Ask the Experts: Avoiding Injury Q+A with Sarah Connors

Hi Adrian,

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 to def need to strengthen the area as well as very light jogging. Any area that's had surgery will be weak. Start with abdominal contarction just holding the muscle tight then add some pelvic tilts and small inner range curls ie knees bent up, then try and slowly start to straighten one leg bring it back then the other.

You must keep your back flat the whole time to prevent any damage from weak muscles stop if any pain and progress slowly if you feel your back lifting/ arching then the exercise is too hard and go back to an easier point. Also start adding bridging and plank on your knees to start with.

make sure though you've had the all clear from the surgeon.

Sarah

Hi Oracleboy,

it sounds like tendonitis of the msucles that lift the foot and toe, did you have your shoes too tight?

One thing to check is too feel the shaft of the bone and check there is no underlying boney tenderness causing the inflammation.

Does the toe/ tendon creak if so this is def inflanntion 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 tale end but not nec caused this i would thinka bout a new pair if poss if you are running the marathon as you will be doing high mileage.

Give it a week and reasses if you can get some treatment that would help. try and release the muscle belly to the tendon follow the tendon olong the front of the shin and it will feel tender in the muscle use your fingers to do some soft tissue release hold the msucle and stretch the foot away.

Good luck

 Sarah

Hi Sarah

I'm not sure if you can give an answer just on a few facts but I thought it was worth a go.

I'm training for VLM.  Training has been going well, I'm following the RW sub 3.30 plan.  Hit 50miles in a week, completed the first 20miler.  After a Sunday 20 miler I was fine.  Rested on Monday and Tuesday did a 5 mile tempo session.  Again, no problems.  Then by weds afternoon i had a strange sensation in my knee which was moving around a lot - up my quad to my glutes.  A little pain, something not quite right.  I did the sensible thing and rested for a week.  After that I did a slow 4miler and the next day had a bad case of DOMS.  The problem hadn't gone away..

I had a sports massage last night at Birm Uni, they didn't see any particular issues, just recommended I do foam rolling.

It's probably a biomechanics issue as I know one leg is slightly shorter than the other - (neutral in one foot and pronate in the other!) I have been doing pilates for a while now which is excellent.   But I can't afford to keep resting!! 

 I'm wondering whether it could the trainers. I'm on 375 miles in my asics 1160s.  The supersix team last year at the selection day recommended them for me and I've never had problems before.  In your experience can a simple thing as replacing shoes really help?  I thought 375 miles was still ok.  Perhaps they do need changing.  At the moment I'll try anything!

Any guidance would be appreciated. Thank you.

Hi Knight Rider,

you should really be doing a regular stretching campaign now as you are deep into training, I would include some lower back stretches rotations knee hugs and push up on arms as well as core work. You will be getting into fatgue in training now and so need to unwind all these effects as much as possible.

A good one to link the lower back and calfes is to lye on back leg in air pull foot down 3x10 with a towel not holding the foot on stretch this is a nerve stretch which will help release the calfs. the key thing though is to keep that core stroing and be able to hold your form during long runs. I'll be able to help next sat with some extra work.

Sarah

Hi Sian,

pain around the knee cap is normally caused by tight quads, these prob got tighter and tighter through your training until on the long run the kneecap starting rubbing as it's being pulled into the wrong place and yes as the muscles rae tight they add extra pressure on the kneecap against the bone.

you really need to release these muscles by stretching the quads and hip flexors, the best way is the Thomas stretch see website and get someone to help you v gently push the knee down so you feel a comfortable strtch not pain.

if you can do this then try and stretch the quad in a lunge position keeping the back and stomach tight not letting the pelvis tilt.

Ask your sports masssur to help you stretch the quads.

Good luck

 Sarah

Hi Sarah

 I have only just taken up running as a way to increase my fitness for Tae Kwon Do. However I have found that my shins really hurt while I'm running and the following day I have painful ankles. My trainers were fitted professionally by a well know store as I am quite flat footed.

Any advice?

Thanks

 Wendy

Hi Sarah,

 Saw a physio on Tuesday because I've developed posterior shin splints in my right leg. She showed me some stretches to do, but I've forgotten how often I should be doing them I've been doing them twice a day - is this enough or should I be doing them more often?

 Thank you!

Hi Mitiog,

yes some do some don't very frustrating. On the whole a stretching programme to unwind tight muscles is a very good thing once or twice a week.

Sports massage is a great recovery tool and helps release tight muscles if you access this monthly esp in hard training great.

The stretching is very easy to add to your weekly programme and is a really good way or having active recovery on an easy day. If a muscle it tight it will stay tight unless you adress the issue.

Some peolpe are more injury prone than others and you will find because of this they tend to do more to combat it those who aren't injury prone only start when they get a problem.

A good habit is to have a stretch ahome 2x per week.

sarah

Hi Sleep bear,

 I think this is a matter of choice I love yoga but am about to start a pilates class taught by a runner so looking forward to that.

Pilates is more core based and Yoga is more strength and flexibilty through range, alot depends on a good teacher see which you feel better after and stick to that one rather than mix and match.

Are you stiff or weak in your core? I would tend towards yoga if your issues are stiffness and pilates if weak poor core. Enjoy which ever you choose.

sarah

Hi Carl,

it sounds like you first need to get to the bottom of the knee injury. Did you ever have it looked at? have you damaged any of the structures in the knee like the meniscus or artcular cartilage. If so this needs treating first.

Have you played alot of football? Is there possibly some wear in the knee?

Barefoot running takes a lot of training and coaching I think to get it right. You will be comlpetely changing how you run and loosing any cushioning from your trainers which your knee may need.

You also need to start very slowly and get your body used to the change as you are going form an awful lot of support inc othotics to none.You will need to do an awful lot of work to make sure your posture is right seek some help from someone who knows about coaching this first.

good luck

sarah

Hi MarcD1337,

it  sounds like you have an issue with the lower back you may have a grumbling disc or just general biomechanical stiffness of the pelvis and lower back. Try stretching your hip flexors before you run as this can release your lower back. as it's been going on for a few months I would go and see a physio used to dealing with runners to try and release the tight structures to ease your running and stop it getting worse they will also be able to prescribe some exercises specific to you.

good luck

sarah

Hi Lfc runner the plank and bridge are very different. bridge is great for the gluts, lye on your back knees bent and rock the pelvis back so back falt on bed then carry this on curling your back of the bed untill the body is in a staright line you should feel the gluts and stomach working not the bcak and hmastrings. If feel back and hmas lower till feel glut working should be on the website.

sarah

Hi Tempo Tom,

it sounds to me like you've got a tight lower back causing the strange pain in your quad this can be fixed with physio to your lower back and then streches inc nerve streches to the quad. Are you local to Birmingham?

Sarah

Hi Wendy,

how much running have you done initially? You may have done too much to start with and your shins are just not used to it, try and stick to 20 min runs every other day preferably off road to start with.

Sarah