  Hope ths helps - Coach Janet Hamilton, MA, RCEP, CSCS

Friday Jan 23rd, 2015

How to break through a training plateau - Ian

As you might remember I've been on here before. Since my last question I've done some research on my running. Unfortunately I've come to the conclusion that I've met a plateau. Over the past two months I've been in this plateau and haven't just stop progressing, but have gotten worse. I was at a point were I could run a 5k in 22:00 minutes. Now I'm lucky if I can run more two miles at a 8 min Mille pace. How can I break this plateau? 

Reply - Coach Janet

Training plateaus are not uncommon but the fact that you feel you've actually lost some progress may point to something worse - overtraining syndrome perhaps?  Improving your performance as a runner entails a balance of overload (to stimulate physiological change) and recovery (to allow the body to accomplish the change you've asked for).  If you've been hammering hard on the overload part (adding miles, working hard on speed, doing hills, etc) but haven't allowed your body adequate recovery time then you're simply breaking yourself down.  Look back at the training you've done in the recent 3-4 months and make sure you're giving your body the right balance.  If you're running all your runs at/near target race pace - that's a common error and easily fixed with a bit of discipline.  Since you've only been running since March (according to your previous post) perhaps you're still trying to run hard on every run?  Remember training is a balance!  Perhaps some guided coaching would help you reach the next level? Hope this is food for thought.  Coach Janet Hamilton, MA, RCEP, CSCS

Friday Jan 16th, 2015

Legs fatigue on obstacle races - Marie

Hi, I've done a few long distance endurance obstacle courses. I set out strong and capable then about half way through I start to get severe pain in my knees and legs they then start to seize and I am unable to run downhill even running at all leaves me in severe pain. Someone mentioned glucose levels or something? What do you think? Kind regards

Reply - Coach Janet

It's hard to know for sure what's the issue but here are some things to consider:  How's your overall endurance base?  Do you regularly run long runs that are longer than the race distance?  Do you do specific strength work for your legs, hips and core? Do you train on terrain that's similar to what you expect on race day? Certainly fueling properly may be part of it - do you practice your fueling and hydration strategies during training?  Hope this is some food for thought - let me know if I can be of help.  Coach Janet Hamilton, MA, RCEP, CSCS

Friday Jan 16th, 2015

Training for first half marathon - Sara

I have been running about 12 miles a week for the past 5 years and just recently decided to start training for my first half marathon. I'm use to running 4 to 6 miles during a normal run so my first long run I started with 6 and I am currently at 10. Over the past couple weeks I started experiencing soreness throughout my legs (pretty much evenly distributed over the length of each of my legs). Prior to that I had run a 10 mile run three weeks in a row and have been averaging 20 miles per week. The soreness and pain in my legs is now present after my shorter runs during the week and is more consistent. When I took a couple day break the pain came back after a five mile run. Is this something I need to consult a doctor about or will the issue be solved by cutting back miles and increasing more gradually with more stretching and cross-training thrown in? Thanks

Reply - Coach Janet

Building mileage for a distance like the half marathon will take time, so perhaps you ramped up a tad too quickly?  The fact that you had been running for several years before taking on this challenge is a good thing - but you still have to ramp up gradually.  The thing that stands out to me in your description is that a 10 mile long run is 50% of your total weekly mileage of 15 miles a week. That's a very high percentage.  You might look over your training plan and evaluate how you can bring your mid week mileage up a bit to support that long run.  Also have you been consistently doing strength training?  Are you running your training runs at the proper pace (hint - not at/near race pace).  Are you being consistent with flexibility exercises?  There are a lot of things to address to insure a successful outcome - let me know if I can help.  Coach Janet Hamilton, MA, RCEP, CSCS

Sunday Jan 4th, 2015

Tired legs on shorter runs - Ian

Hello. I've been running since March of this year. I've gotten much better, being able to go from not being able to run a mile, to running 6.7 miles! But my problem is with shorter faster runs. Like a 5k. Most days when I run (I run every other day) I can only run 1.5 to 2.2 miles, when I want to run 3. I have run three before but it seems I can only do this every now and then. Especially at a 7-30 to 8 min mile pace. It's always my legs that get tired and make me stop. What do you think my problem is?

Reply - Coach Janet

It's hard to know exactly what the problem is, but my first suspicion is that you're trying to run your shorter runs at/near your race pace rather than at an appropriate training pace.  If you've run a 5k race - you have a known data point you can estimate from to determine what your proper training paces should be.  If you can run over 6 miles at a time but struggle on the shorter runs, perhaps it's because you're running them too fast?  Hope this helps.  Coach Janet Hamilton, MA, RCEP, CSCS

Friday, Jan 2nd 2015

Multiple running injuries - Jas

I'm a bit frustrated at this point, and hope you can possibly shed some light on what I may be doing wrong. Over the past 3 years, I've had a stream of minor running issues - can't even really call them injuries. Hip pain, knee pain, piriformis syndrome...I've been to a PT, identified some weaknesses, and according to the PT, have corrected them and continue my maintenance exercises. I've had a detailed gait analysis, where nothing concerning was identified. I run in the appropriate shoes, don't make drastic increases in training intensity or volume, and train mostly by feel to really listen to my body. I've been running for almost 20 years, so I'm not a new runner. It seems like I'm doing everything right, yet I can't seem to shake these recurring pains. In your opinion, am I missing something? 

Reply - Coach Janet

It sounds like you're covering your bases pretty well but the missing piece that I'm not sure of is your training -- pacing, terrain, intensity, etc.  It may also be that some of the exercises you're doing for maintenance are too easy for you now and perhaps you're ready for a progression?  I'd be happy to help you work through this -- if you're interested, drop me an email to janet at runningstrong dot com.  

Friday, Dec 19th 2014

Resuming training after an ankle fracture - Jean

How would you approach training for a track & field event in August 2015 after a fractured ankle? Injured early October 2014, currently in physical therapy 2 x week to strengthen and regain mobility. Elite level masters runner.

Reply - Coach Janet

First step is to get the mobility and strength back - not only in the ankle but in the entire foot/ankle complex.  Often after an ankle fracture, the immobilization that's needed to heal the broken bone tends to result in lost mobility in other joints of the foot and this can affect biomechanics of running -- especially sprinting or jumping! Work closely with your PT and make sure that your mobility and strength are maximized.  It's also important to work on regaining balance and proprioception as these neuromotor functions are critical to insuring ideal biomechanics.  If your strength/mobility/proprioception are not balanced between your two legs it sets the stage for a compensatory injury above (think knee, hip, low back).  When you're cleared to resume some running - work at easy paces first and rebuild your tissue stamina, then when you've established your base you can ease back into the higher intensity stuff.  All of this is relative -- to the event you're training for and to the type of fracture you had!   Hopefully you'll be back on track (literally) soon! Good luck.  It's a process and you can't skip stages -- be patient and diligent with the exercises and get your body back to balance -- you'll save yourself a lot of future grief if you do that.  Coach Janet Hamilton, MA, RCEP, CSCS

Tuesday, Dec 2 2014

10k performance not improving as expected - Mary

Dear Coach,
I would like to have an advice or opinion on the following "problem" - I have been running for several years and last year I decided to find out how quick I could get in 10K distance. Training on my own, I managed to improve my 10K time from 50min down to 42:40 just in 3 months! After that, I was invited to a local running club and started to train by schedule created by a running coach. Now, after 1 year of training, I have improved my 10K time just by 7 seconds... I don't know am I just being impatient or am I doing something wrong. After reading lots of information about running and training plans, the plan created by my coach seems quite correct - I am doing easy runs, long runs, interval training each week and a tempo run every other week. I am running 150-200 km each month, 30-70km each week (depending on race schedule). Adittionally 1-2 times per week I am doing strength training. My times for shorter distances have improved during this 1 year (1000m from 3:38 to 3:28, 3000m from 11:46 to 11:03, 5000m from 20:57 to 19:01 (on track)), but the 10K results are not improving. My aim was to run 10K in ~40 minutes this year, but it looks like it will not happen. What could be the reason why I have stopped progressing? I have had no injuries whatsoever, I have a healthy diet and lifestyle and following the coache's plan very accurately.
Is it normal that last year I managed to drop my 10K time from 50min to 42:40 in 3 month, but now it's been a whole year of training and no improvement? Thanks very much in advance.

Reply - Coach Janet

Your 15% improvement in 10k time from 50 min to 42:40 in just 3 short months is quite remarkable.  Improvements in performance are rarely linear though, and subsequent improvements are much harder to come by as you've found out.  When I look at the data you provided, your 3k and 5k times line up nicely and both predict a faster 10k - something in the 39:42 range is possible.  Since your 3k and 5k times line up pretty well, but your 10k seems to be falling off, this usually makes me look into issues related to endurance and stamina. In other words you don't appear to have the endurance base to sustain a comparable effort in the 10k. Usually the best way to address this is to work on long run and total weekly  mileage for a bit, then return to the intensity stuff and fill in the missing pieces there.  Your total weekly distance of 30-70km per week might be a little conservative on the lower end - perhaps keeping it in the 55 to 70km range would help?  At the upper end of that, you'd be doing long runs of about 21-23 km.  Some athletes tolerate high mileage better than others, so it's hard to say what's right for you without knowing more about you - but that's some food for thought.  Also important is making sure that you respect the purpose of each workout and run the paces that are appropriate for the workout.  I think you have a faster 10k in you -- no doubt there -- just need to address your missing links!  Once your mileage is well established at higher levels (55-70km or more), you should be able to tolerate more aggressive intensity workouts like progression runs, longer pace runs, and sustained segments at/above threshold.   If you ever decide to try a different coach - get in touch with me, I think you definitely have unrealized potential!  Best of luck to you.  Hope this has given you some food for thought.  Coach Janet Hamilton, MA, RCEP, CSCS

Monday, Nov 10 2014

Avoiding injury with treadmill training - Janet

Hi Coach,
Do you have any suggestions for minimizing the risk of injuries from treadmill running during the winter? I live in a part of the country where running outside, regardless of the quality of my apparel, isn't safe for weeks at a time during the winter months. I don't want to go for weeks at a time without running, but I also don't want to experience the usual injuries I seem to get from a lot of winter treadmill time.

Reply - Coach Janet - Really the best thing is to think about what you do with your normal running outdoors and try to mimic that as well as possible during the runs on the treadmill.  If you usually run a fairly flat course most days and do hills once a week, then that is a good place to start with the treadmill.  I generally do NOT like to encourage people to put the treadmill on an incline and leave it there to "make it more like outdoor running" - because it really doesn't make it more like outdoor running and it places additional loads on your legs and back that may not be well tolerated.  It's fine to put the incline up -- but don't leave it there.  You wouldn't walk out the door and look for the longest uphill you could find and say "I'll go that way!" -- you'd look for a course that had some inclines and some flat stuff.   Similarly, pacing on the treadmill should be similar to what you do over land.  You may be able to tweak the pace up very slightly since you're not having to cut a path through the air (you're running in place, remember?) but don't go overboard with it.  If you use a HR monitor you may be able to get a sense of pacing/effort by trying to run at a similar HR to what you usually have with your outdoor running.  Hope this helps - feel free to reach out via email if this didn't answer your question!  Coach Janet Hamilton, MA, RCEP, CSCS

Thursday, October 23, 2014

Meniscal Regneration - James

Hi Janet, I am wondering if you knew much about regenerative medicine being used to treat meniscus tears. I tore mine six months ago and haven't run since but I can bike. I was unaware of the seriousness of the injury and though it was a mcl tear. Anyhow I am having surgery to remove a portion of my medial meniscus. I'm worried that this is the end my running career or at least it will compromise the level of intensity at which I can run and hasten the onset of osteoarthritis? Do you think that this type of injury will be 100 fixable with the advent of stemcell technologies? Example growing a new meniscus inside the knee? Thanks James

Reply - Coach Janet - I know there are a lot of researchers working on this but I don't know the status of the procedure at this point.  There are many runners who are able to return to running after menisectomy - it sort of depends on how much had to be removed. The best thing you can do is be diligent with your rehabilitation, get your hips and core as strong as you can since that helps alleviate some loads on the knee.  As you return to activity post-op, work your way through a walking program before you transition carefully back into running and make sure the paces you're runnig are appropriate.  Listen to your body - make your progressions very gradual.  Talk to your surgeon about getting a referral for some post-op Physical Therapy to make sure you get started off on the right foot.  Hopefully the amount of meniscus removed is small, your strength and flexibility are optimum and you're back running before too long.