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Webchat with physio Sarah Connors
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Hi Norfolklass, is the pain over the Iliotibial band if on the outside of the knee if not the band then some of the attachements to the kneecap, especially if you had downhill pain. The band could be pulling the kneecap out of line and rubbing or just being in the wrong palce causing ITB friction syndrome runners knee. You need to get your glut strength checked the old one leg knee dip and see what is happening to the knee when you do this is should stay in line do this in front of a mirror and try and improve using some bridging and some wall support initailly what you need is an accurate diagnosis so you know what to treat.
Hi Warren, yes sounds like you have definite waekness going on on that sound as the last post try the one leg dip in a mirror and see what happens also try the bridge with one leg which will tell you if one glut is weaker than the other.
Hi Gemma, do the one leg and brisge test as in last 2 posts and show your physio any weakness! Then look at your shoes do they twist easily? If so you may need more support get your physio the check this and your lower back lots of ITb comes from lower back stiffess and hip tightness. Look for the cause. Good luck
Andre seems like your question has been answered quite agree!
To Infinity, sounds like you have a hip impingment great if no structural damage. Your pelvis could be sat anteriorly rotated with tight hip flexors causing an impingement in the anterior hip. Try simple hip flexor stretches and get your lower back checked out too.
Thanks Sarah for your reply. That's really helpful.
In case I get another go - do you recommend running through mild shin splints, or stopping running until they've gone totally? I see different recommendations. At the moment, they feel fine while walking & don't flare up until I start running, last night they got much worse after a few miles, so had a long walk home! Where as in my 17 miler at the weekend they went away after 5 miles and didn't feel them until I started jogging again.
If I don't get another go, thank you very much for your help!
Hi Jon, it's ok to manage the achilles as long as ok to run and not getting more sore and only minimal soreness in the am. Obviously it's better to get rid. I help a lot of achilles with releasing the tension from the lower back and all the nerves to take the pressure of them, then strengthen the core so the gluts are working rather than the calf.
Hi kirsty what you are feeling is neurological symptoms from an irritated nerve there is probably some stiffnessin the facets of your lower backyou can try some gentle lower back mobilisations like hugging the knees and gentle rotations but you may need some further help.
Thanks Sarah really helpful; what exercises do you recommend to release the back tension ( I work daily on the hams, glutes, hip flexors etc.).
Hi stewart could either be the medial hamstrings as mentioned before or if you have twisted the knee could be the medial ligament. Try some knee strengthening exercises like squats and one leg dips if pain free. Does it hurt to sqaut all the way back onto your haunces if so you may have torn the cartilage.
Hi Phil, to address the cause I look at the whole chain and if there is tension further up the chain ie in your case probably your back then I would work on that area first, mobilise it do nerve stretches to help release the calf/ achilles so the area is freer to actually try and heal. Yes the tendon has a poor blood supply and it's hard to settle thats wehy we try and off load it as much as possible. Eccentric exercises have been shown to help regenerate the tendon aim for at least 3x 20 on one leg to cope with running I know this is hard to do yourself but at least you can have some pointers to ask your physio. Youy caouls also try wearing the support socks especially in winter.
Hi David, I'd stick to your old trainers. use a golf ball or rolling pin to roll the foot over and see if you can gently ease the stiffness and its ok to take hold of the foot and gently mobilise the toes. then stretch the foot putting the toes on a step and bending kneee and ankle.
Hi Sarah,
I have focussed pain on my tibia a couple of inches up from my ankle. It's been a problem since mid Decemeber. The physio told me to reduce my running and to do some strength exercises, but it isn't working. Any advice?
Thanks
Hi Rose are you doing eccentric heel raises as well as stair stretch to increase the strength of the tendon? This is then a god indicator 3x 20 on a one leg is a good pre running goal also being to hop painfree is another good indicator. You may get a bit of soreness initailly but this should be mild and ease very quickly.
Hi Jen the key is slowly slowly initially not too much too soon and increase only by 10% per week. Try and do alot of running off road too tolimit the stress. It's hard with ultra running as you are pushing things good shoes not worn out and correct for you. Also as a female diet and plenty of calcium are important. Try some cross training too initally
Thanks Sarah, no it doesn't hurt to squat all the way back, I had a similar problem in my right knee a while ago and doing squats and leg exercises seems to have corrected that one so I will try the same again.
Hi Richard that's a difficult one! It depends on wether you are just wanting to run or want a pb time, the later will be hard to achive from limited training. Aim to try and get to 20 miles 2 weeks before then ease back, more of a question for sam and Steve!
Hi Samantha, good time to stretch is after running when you're all warmed up I go to Pilates after my Friday run and it's perfect to redress all my imbalances and there are lots!! foam roll then too also I know you do lots of classes / yoga are your gluts strong and functional??
Jon great answer for Jen no tea yet still plugging away!!!
Hi Hilary think you've answered your own question there ther were obviously worse after sunday as they were so sore last night. It's not good to try and run through as pain will get progressively worse off load cross train vary surfaces strech and self massage to help and ice.
Jon the cat stretch is a nice general back mobility on all 4's arching then lowersing the back and neck at oposite times.
also rotating the back dropping the j=knnes from side to side
Stuart sounds like shin splints is the bone tender? If so then lay off cross train and let it recover as probably a stress frtacture.
Stwerat great strengthening the area is always a good start.
Thanks Sarah! Do you think I need to hold off running until I get it seen to?
great thanks
Thanks everyone some great questions now to get that cupa!!
Remember lots of overuse biomech injuries runners tend to just run don't forget to add stretching and some easy strength work like body weight circuits into your weekly training. Yoga and Pilates aslo fit very well.
Good luck and enjoy your running.
Many thanks on behalf of all of us !
It has been very interesting following your answers (I really should be working !) and I shall read through them all again tonight.
Kirsy def ease back and do gentle runs and see how feels.
Thanks Sarah! Some great Q&As here.
I hope you all found this webchat useful. Look out for Sarah's expert injury prevention videos coming soon to the site.
Have a happy Valentines day all!
Annie RW
Thanks Sarah,
I'll try the dips after work tonight