Friday lunchtime Six Physio Q&A

Get your questions in for Matt Todman

1 to 20 of 66 messages
17/09/2013 at 16:00

Join us here at 1pm on Friday 20th September as we have Matt Todman from Six Physio answering all your training and injury related questions. 

Matt Todman is a consultant physiotherapist with 20 years of physiotherapy experience and is clinical director of Six Physio.

Post your questions below. Thanks. 

17/09/2013 at 18:25

I've suffered from a couple of low grade calf strains this year.  The first, in the gastroc, cleared up after a couple of weeks, but I've recently had problems with a soleus strain that I think was a result of an over enthusiastic game of football.  The soleus strain, whilst appearing to relatively low grade has persited and put me out of running for over two months. 

I do bent and straight leg calf raises and stretches, but is there anything else I should try to reduce the likelihood of future problems?

18/09/2013 at 17:21

Am recovering from a tibial stress fracture, physio suggested I start making a slow running return 4 weeks post incident. Pain started up again within 2 weeks after building up gradually to 10min continuous running - how long should I refrain from running again before I re-start again.

I am continuing to undertake other exercises as advised including weighted squats, lunges and dead lifts, as well as stretching calves and hamstrings religiously. I have also just bought 'the stick' which will hopefully help out with the tight calves - any other suggestions?

18/09/2013 at 18:09

hi, after a track speed session 6 weeks back ive been having slight discomfort on the back of my leg, directly behind the knee height, its ok to run and stuff and not that painfull I just notice its there when im going fast e.g. i noticed it in a 5k race and put me off a bit, any suggestions what it could be and how to treat it? thought it would go with time as small stuff like that usuall do, but it hasnt this time. cheers.

19/09/2013 at 07:36

Is there a complaints procedure against negligent physios? 

I went to a local physio who had been recommended by someone at my running club with shin back in May.

She diagnosed mtss and said it was ok to race a 10k the  following weekend.  I had weekly sessions with her thereafter until August in which she would massage my legs and advise on various excercises but all the time encouraging me to continue running, albeit a bit slower and slightly shorter than I had been doing previously.  

Leg didn't heal so a went to a Gp in June.  Going to the Gp was my own idea, the physio was not aware of it.  Finally got the results of the Bone scan back yesterday which confirmed a stress fracture - Nhs works very slowly as you know.  The physio had repeatedly assured me that i didn't have a stress fracture.

 

19/09/2013 at 07:52

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

19/09/2013 at 09:33

Hi there,

I have been struggling with plantar fasciitis for about 6 months now - went to see a physio who gave me some exercise to do etc. mentioned that i should start running again.  However I still have pain in my heel when I do run and am now getting sharp pain in my knee on the other leg (i.e. the heel that is perfectly fine).

Could you let me know if i should stop running or what the best course of action would be?

Many thanks,

20/09/2013 at 11:19

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

20/09/2013 at 13:00

Thanks for all the questions...let's crack on.

20/09/2013 at 13:06
kittenkat wrote (see)

Hi Matt,

which muscle groups (in general) should a runner with sciatic pain work on? I'm assuming glutes for one...

Thanks.

Kate

 

 

Hi Kate

All depends on why you’ve got sciatica. You can drill loads of muscles to death, but unless you move well and allow the muscle to work properly, it won’t do much for your sciatica.

Saying that, I’d plump for recruiting your deepest of deep tummy muscles, pelvic floor and diaphragm (all together and not individually), work on control of your glutes and adductors and try to get some length in your quads and hammies – but instead of stretching them try lengthening by keeping good spinal alignment when running.

Oh and go wild with you tib post, too!

Edited: 20/09/2013 at 13:06
20/09/2013 at 13:08
Lou Diamonds wrote (see)

I've suffered from a couple of low grade calf strains this year.  The first, in the gastroc, cleared up after a couple of weeks, but I've recently had problems with a soleus strain that I think was a result of an over enthusiastic game of football.  The soleus strain, whilst appearing to relatively low grade has persited and put me out of running for over two months. 

I do bent and straight leg calf raises and stretches, but is there anything else I should try to reduce the likelihood of future problems?

Hi Lou

Gotta know why….

Strength - should be able to do at least 20 single calf raises on straight and bent knee.

Stability - what’s your single knee squat doing, especially when you dynamically lunge onto it – where do you cheat? Hips, knees or feet?)

Style (mid foot, heavy hind foot?)

and finally Structure - what your foot’s doing in your shoe – if you roll your foot in uncontrollably, then it’s your calf muscle structure that acts as a brake (and breaks!) rather than the structure of your foot.

Edited: 20/09/2013 at 13:09
20/09/2013 at 13:10

Good Afternoon

I have been running for 8 months and training for a half marathon. Two months ago I got pain around the side and under my knee cap but than the pain would move to the back of my leg where the joint is in your leg to move your leg up and down.

I took a step back from training and did gentle runs and I run two X half marathon distances in 10 days and everything was fine during the runs but now I get the pain back again mostly at the back of my leg though opposite the knee. Its strange that it moves around... I am doing glute/quad excercises and foam rolling but the niggle is still there its just dull pain but is really annoying and I do not feel like I could do any speed training with it. I have rested for two weeks but still it is there. any help or ideas please?

Kind Regards

Mark

Edited: 20/09/2013 at 13:12
20/09/2013 at 13:13
Lisa123 wrote (see)

Am recovering from a tibial stress fracture, physio suggested I start making a slow running return 4 weeks post incident. Pain started up again within 2 weeks after building up gradually to 10min continuous running - how long should I refrain from running again before I re-start again.

I am continuing to undertake other exercises as advised including weighted squats, lunges and dead lifts, as well as stretching calves and hamstrings religiously. I have also just bought 'the stick' which will hopefully help out with the tight calves - any other suggestions?

 

Hi Lisa

 

As a rule of (web) thumb only attempt to run when it’s pain free – you are still experiencing a periosteal reaction on the bone surface, which tells me you’re putting too much load through the bone, so pull back to zero.

All the other stuff sounds great; I’d be tempted to get you loading up in a pool (running) or on a trampet first. Take a step back to go forwards

 

Edited: 20/09/2013 at 13:13
20/09/2013 at 13:19
Twister wrote (see)

Good Afternoon

I have been running for 8 months and training for a half marathon. Two months ago I got pain around the side and under my knee cap but than the pain would move to the back of my leg where the joint is in your leg to move your leg up and down.

I took a step back from training and did gentle runs and I run two X half marathon distances in 10 days and everything was fine during the runs but now I get the pain back again mostly at the back of my leg though opposite the knee. Its strange that it moves around... I am doing glute/quad excercises and foam rolling but the niggle is still there its just dull pain but is really annoying and I do not feel like I could do any speed training with it. I have rested for two weeks but still it is there. any help or ideas please?

Kind Regards

Mark

Hi Mark

I take it there is no swelling or it doesn't feel like it's going to give way? If so go for obvious things first, such as patella tracking issue (which can spread/refer pain) to the back of your knee or and ITB type thing, which also has similar origins to a patella tracking issue.

The rehab your doing sounds OK, but the crux of it is how your doing it. If you're getting stronger - great, but it won't help with the stability or the endurance componant, which is I think the key.

Lunges, squats and all the variants in between need to be done functionally, weighbearing and with great dynamic control....

20/09/2013 at 13:21
cliff781 wrote (see)

hi, after a track speed session 6 weeks back ive been having slight discomfort on the back of my leg, directly behind the knee height, its ok to run and stuff and not that painfull I just notice its there when im going fast e.g. i noticed it in a 5k race and put me off a bit, any suggestions what it could be and how to treat it? thought it would go with time as small stuff like that usuall do, but it hasnt this time. cheers.

Hi Cliff

Could be a hammy (the most obvious) so try a little stretching and strengthening or could be an over stretched popliteus, which controls the last bit of tibial (leg bone) rotation when you straighten your knee.

Failing all of the above, your knee cap – if moving poorly, can refer to the back of your knee. Try rolling out your ITB on a foam roller

Edited: 20/09/2013 at 13:21
20/09/2013 at 13:21

Thanks for your reply.. No swelling at all. When I first got the problem It felt like it was going to give away twice and that was whilst walking never whilst running but that was two months ago and I have not had that give away feeling again and also back than I was limping but no limping at all now.

Edited: 20/09/2013 at 13:22
20/09/2013 at 13:21

Hi Matt,

I finished ran my first half marathon on Sunday and the week prior to it I had a niggling pain in my left calf.  My calf actually seized up on a run last week.  On the day of the race, evening walking to the line I could feel a little pain, but I never noticed anything during the race and finished in good time. 

However, the pain did come back and although it is not significant, I am a little concerned that it is more than just delayed onset muscle soreness.  Any recommendations on how to take care of it, other than some R&R of course!

20/09/2013 at 13:24
Twister wrote (see)

Thanks for your reply.. When I first got the problem It felt like it was going to give away twice and that was whilst walking never whilst running but that was two months ago and I have not had that give away feeling again and also back than I was limping but no limping at all now.

Sounds more knee cap related then. They can present with a "false" giving way feeling.

Check your shoes, long distance technique ie related to fatique and maybe add in some strength training too.

20/09/2013 at 13:25

Yes I am moving to a more minimalistic shoe but slowly does it I have a pair of Nike Free 5.0 on there way and I am going to change my form to midfoot striking rather than heelstriking.

I figured whilst I am attempting to recover from this dull pain I may as well work on my running form aswell.

 

PS: what strength training would you recommend?

Edited: 20/09/2013 at 13:26
20/09/2013 at 13:29
LazyDave wrote (see)

Hi Matt,

I finished ran my first half marathon on Sunday and the week prior to it I had a niggling pain in my left calf.  My calf actually seized up on a run last week.  On the day of the race, evening walking to the line I could feel a little pain, but I never noticed anything during the race and finished in good time. 

However, the pain did come back and although it is not significant, I am a little concerned that it is more than just delayed onset muscle soreness.  Any recommendations on how to take care of it, other than some R&R of course!

Hi Dave

Sounds like it's knackered - but not too literally. Fulls and halfs involve endurance and strength - and for your calf you're going up and down on tip toe 1000's of time. The muscle tires, doesn't have enough strength and starts to give up. Adrenaline helps, but when it's knackered, it's knackered.

There maybe some try of remedial gel/rub/arnica etc that you can apply, but I go for the rest route for the next 10 days. Let your body do what it does best and heal. Gentle stretches, bit of ice if sore but don't try to hurry it along. Small run next weekend please!

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