Sarah is a chartered physiotherapist who has specialised in treating track and field athletes for the past 20 years. She has worked for the British Athletics Team and was lead physio for the English Institute of Sport in London before setting up a successful sports injuries clinic.
This spring, she joins us as one of the ASICS Target 26.2 PRO Team, working with our five spring marathon contenders as they look ahead to the Paris Marathon on April 15.
Read the whole forum debate.
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Q. I strained my hip (apparently the right adductor) over a month ago and it is very slow in healing. Five weeks on I still can’t run on it. Is there anything specific I can do, other than rest, to speed up recovery? Also, once it has healed, what can I do to strengthen it for the future? Not being able to run for a month has been one of the most frustrating things I've endured! Ash Mann
A. If you've hurt your hip, you need to look at the cause. Was it a sudden injury, for example a pulled muscle? If so, it could take 4-6 weeks to settle with a stretch and strengthening programme. It’s more likely a gradual onset, where the wrong forces are on the muscle causing it to overwork. This can happen because the pelvis and lower back are tight and out of line and the glutes aren't working properly.
Have you had a physio assessment? If not, I would think about it. Also try some core work to activate the glutes. The bridge and the plank should help to take the pressure off the adductor.
Ash Mann: It was a sudden injury caused by over-ambitious intervals on a treadmill. Physio assessment seems like the logical next step. Cheers!
Q. I've got a question myself actually! I strained my left knee medial ligament in a botched ski jump last February (I think you had a look at it on a training day in Birmingham, in fact!).
It's OK now - I get no pain walking or running (I've only run up to half-marathon distance since then) but I definitely notice something still odd when I kneel down or squat. It's like there's something moving that shouldn't be.
Should I worry about this - is it connected? Could it affect my running over longer distances? And if so, are there any exercises I can do to continue sorting out my wonky knee? Alice RW
A. It sounds like you may have a very small tear in the meniscus inside the knee and it catches when you kneel or squat. I probably wouldn't do anything with it at this stage, as it’s not causing any pain.
It’s a good idea to do general knee circuits to keep the knee strong, for example small squats and lunges.
Q. I regularly run 4-5 times a week. My long run (10-11 miles) is on a Saturday and my mid-week runs are around 5-8 miles. My mid-week runs are fine but when I do my long run, I get to around mile seven or eight and I begin to get some discomfort in my left knee and right hip. My hip hasn't been causing me as much trouble recently but my left knee is still problematic and it feels like it’s going to give way at times.
Last year I had some physio on my right knee following a football injury. I was told that my hips are not fully straight and that my legs lean/bend inwards when I bend down.
Is there anything that I can do to eliminate this discomfort and help with my knees and hips? Jamie Farmer
A. It sounds like you have issues with your core and your biomechanics. You are probably OK on shorter runs but during the long runs the core gets more tired, the pelvis drops and this causes the knees to turn in more.
Check your trainers and make sure you have the correct ones for your gait and if they give enough support - a good running shop will do this for you. You also need to start doing some strength and core work to hold your form when you run further.
A general circuit is a good starting point: squats, lunges, calf raises, the plank and bridging. Try this twice a week, with three sets of 20.
Jamie: Thanks for the advice. I’ve been doing some core exercises for a few weeks now, which I'm hoping has contributed to my hip not giving me as much trouble.
As for trainers, my current pair are 'off the shelf', so I will definitely invest in some gait analysis to get the correct pair next time. I'm running the Milton Keynes Half Marathon in a few weeks, so it's probably a bit late to be getting new trainers for the race.
Q. I stopped running for a couple of months as I was getting lots of little injuries followed by a torn hamstring in the latter half of last year.
I've just started again and I’ve done a few five-milers. My knees hurts straight away then the pain eases off after a couple of miles, though they still give some discomfort. I do stretches before and after the run. The pain is worse in the leg where I damaged the hamstring. Is there anything I can do to combat this? lfc runner
A. Have you done any rehab to strengthen the torn hamstring? You need to specifically strengthen a muscle if it’s torn and stretch it as it heals with scar tissue, which is inelastic.
Try some prone (on front) hamstring kicks to start with. Lie on your stomach, kicking your heel to your bum at first slowly, then increasing in speed. This can also be done standing.
Try some bridging to see if the glutes are working or if the hamstrings are doing all the work. You shouldn't feel them when doing a bridge. If this is the case your hamstrings have been overworking, which is the cause of the tear and you’ll need to also work on your core.
You’ll also need to stretch the quads and hip flexors and if these are tight the knees can be sore. Try the Thomas stretch and see if your legs hang to a straight line or if your hips are tight and the knee lifted.
Q. After doing my longest run so far (14 miles) I've got blisters under nearly all of my toenails or at the very ends of my toes. I wear 1000 Mile socks and my shoes were properly fitted after gait analysis (I am a neutral-gait forefoot-striker). Any tips to avoid this in the future? Lady l
A. Sorry, no great tips for this other than applying Vaseline over the toes or trying to see if a slightly bigger shoe helps.
Q. I had an inguinal hernia operation on my left side two weeks ago today. Should I do any rehab before I start running or just start with gentle jogs and see how it feels? When should I start running again? Adrian monti
A. Have you been given a rehab programme and guidance from your surgeon? They normally tell you when to start with running and exercising dependant on the repair.
If you have the all clear then you definitely need to strengthen the area as well as starting with very light jogging. Any area that's had surgery will be weak. Start with abdominal contractions, just holding the muscle tight. Then add some pelvic tilts and small inner range curls - knees bent up, then try and slowly start to straighten one leg, bring it back, then repeat with the other leg.
You must keep your back flat the whole time to prevent any damage from weak muscles. Stop if there’s any pain and progress slowly. If you feel your back lifting or arching then the exercise is too hard and go back to an easier point. Also start adding bridging and the plank on your knees to begin with.
Before you begin any exercises, make sure you've had the all clear from your surgeon.
Q. When out running last weekend, I started to get a lot of pain along the top of my foot/the tendon which goes to my big toe.
If I lift the front of my foot up, it's extremely sore. I stopped exercising for a few days but went running last night (6 miles) and it’s back again.
My shoes are ASICS gel nimbus 11s which I've had for over a year. I’ve done about 500 miles in them with no issues. Does this sort of injury sound like it’s down to the age of the trainers?
What suggestions do you have to relive the pain as I'm running the VLM this year? Also, my budget to purchase new shoes is very limited. oraclebhoy
A. It sounds like tendonitis of the muscles that lift the foot and toe. Did you have your shoes too tight?
Feel the shaft of the bone and check if there is any underlying bone tenderness causing the inflammation.
Does the toe or tendon creak? If so, this is definitely inflammation of the tendon and you need to give it a bit longer to rest. Ice is good for inflammation.
It does sound like your shoes are at their tail end but they haven’t necessarily caused this problem. I would think about a new pair if possible if you’re running the marathon, as you’ll be doing high mileage.
Give it a week and reassess. If you can get some treatment, that would also help. Try and release the muscle - follow the tendon along the front of the shin and it will feel tender in the muscle. Use your fingers to do some soft tissue release, hold the muscle and stretch the foot away.
Q. I’ve had two sports massages so far on this campaign, with one more due at the end of March to help ease my muscles, particularly my calves, as I have issues with cramping during marathons. Are there any exercises or stretches I can do to compliment the massages and if so how often should I do them? I have also noticed my calves are a bit tight generally. knight rider (and Team ASICS Target 26.2 member Colin).
A. You should really be doing a regular stretching campaign now you are deep into training. I would include some lower back stretches, rotations, knee hugs and push-ups on the arms, as well as core work. You will be getting some fatigue in training now and so need to unwind all these effects as much as possible.
A good stretch to link the lower back and calves is to lie on your back, legs in the air, pull your foot down (3x10 reps) with a towel. Don’t hold the foot on the stretch - this is a nerve stretch, which will help release the calves. The key thing though is to keep the core strong and to be able to hold your form during long runs. I'll be able to help next Saturday with some extra work.
Knight rider: Thanks Sarah, I've found myself doing more stretching than previously. I’ll try that towel foot stretch this weekend.
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