Webchat with physio Matt Todman

A date for your diary!

Right here this Friday at 1pm (November 23) physio Matt Todman from Six Physio will be joining us for a live webchat to discuss injury prevention.

Matt qualified as a physio 20 years ago and has spent the past decade at the forefront of sports medicine. He works as a consultant in private practice dealing with everyone from elite level runners to beginners.

Have you got a physio-related question for Matt? Post your questions below.



  • I fell over in the summer, in the process bashing my left knee on tree stump / root? I don't actually remember. I hurt myself enough that I wasn't able to get up immediately. I had to walk 3 miles to pushy then cycle 8.5 miles home.

    My knee appears to be fine when running except when running downhill and that isn't consistant. I had a week out in the summer and forgot that I had hurt my knee afterward. Had no pain or discomfort for several weeks. However, I cycle commute and a couple of weeks of high mileage running and cycling and my knee started to hurt again in the same way. Swimming breaststroke will also aggravate it.

    I can't really quantify or identify the pain. If I kneel or knock my knee it will hurt. If I straighten my leg after sitting for a while it will hurt but then not. It doesn't hurt day to day, running doesn't hurt it, doing too much cycling can but yesterday I did a 10 mile sprint and didn't notice it.

    It seems to be related to getting a little stiff or tired and mostly moving in a sideways motion. ( I can't side step for example). Bit difficult to identify and work out what hurts as I can't induce pain, it'll hurt once then not again even if I do the same thing.

    For the most part it doesn't hurt unless I knock my knee or do too much. I can be no more specific about the pain than that, it's not behind the knee and not above the knee but anywhere in a u shape around the knee.

    Any ideas or anything I can do?


  • whats the best exercises for  strengthening weak glute muscles


  • ITBS - this is back to revisit me after a recent injury, but on my other leg. Last time I had this I strength trained my why out of the problem - the focus was on glutes, TFL, and hamstrings, and trying to loosen up the quads. Do you have any tips on dealing with ITBS, or are there too many causes to give specific advise.

    Do you advise complete rest or to continue with running?

  • Can I follow on from that ITBS question.

    During a race a few weeks a go, I suddenly got a pain on the outside of my knee.

    I've self diagnosed it as ITBS...that might not be what it is. 

    I got rid of it after two weeks only for it to come back worse when I did the next race. 

    I've googled stretches, and will try those. But what else will help, marathon training at the moment and have had to step it right back. Should I still be doing things like spinning, body pump? Never had problems with my knee before, so this has come a bit out of the blue.

    Thanks, will tune in next week image


  • At 43 I have recently returned to running (with my surgeons approval) after 6 hip surgeries, including 2 to reconstruct my hip sockets due to dysplasia. Hips are fine and I regulary stretch etc and keep trying to work on strengthening glutes and quads with squats,clams, bridges side leg raises etc...but Achilles seem to flare up easily, could this be related to weaknesses further up and what exercises are best to help, apart from heel raises and stretches on stairs? I am trying to increase my mileage slowly, presently averaging only around 17 a week with the longest an 8 miler. I am hoping it will be possible to complete some half marathons next year.


  • I was diagnosed with insertional achilles tendinpathy 6+ months ago. Haven't run in almost 8 weeks however, I bike for 20-25 minutes 3 times per week and started weight training. I've been following my physio's advice of light stretching, clams, one leg squats, planks and bridges for the last 3 months. Light stiffness is still present along with minor pain at the point of insertion. Should I be 100% pain free 100% of the time before slowly getting back into running? Or can I start again while still experiencing stiffness and minor discomfort/pain? I don't experience any pain during physical activity, only after periods of inactivity (sleeping, extended time sitting down, etc).


  • I only run very moderately. I wish I could run more as I find it very enjoyable.

    When I first started running I suffered from calf cramp. I now take sports salt tablets to overcome this issue. I generally suffer from shin splints. I manage my running around the problem.

    I've been to a recommended running shop to get advice and new shoes. I started as a heel runner but I've adjusted my techique so that I now land on my forefoot with my foot landing under my body. I was previously overstriding.

    I've found that when I run out doors (generally on grass) that the shin splints return if I have more than two 5K sessions a week. Due to the approach of winter weather I currently do my running on a treadmil. I've found that the shin splints no longer appear but the calf cramps do!

    Does this situation give you any insight in to what I may be doing wrong, or am I just a peculiarity on nature?!!



  • I get pins and needles and numbness in my left foot after about 4-5 miles.  I have had Chiropractic treatment, physio, different shoes, different lacing structures and new insoles.  It is better than it was as it doesn't travel up my leg now (it used to go up my leg to my knee and would stop me running) now I can generally run through it, but its frustrating.  Any ideas?




  •  Left knee has started to ache (more AFTER a run than during). When at work, as a postman it sometimes feels like it 'locks' for  a split second then moves ok [sometimes emitting an audible 'click' in doing so] -, but also aches after this happens.Cannot squat or kneel on this knee at all. No heat or swelling ?? Ideas?

  • I've been running for around 6 or 7 months now, started slowly with less than 1.5 miles a couple of times a week. Discovered parkrun and so do the Saturday 5K and have upped the distances during the week (gradually) to between 3 and 4 miles twice a week. On the week days that I don't run, I go to the gym, button to leg work. I cycle practically every day, but only a couple of miles there and back, nothing strenuous. Everything seemed to be going well, and the last parkrun felt great. However, the next day I started to get a dull ache in my shins (whilst not actually doing anything), and occasionally in my calves. I'm assuming I've somehow managed to damage myself and should probably rest a while - any thoughts on how long/what ican do to prevent recurrence? Thanks.
  • I have suffered for the last 2 years with recurring bouts of achilles pain, going from one leg to the other and back! The achilles is never sore to the touch and is only ever sore during or after running. I've struggled to find someone who can diagnose exactly what is wrong and how I prevent it from recurring like this. I'm sensible with my mileage and I'm pretty good and stretching after every run but this issue is really starting to affect my ability to train for any kind of race successfully whether it's a 10k or half marathong I end up injured before the race image Your help is greatly appreciated. I've seen 3 different physios, 2 osteopaths and no one seems able to say exactly what the cause is.

  • A recent MRI scan showed that I have a femoral neck stress fracture and labral tear of my left hip after a 50 mile ultra. Can you give me any idea of what to expect during physio in the months following surgery for the labral tear? 

  • I have an issue with my knee which began after running a marathon.  As soon as I stopped running within a few seconds I couldn't put any weight on the knee if it was bent, straight it was OK.  A few months on it's much better but there's still a small amount of discomfort putting weight on the knee when it's very bent (90 degrees ish) and also it begins to ache if my leg is immobile in a bent position for long periods of time e.g. driving.  There's no locking or clicking.  My regular physio thinks it's just inflammation and will sort itself given time/rest but I guess I'm looking for a second opinion since I've been resting it for about 3 months now.  Should I be seeing a doctor and pushing for a scan?




  • Back pain.  Dull ache right lower back for 3 months now.  Doesn't go away.  Have been seeing a podiatrist on NHS.  Tried heel raises but not solved problem.  Now been told not to run until inflammation goes down.  Pain only improves to a point then its just dull ache all the time.  At desk all day with work.  Hard to get comfortable. 

    In your opinion is it harmful to continuing running with lower back pain?  Do you subscribe to the view that pain when walking = no running?  (apologies for the use of short hand!) 

  • Anybody fit out there? image
    As above question from Shelby, slight pins and needles in one foot and leg when I ramp up the mileage... do stretches and trying to improve strength of pin skinny legs with various exercises.....Any pointers appreciated.image Thanks in advance.

  • Hi Matt,

    Following a few months in a leg brace I had massive muscle atrophy, I've now made big steps in getting the size back, but I'm finding my leg is so tight, despite stretching lots.

    I've been told that the muscles 'shorten' from where I had the leg brace on for so long, how can I lengthen them while still continuing to build muscle size again?


  • Another one with tight ITB, but only up into my hips. I have regular massage, foam roller and wear compression tights after long sessions, any other tips? I'm a pretty high mileage runner, 50-60 miles a week and 13 marathons and ultras this year, do I just need to suck it up and expect it to be sore?

  • Hi Matt,

    Yet another with tight muscles wanting to know what to do.

    I have found that since I have started running I have really tight muscles in my legs. I have tried static stretching after my runs and more recently during my runs. My leg muscles still seem to be very tight. I have also tried using a foam roller and had borrowed a 'stick', still didn't seem to change much, though maybe I didn't use them for long enough?

    If I stop running for any period of time then my legs appear to recover. When I start running again I'm soon back to square one.

    It's different muscles in each leg, my right calf, my left glute. Although I target this during my runs, post run my stretches are more comprehensive.

    Nothing much seems to effect the tightness apart from not running.

    I would hate to have to 'just suck it up and expect to be sore' (and stiff) as KateF suggests. I'd like to be more flexible and not say ow when I try to touch my toes.


  • hi matt,

    i picked up plantar f. in july,and spent 2 months doing cycling instead.i have been able to run again since september and as god as before with very little pain except when ive finished the run/race,when it then is inflamed and uncomfortable for a day or two.

    ive been recommended to not have a cortisone injection/and to have one,so am not sure what to do.will it go if i just keep racing,then massaging as i am doing?


  • Welcome to Matt from Six Physio!

    Thanks for joining us on today’s physio webchat, Matt.

    Matt will be answering the questions that you’ve posted through the week, and any more you have over the next hour.

    Over to you Matt…

    Katie RW

  • On your marks......

  • Hi Everyone, thanks for the questions....here goes


  • Hi I've been getting pain in my left hip when running.  It only started recently and only when I plant my foot.  I've had some therapy on a trigger point in my TFL, it only starts to hurt 2/3 miles into a run.  Any ideas?

  • Malcolm - PF is an over stretch issue, and because of this really doesn't do well in the long run with excessive stretching. It needs to restored to its normal lenght but not beyond.

    The issue with jabs is that they may well deal with the inflammation, but if you haven't dealt with why you've got the inflammation then problem may go, and then reappear later.

    Jabs into the PF are at best very painful (sorry!) and controversial, BUT do helpwith some people especially if evrything else has failed....

    Go easy on the massaging, go big on the stability and control - what's you 1 legged balance like?

  • Gaz, where is the pain?

  • Bex - are you sure that it's muscle stiffness from use or is it your muscles protecting the nervous tissue below?

    You maybe able to differentiate the 2 by if your slouch when sitting then straighten your leg to feel the tightness and can change (better or worse) the tightness sesnsation by putting your chin on your chest or looking up to the sky (without changing your slouchability) you may well have the latter and will need to aproach it very differently.....

  • Kate F - Go very large and very big on improving your gluteal stability and control. This is not the same as getting stronger.

    It seems you are doing all the right things thus far, but there is a correlationship better ITB and glut (med especially) stability.

    Control, form and weightbearing are key. Lunges, single knee squats and running man are great...

  • In my left hip area, across the front into the groin area.  Feels like a sharp pain when running on it and then a dull, dead leg feeling after.

  • Wetfish - How about using a PNF (proprioceptive neuromuscular fascilitation…huzzah!) pattern such as Hold/Relax.

    Take your muscle to the end of the available range and make it contract here, without any movement. Hold if for 15 seconds, then relax. Try now to increase the range and repeat.

    However, every muscle has an equal and opposite. If one is short and tight the opposite must be long and baggy….why not try addressing these?

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