Webchat with physio Matt Todman

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05/04/2013 at 13:55
Angela Muddle wrote (see)

Hi Matt

I'm due to run Paris Marathon this Sunday, but my right calf muscle has been extremely tight and causing me pain when I run.  I've run 2 marathons, and numerous half marathons over the past 18 months and never had any trouble.  My training had been going well, with gradual progression up to 20 miles, until about three weeks ago when my calf muscle gave out about 5 miles into a run on a treadmill (I'm normally an outdoor runner). I think the likely cause was a stupidly-high pair of stilettos I'd worn for a few days (including the night before the run) which probably shortened the muscle slightly, and then didn't cope so well with being stretched out on a flat treadmill.  It hadn't even crossed my mind at the time that heels would impede my training.

I've spoken to a physio, had a sports massage, taken anti-inflammatories, done strengthening exercises, and tried to rest as much as I can (thankfully, being the taper weeks, i was winding down the mileage anyway).  I managed one 16 mile run just after the injury, but i've not done anything further than 3-4 miles for the past few weeks in case I exacerbate it any further....it has improved, but there is still a niggle of pain - sometimes minor, other times quite sharp.

The problem is, now I don't know whether I am capable enough to do the 26.2 miles in less than 2 days time.  I know the run is challenging enough at 100% fitness, and I'll be lacking in confidence, for fear of it all going wrong part way through and having to pull out or hobble home.  My head says maybe just forget it and wait for an autumn marathon...my heart (it is the city of love, afterall!) wants to do it, regardless of the time, as I've spent months training through a bitter winter, and I'm heading on the train to Paris tonight anyway, with roam roller tucked in my bag!

What are your thoughts, and what's your advice for the next 40 hours, if I do want to run? 

 Many thanks



Ahhh Annie

Sounds like an issue with your musculotendinous junction, rather than just the belly itself. The crunchiness is an inflammatory reaction due to the over stress.

Here’s the plan. Do lots of single leg balance work for 40 seconds often during the day. Get on your (emotional) foam roller(coaster!) and roll your calf BUT not over the sore bottom bit. Make sure your shoes have enough support –it’s not the end of the world and there are options rather than attempting to change at this late stage.

After 3 days of doing this (so Mondayish) start also walking around on tip toe for periods of 2 minutes  (which you can build if pain allows) – little and often and do this for the week until Friday. Now go for a paced run after rolling all normal things.

Think of this as a pre taper, taper!

05/04/2013 at 13:58
Slow_coach wrote (see)
Slow_coach wrote (see)

Hi Matt,


Im in a similar position to MDC. I trained to 14 then 16m without a hitch (a month before the race so plenty of rest) and on race day on a 21m run on March the 24th and my knee went at mile 13.

I did completed the distance with a combination of walking and running.

I never had a problem with this knee before, no new trainers or anything odd like that.

I used Dr Google and as my pain is on the outside boney part on the inner side of my left knee (as if I had knocked it), it sounds like it's patellofemoral pain / Syndrome.

I can walk ok with no pain but yesterday I tried to run for the first time and it hurted within a few minutes so I stopped.

I can cycle and swim with no pain.

I have my first marathon (xc) on June the 8 and I m in desperate need to train!



Hi Slow coach

Similar to MDC, and sounds like PFJD – but it’s not as advanced, yet! I think it sounds as if you’re feeling an over stretched medial retinaculum…..half of a bit a cling filmy tissue that keeps your kneecap on the front and in the middle of your thigh.

Advice is pretty similar, but I’d add get some gluteal stability – lunges, squats, single knee dips, balance work ALL with really good body alignment so you feel your bum working. Taping is great too as long as it feels better when taped, rather than just taped.

Do have a check of your knee to wall distance on the painful versus the non-painful side – it shouldn’t be tighter.

Shoes all OK?

Thank you Matt, much apprecciated. Do you think my marathon is still doable? how should I go about getting back to run training?

Yes, absolutely - with the right and sensible input.

Get the things I mention above looked at and sorted, then slowly reintroduce by running paced pyramids. Your pain needs to be well controlled - too much and you'll take a step backwards not enough and you'll flounder...not the fishy type!

05/04/2013 at 14:02

That's me done - laces undone.

I'll answer any stragglers later.....

SheTRI    pirate
05/04/2013 at 14:02

thank youuuuuu

05/04/2013 at 14:03

Not what I wanted to hear but thanks Matt

05/04/2013 at 14:22

Thank you very much for your help Matt!

05/04/2013 at 14:26
Thanks Matt.
05/04/2013 at 14:59

Thank you, Matt! 

14/04/2013 at 09:13
who can tell me where i can catch a cable car
15/04/2013 at 08:21
is it good to bodybuild with light weight and plenty of reps 4 a marathon
16/04/2013 at 12:22

what kind of training can you do when suffering from central sensitization? I am getting nerve pain up and down the left hand side of my body and its stopping me from being able to run

18/04/2013 at 06:38

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