Friday lunchtime Six Physio Q&A

2

Comments

  • Jacqui Thorpe 2 wrote (see)

    Another calf-related question:

    About a month ago I noticed the tendon running underneath my foot from big toe towards the heel was tight ( I do roll under my feet after plantar fasciitis some years ago) and then also a feeling of 'pulling' around the inside ankle bone. Both those eased off, but I now have a tingling in that calf muscle and some tightness in the meat of the muscle, higher up. It is most obvious when going downstairs and seems to improve when warmed up. Exercise has not made it worse, but it is not going away.

    Thanks very much

    Hi Jacqui

    Sounds (amongst others) like you’ve got something happening with your tib post, which can look and feel a lot like PF. It’s a muscle that runs deep down your calf. The tendon appears on the inside of your shin about the ankle, runs behind the ankle bone and into your foot.

    To see if it’s tight or overstretched try this. With a shoe on, in stride standing (as if you’re going to calf stretch) and wedge your forward foot (the dodgy) one, up the wall with your heel on the ground, knee bent and toes up the skirting board. How far can you bend you knee towards the wall? Here’s a vid of it http://www.runnersworld.co.uk/health/video-stretch-on-holiday/9575.html

     

    Compare left to right – if it’s tight, stretch it. If it longer then stabilise it (balancing on 1 leg, eyes closed is great!).

  • Great advise thank you - will get on a roller hunt!

    Thanks!

    Ella

  • Twister wrote (see)

    Thanks for all your replys. I am thinking about doing 5-10k runs three times a week again but I just worry about the dull pain all the time I suppose I just need to do it!

    Keep to the shorter side of running, improve your running style, shorten your stride and up your cadence.

    Quality not quantity...

  • I've been training for two marathons, first is Nottingham next week, second Palma 3 weeks later. About 3 weeks ago I got a pain on the outside of my left knee, which I can run through, though with a bit of slowing when it really hurts, and I can control a bit with ibuprofen gel rubbed in.

    Since it started I've still managed to race (5k, 10 mile hills, 10k, all PBs) and managed a couple of LSRs (20 miles with a niggling background ache rather than pain).

    The pain is to the side of the kneecap and sore to touch. I suspect my hips/glutes are weak, and achilles tend to be rather tight and sore too.

    Any ideas?!

  • Hi

    If you were going to lead a group of completely unfit, novice runners on a couch to 5K programme...  what would be your top 3 pieces of advice, to make sure they stay fit and motivated?

    The outline structure will be a dynamic warm up...  follow the walk-run programme...  then do some stretches.

    Thanks

  • Six Physio wrote (see)
    carterusm wrote (see)

    I have been suffering from an ITB injury for about 6 months. I went to see a physio in March who gave me some exercises (clams, lateral leg raises, single leg squats, plyometrics etc) to do and after a month off running I started again slowly and built up my mileage. After about 3 months the pain came back again so I went to see a different physio, this time one who specifically treats runners. As the pain was only coming on after about 8 miles of running he suggested limiting my runs to 5 miles. I have been doing that for about 6 weeks now and while the knee pain is not too bad I can still feel it is there and that it could return at any minute. 

    I dont feel that my knee is improving really and wondered if you had any other suggestions ? Or is it just a case of time and it should heal eventually ? Cheers

    Sheriff Fatman? I hope not!

    ITB never just happen. They always happen because of something….and that’s what needs to be established. You don’t sound like an overuse or too much use injury because you’ve got back to running, but I think it sounds like a technique thang.

    The quality of the rehab you’ve been doing  - rather than the quantity is super important. When running, unless your foot lands in the right area with the rest of your body above and below it also following suit, you’ll breakdown.

    You need to work on form (of what you’re doing) and also endurance of what you’re doing too. Do more of the weight bearing, running mimicking type rehab, but do them more often for longer.

     The longer you have ITB type symptoms, the longer you’ll have them for as the bone under the ITB will react to having to take excessive load – time is not always on your side, so make sure your rehab rocks.

    Sheriff Fatman, thats me !

    You say "running mimicking type rehab" - I'm currenly doing some plyometic hopping about and single leg squats. Could you recommend anything else ?

    Thanks

  • Madeleine Harrington wrote (see)

    The pain is around my kneecap.  It's worse going upstairs and if I squat down.  It had eased off a bit before my run on Tuesday, but it doens't seem to be easing off now.  I sit down a lot during the day at work, and I guess that's not helping.  Tried elevating it, but that seemed to hurt.

    Got 2:13 for my last half marathon and wanted to get under 2 hours for this one image

    Under 2 hrs? Gotta be in the bag, so....

    Sitting doesn't help as your knee sits at 90 and this raises the pressure at the back of your knee cap (where I think the issue is coming from). A short blast of anti inflams (if you can take them) wouldn't go amiss. Certainly grab a foam roiller and hack away at your ITB's. Taping (your knee cap) can also help too...but best put on by someone who knows what they're doing.

    Glut med exeercises are really important....as is a little more rest image

  • Hi

    I have for over two years suffered from ankle pain in my left foot when I run. I have seen doctors who referred me to a physiotherapist who was very supportive and after 8 sessions of various exercises referred me to another physiotherapist who was trying a new form of exercises for pain from tendonitis (which is what I was diagnosed with) which again failed, he offered me injections but to me that would only mask the pain, in my view we suffer pain so the body can warn us something is wrong. I had  6 sessions with a podiatrist and again still have not overcome the problem. I have conceded and given up running but am now really missing it is there anything else I can do for my condition. 

  • Iccle Jim wrote (see)

    I've been training for two marathons, first is Nottingham next week, second Palma 3 weeks later. About 3 weeks ago I got a pain on the outside of my left knee, which I can run through, though with a bit of slowing when it really hurts, and I can control a bit with ibuprofen gel rubbed in.

    Since it started I've still managed to race (5k, 10 mile hills, 10k, all PBs) and managed a couple of LSRs (20 miles with a niggling background ache rather than pain).

    The pain is to the side of the kneecap and sore to touch. I suspect my hips/glutes are weak, and achilles tend to be rather tight and sore too.

    Any ideas?!

    Hey Jim

    Sounds like an over stressed ITB, where it attaches into the outer side of the knee. Foam rolling is good as a pre run reliever. Some of the velcro bands can also help. Ice post run is a must.

    With Notts next week it's probably a little too late to try to alter your cadence, as it sounds as if you may be an over strider...maybe for the next?

  • Thank you for your advice it has been very helpful.

    I do have one more question though. Do you thinking normal running shoes from running shops have too much padding and support?

  • Runny Knows wrote (see)

    Hi

    If you were going to lead a group of completely unfit, novice runners on a couch to 5K programme...  what would be your top 3 pieces of advice, to make sure they stay fit and motivated?

    The outline structure will be a dynamic warm up...  follow the walk-run programme...  then do some stretches.

    Thanks

    Sounds great, but always put down some tangable markers and get them to set some doable goals. If they start to wane show them what they've achieved to keep them on track.

    Make it fun, get them sweaty and create an A team of runners!

  • carterusm wrote (see)
    Six Physio wrote (see)
    carterusm wrote (see)

    I have been suffering from an ITB injury for about 6 months. I went to see a physio in March who gave me some exercises (clams, lateral leg raises, single leg squats, plyometrics etc) to do and after a month off running I started again slowly and built up my mileage. After about 3 months the pain came back again so I went to see a different physio, this time one who specifically treats runners. As the pain was only coming on after about 8 miles of running he suggested limiting my runs to 5 miles. I have been doing that for about 6 weeks now and while the knee pain is not too bad I can still feel it is there and that it could return at any minute. 

    I dont feel that my knee is improving really and wondered if you had any other suggestions ? Or is it just a case of time and it should heal eventually ? Cheers

    Sheriff Fatman? I hope not!

    ITB never just happen. They always happen because of something….and that’s what needs to be established. You don’t sound like an overuse or too much use injury because you’ve got back to running, but I think it sounds like a technique thang.

    The quality of the rehab you’ve been doing  - rather than the quantity is super important. When running, unless your foot lands in the right area with the rest of your body above and below it also following suit, you’ll breakdown.

    You need to work on form (of what you’re doing) and also endurance of what you’re doing too. Do more of the weight bearing, running mimicking type rehab, but do them more often for longer.

     The longer you have ITB type symptoms, the longer you’ll have them for as the bone under the ITB will react to having to take excessive load – time is not always on your side, so make sure your rehab rocks.

    Sheriff Fatman, thats me !

    You say "running mimicking type rehab" - I'm currenly doing some plyometic hopping about and single leg squats. Could you recommend anything else ?

    Thanks

    Have a look on the RWTV section - we've done some running specific rehab drills

  • Damn I do have another question! Stretching before running do you recommend this? If so which ones and also any good warm down tips?

  • Tezle wrote (see)

    Hi

    I have for over two years suffered from ankle pain in my left foot when I run. I have seen doctors who referred me to a physiotherapist who was very supportive and after 8 sessions of various exercises referred me to another physiotherapist who was trying a new form of exercises for pain from tendonitis (which is what I was diagnosed with) which again failed, he offered me injections but to me that would only mask the pain, in my view we suffer pain so the body can warn us something is wrong. I had  6 sessions with a podiatrist and again still have not overcome the problem. I have conceded and given up running but am now really missing it is there anything else I can do for my condition. 

    Hi Tezle

    Scrap the physio and podiatrist intervention and don't try to proceed unless someone tells you why you've got this issue.

    It sounds as if you're chasing symptoms rather than identifying then changing the cause. I'm sure you're fixable, just gotta know why you keep breaking down, despite their best interventions...

  • Twister wrote (see)

    Thank you for your advice it has been very helpful.

    I do have one more question though. Do you thinking normal running shoes from running shops have too much padding and support?

    ...depends on what you think normal is - a bit was awfully misquoted in the Nationals last week

    As for stretching always dynamically stretch pre exercise, never statically stretch before

  • ooooo what was mis quoted have you got a link image

  • Thanks Six Physio

  • Thanks,

    I don't think I over-stride... I'm only 4 ft 10 and do about 200 steps per minute!

     

  • Iccle Jim wrote (see)

    Thanks,

    I don't think I over-stride... I'm only 4 ft 10 and do about 200 steps per minute!

     

    ...I guess where your foot lands in relation to your CoG, rather than the length. All to do with air versus land time....

  • Hi,

    Apologies for the delay but I am currently in Sierra Leone (West Africa)!

    I am 50 days  from my 1st marathon -the Athens Marathon- and my right Achilles tendon became inflammed after an 8km run on near minimalist shoes (I have had problems with both over the last 18 months of transitioning to a forefoot style).  When I discovered this the next day I iced and used paracetamol both in cream and tablet formats.  As of today the swelling is down 85%, and I have no pain even after walking 10kms yesterday.

    I have since decided to shift back to my normal heavy duties shoes, but I am very aware that I am nowhere near Marathon running distances, although of course the average rainy season 26-28c heat + 80%+ himidity here makes things tough on long runs.

    I feel trapped between managing my Achilles tendon, the impending dry season here making long runs even more difficult, and my dream of running the actual marathon being of Greek origin.

    My question is: is there a way I can train with a disregard for time, therefore taking it "easy" and preserving as much as possible my Achilles' tendon?

    Thanks,

    John 

  • Hello experts!

    I'd love some advice... I've been a fairly consistent runner (except in really cold spells!) for about 4 years now doing 3 x half marathons and various other races at lesser distances. Earlier this year on a half marathon training run which was particularly awful I ended up with a really painful left hip, in fact my whole body ached. I ended up not doing the half, for a few reasons, but the hip injury just hasn't left me.

    I did a 5 mile run in early June with adventurer Mark Beaumont for a challenge, he did and had it not been for it being a charity/televised thing, I certainly would have dropped out as it was pretty painful. Since then I have managed only a few very short runs - one this morning.

    It's really strange that running aggravates it so much more than anything else - walking, cycling, zumba - and afterwards and next day it feels achey. A couple of yoga classes helped, and I'm not sure whether I should keep at it and start building up whilst incorporating some of the good yoga hip stretches, or whether I should just call it a day on running! Which I really don't want to do.

    Any advice?

    Thanks

    Shona

  • Hello,

    I started to do Jazzercice one year ago, and then to run in June. I followed the program CK25, and the September 15th, I managed my very first 5K race. 

    But in my Jazzercice class I felt like a stab in my claf, in the middle.

    The pain wasn't staying but I could feel it when I exercised.

    Somebody lended me this week end a foam roller. I ran 45' ... and started afterwards the foam roller. There I realised that it was the achille that was painfull, all along.

    What can I do about it? When I run it does not bother me, but I feel it after... it is there.

    Thank you for your advice,

     

  • Any advice for groin strain?

     I tweaked my groin about 7 weeks ago doing hill sprints, then (instead of resting as I should!) I ran a 10 mile quite hilly off road race a few days later.  This obviously finished it off!  I have seen the physio 3 times and have iced and totally rested it.

    It is feeling better than what it was, but it's still there and running is out of the question at the mo.  I can feel it on and off when I am walking, and it is worse in the morning when I get out of bed or if I have been sitting.

    Fed up of doing no exercise this week I went swimming and was fine doing 40 mins of front crawl and have also been doing pilates, again it has been fine for that.

    I have got the physio again next week.  I have a feeling me may want to send me for a scan or mri to figure out exactly what is going on.

    Any advice.  I have a horrible feeling I am not going to be running for a long time.

    Thanks.

  • Hi

    Any advice for back pain, base of my neck actually and shoulder blades, more on one side.

    It started about 3 weeks ago and I ran a half 2 weeks ago which made it feel a lot worse.  The day after that it was so bad I booked for a massage which really helped and it subsided.

    I think it is linked to running because it seems to be a lot more painful after long runs, yesterday I ran 9 miles and it is really painful again.  I feel like I have soem shooting pain from it when lying in bed for example on my side.

    I'm worried that it won't go as it has been pretty persistent for 3 weeks now and my husband has had ongoing issues with a bulging disc for 3 years so I panic it could be something like that.

    El

  • HMac3 wrote (see)

    Any advice for groin strain?

     I tweaked my groin about 7 weeks ago doing hill sprints, then (instead of resting as I should!) I ran a 10 mile quite hilly off road race a few days later.  This obviously finished it off!  I have seen the physio 3 times and have iced and totally rested it.

    It is feeling better than what it was, but it's still there and running is out of the question at the mo.  I can feel it on and off when I am walking, and it is worse in the morning when I get out of bed or if I have been sitting.

    Fed up of doing no exercise this week I went swimming and was fine doing 40 mins of front crawl and have also been doing pilates, again it has been fine for that.

    I have got the physio again next week.  I have a feeling me may want to send me for a scan or mri to figure out exactly what is going on.

    Any advice.  I have a horrible feeling I am not going to be running for a long time.

    Thanks.

    Doomer!

    It's a long time to have a tweak, not do very much and it still persists....I guess the question to ask is it groin or is it something that feels like a groin..

    Has your physio had a look at your back or hip? Is it bruised? Any knee or achilles type pain before? Age related?

    Fine the cause, deal with that, then you don't need to worry about the symptoms....

  • A

    Ejjie wrote (see)

    Hi

    Any advice for back pain, base of my neck actually and shoulder blades, more on one side.

    It started about 3 weeks ago and I ran a half 2 weeks ago which made it feel a lot worse.  The day after that it was so bad I booked for a massage which really helped and it subsided.

    I think it is linked to running because it seems to be a lot more painful after long runs, yesterday I ran 9 miles and it is really painful again.  I feel like I have soem shooting pain from it when lying in bed for example on my side.

    I'm worried that it won't go as it has been pretty persistent for 3 weeks now and my husband has had ongoing issues with a bulging disc for 3 years so I panic it could be something like that.

    El

    Ah ha!

    I think this is really common - it's pretty easy to deal with the symptoms by massage and stretching etc, but you need to know why!

    The most common pattern of presentation (what you've got!) is that you poke your chin out too much when you run, because you've got a really stiff and tight thoracic spine.

    So run tall, avoid slouching (but don't act like a sgt major with a postural comlpex) and have a good look at how you sit at work all day. If you sit and slouch, like a sack of spuds - you'll run in a very similar manner.

    Try stretching your thoracic spine on a foam roller or on a rolled towel down your back, lying on the floor. Head on a pillow and knees bent up. Try lying for 10 minutes, lift your chest and get back out there....

  • Thanks for the reply - I actually went to get a second opinion tonight (and was much happier with this physio!) and he is pretty sure I have psoas tendinopathy.  He has prescribed me exercises to do 2x a day and I can go swimming and do pilates (avoiding certain stretches).  If I ache a lot the next day I am to do less until we find a level I am happy with, then increase from there.  I have got to go back and see him next week.  He said that he is looking for pain to be lessening in the morning when I get out of bed - he said this will be a good indicator of things improving.  If no better in a month, then to look at mri....

  • HMac3 wrote (see)

    Thanks for the reply - I actually went to get a second opinion tonight (and was much happier with this physio!) and he is pretty sure I have psoas tendinopathy.  He has prescribed me exercises to do 2x a day and I can go swimming and do pilates (avoiding certain stretches).  If I ache a lot the next day I am to do less until we find a level I am happy with, then increase from there.  I have got to go back and see him next week.  He said that he is looking for pain to be lessening in the morning when I get out of bed - he said this will be a good indicator of things improving.  If no better in a month, then to look at mri....

    Cor - he must have xray vision! Ask him why you've got it....if you don't know it'll come back.

    Good Luck image

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