Ask the Experts: Half-Marathon Injury Prevention with Sarah Connors

Hi everyone,

Sports physio and ASICS PRO Team member Sarah Connors will be answering your injury prevention questions ahead of your autumn half-marathon in the forum today between 1-2pm.

She'll help you banish any injury niggles with stretching and strengthening advice. All you’ll need to do is login and join the forum debate below.

Sarah Connors is a chartered physiotherapist who has specialised in treating track and field athletes for the last 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. With all these expertise, she’ll be more than ready to answer all your questions.

We're opening the discussion now so Sarah will be able to get stuck in straight away at 1pm - so start posting your questions now!

Dominique RW

Hey Sarah,

I had plantar fasciitis during spring marathon training in 2011, managed to get rid of it but it's come back again this summer following a spring marathon.

Every time I feel like it is much better I start to build up my millage and do some speed work but it seems to aggravate it. 

I've got the Cardiff Half Marathon next month but after three weeks without running I can still feel the PF a little when walking. It's not overly painful but I'm obviously keen to get it sorted properly rather than risk making it a lot worse.

I'm rolling an iced bottle of water under my foot twice a day and stretching my calves, is there anything else I can be doing?

Thanks

I've got five weeks to go before my first half marathon and after this weekends long run i'm in quite a lot of pain from my right knee when I bend it or go up or down stairs. My left is slightly niggly but isnt' giving me the same level of pain at all. I have a day off today and plan to take it really easy on my run on Tuesday, i've taken and ibuprofen this morning - is there anything else I can do to make sure this doens't get worse in the next five weeks before the race?
Thanks
Alex

Hi Sarah,

I was diagnosed as a big overpronator approx 5years ago and ever since I have worn made to measure orthotics.  These allow me to run, but I still suffer problems especially with my left knee when I increase pace/mileage.  I am currently running approx 30miles a week with the Peterborough 1/2 in 7weeks time, and at the end of a 10miler last night I had to slow down considerably in the last mile due to pain in my left knee.  Whilst this was aleviated with ice it is still a concern + the issue is holding back my ambitions of running past 1/2 distance.

Is there anything that I can do to help this, both short + long term.

Thanks

Hi Sarah

I fell and damaged a ligament in my foot 6 weeks ago and felt ready to run again last week. I started slowly (with a foot support) and have built up to 8k over four sessions, but there was some throbbing after the last session so I did not run at the weekend. 

I have a 1/2 marathon in 8 weeks, and my question is how hard can you push ligament damage? I could run little and often, but my preferred approach is 2 medium runs during the week followed by one long run on the weekend.

Any guidance would be appreciated

Martin

My running partner broke her big toe (inside and outside bones) 7.5 weeks ago and it's still very sore, even to walk on, and very swollen. When is it normal for toes to heal and when can she start running again safely? Thanks!

Hi Sarah,

Last summer I either had a plantar fascia tear - or a sudden onset of plantar fasciitis whilst out running.  After 8 months of icing, stretching etc. I started running again gradually - but after a few weeks developed pain in my 2nd and 3rd toes, and the top and bottom of the forefoot.  I wonder if this was caused by too much stretching (I had some quite vigorous sports massage on my foot).  Is it possible that I've inflicted damage by stretching?   I'm hoping this isn't morton's neuroma.

Hi Tim,

Plantar fasciitis can be notoriously stubborn. the key things to look for are biomechanical, have you got the correct shoes that are not worn out? Do you overpronate putting extra torsion on the PF. Is there tightness further up the chain into the lower back that could be contributing to this. It's worth getting an assessment form a sports physio to look at these things. In the mean time continue with the ive and stretching putting the toes on a step and bending the knee and add some nerve mobilisiations, ley on you back leg in the air and pull foot up and down. This may release some of the stubborn tightness. You may also need some temporary orthotics to relive the pressure on the foot. I would advise against trying to run through it as pain means further inflammation.

good luck

Hi Toots,

its sounds like you have a tight quadriceps muscle the muscle at the front of the thigh. This causes increased pressure on the kneecap and tendon and pain up and down stairs. Do some stretches for your quads and hip flexors. The Thomas stretch is great which should be on the site in stretching.

Also on one knee stretch the forn of that thigh keeping the back straight.

You could also try rolling your quad over a foam roller to ease some of the tightness.

Try stretching before your long run and do some glut exercises like bridging and squats to ensure the correct technique when running and not overloading the quads.

Good luck

Hi Liz,

it would be great to get someone to have a look at your hip to check your range of motion and muscle length. Try the Thomas test to see if your hip flexors are tight on that side. You also need to check your gluts are working on that leg an easy test is to stand on one leg in front of a mirror and check you stay centrally, any shift across means your gluts aren't holding you still. Try then lifting the knee to waist hight and see if your pelvis stays level, then see what happens when you bend that knee.

Pilates would also be a good starting point as it would be great for someone to show you all the basic exercises and check you are doing then correctly.

Start with the easy core exercise like bridging and bent knee fall out and make sure the muscles at the front of the hip are stretched.

good luck

Hi Sarah,

I have a calf strain which started as tightness during a half-marathon three weeks ago and got much worse a week ago. I rested and iced it for a week then did a sprint triathlon yesterday, it was fine until I started running and then it immediately started hurting again. I wanted to do a marathon in October but have given up on that idea, but would still like to do a half-marathon towards the end of October if possible.

I'd like to know how long I should lay off the running completely to let it heal, and whether I'll be able to get back up to 13 miles by the end of October. Also, can I swim and cycle as long as it doesn't hurt?

Thanks very much!

Hi Howard,

you don't say what trainers you are wearing, I overpronate and wear orthotics but find I also have to wear stability trainers like the kayano.

I also do Pilates to help strengthen my core as when you increase the distance fatigue sets in and it's harder to hold the correct form. You may find both of these with your running allows you to increase the mileage enough to do along Si=unday run, then concentrate on quality in the week.

You could also try some circuits to strengthen the quads and gluts, any of these things to prevent fatigue and keep form will help. You can start some squats and bridging now. Also make sure you add regular stretching to combat the tightness of the long run. Running gradually tightens the muscles and joints and if you don't stretch and unwind them something invariably gives. This is esp true if your technique and form is not as good ie overpronating.

Hope that helps

Hi Sarah, Over the past year i've ran 3 halfs and the VLM. In two of the halfs and at VLM i've had major calf cramps at 10 miles and 13 miles (VLM) however all through my training in over 600 miles of varying distances up to 21 miles no cramps at all. I'm pulling what's left of my hair out to find a reason for this. The pace dosn't seem to be the issue as i was doing 10 min miles at VLM. Ran a 10 k at 8 min miles with no issue, for example. I've hydrated well, eaten well, warmed up as per training runs. The only thing i've done different from my long weekend training runs is hydrate more the days before and on the day. I'm looking at why i never get cramps in training at whatever the distance or pace. As i've said i've looked at hydration and food. Is there anything else you could suggest that may help please? Thanks

Hi Martin,

one of the keys to rehabing a foot injury is to strengthen the muscles back up agian. This doesn't happen by running. You haven't said where in the foot you damaged but any one leg balance work, on a wobble board or bosu ball. Going up onto your toes on one foot, doing lots of walking drills on toes high knees fast feet etc.

You cal also use a cliniband to hook around the foot and pull in and out forwards and back.

Once you can toe raise on one foot you need to progress to 2 foot jumps and hopping use a square and go forwards back and side to side plus diagonally.

Use pain as a guide with your running.If sore after you've done too much and so ice it and rest for 24hours. Add cross training if you feel you need an extra session, ie bike or step machine.

Good luck

Hi Jackie,

has she been in plaster I would expect so for 6 weeks. If that's the case then the foot will be very stiff and weak. You need to start with foot mobility exercises to get the joints moving then 2 footed weight bearing exercises the pool is great for this.

She really needs to be able to toe raise 3x20 on that before it's anyway strong enough to run. Try cross training as a starting point.

If you have anymore info like which bone and wether in plaster I can be more specific.

thanks

Hi Sarah, Thanks. She hasn't been in plaster, the GP just said yes it's broken and it'll heal on its own.  Her toe isn't even bending at the joint at the moment as it's too sore and swollen still.  I'm not sure which bones she broke, but it was outside and inside of her left big toe. 

She's started doing an exercise dvd including ab work and squats. Hope that's ok.

Hi Sore toes,

it could be you have dropped metatarsal heads than can happen, try stretching the top of the toes to counter balance all the sole stretches. You can get a small support from boots that sits under the toes and lifts the heads worth a try to see if can ease the pain while you get the balance back.

This is called a metatarsal head support.

You haven't said how much running you've done so doesn't sound like too much . If you'd done alot then a stress fracture could be the other cause if the pain is along the shaft of the bone. rest is all you can do for this.

Good luck

Hi Jen,

lots of these calf tightness come form the lower back especially if there isn't a sudden onset of pain meaning a tear.

If you can get to see a specific running physio that would be great they need to loosen off your joints in your lower back and then do some nerve stretches to mobilise the sciatic nerve that goes to the calf.

If you can't then do some lower back stretches rotation is good to open up the joints lye on your back and take one knee up over the the other leg. Then do some nerve mobilisation lye on back leg in air and pull foot up and down.

You also nned to do some calf strengthening work, start off with calf raises on the falt on toe feet then progrees to one then do the same dropping the heels over the edge of a step. You should be able to do 3 sets of 20.

Good luck

Tendonotis

Picked up achilles tendonotis in April just after the Brighton Marathon.  After performing the eccentric stretching and changing my running style (higher cadence-midfoot strike) the problem is 25% gone.   Two questions:

- my recovery seems to have levelled off - how do I get all the way there

- I have changed phsios during the recovery.  The first was keen to get me into shoes with a smaller heel-forefoot drop.  My current physio suggets if I am comfortable in my current shoes I should stick with them

Any advice?