Physio webchat with Paul Hobrough

Catch up on our webchat for expert advise from Paul Hobrough.

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Q. Similar to Kemmaw, I have pain to the side of my left knee, which comes on 2 miles into a run. This is my 3rd episode of IT band trouble in just under 3 years. I managed to train for the London Marathon last year with no problems. I was training for this year's London Marathon and had completed one 20-mile long run. The physio this time thinks I should try orthotics as I over pronate. Do orthotics help much for IT band problems? Does it make a lot of difference going for custom made as opposed to off the shelf ones? I have also been doing hip and glute strengthening exercises as well as using a foam roller. - Slowkoala

A. The part of the question where you ask about orthotics, there is evidence to support little difference between custom made and off the shelf orthotics, but as any practitioner will tell you this is not what we find in practice although a basic issue will just as easily be solved with something off the shelf… the question is we need to do such a lengthy assessment to find this out that a great deal of the cost value is already met by the consultation.

Correcting overpronation does have a positive effect on many people but not all pronation is bad, it is usually that your overpronation is affecting the mechanics higher up the leg and resulting is a tightening of the ITB.  You are right to strengthen your core and gutes, but again the evidence is out to jury on the benefit of glute strength to knee control (despite my beliefs).  Keep gong on the strength work and add in pilates based exercises for the core (lower level work - not a plank) to try to support your body better as it sounds like the mechanics are playing an important role here.  Please read my article in next months mag for a fuller reply.

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