I am a Physiotherapist. If anyone needs injury advice I am happy to help !

[gymJUNKIE]

If anybody is suffering from acute, sub-acute, or chronic injuries let me know. I am happy to offer advice and management strategies. If you are unsure what you are suffering from, write down the signs and symptoms and I will give you a diagnosis.

[jaycatmac]

oh man! I've had a ton of new runner doing too much too soon injuries. Over winter I have started walking. Too icy to do anything else right now.

Any tips for restarting running in the spring?

[gymJUNKIE]

Number 1 is appropriate footwear - if you have a lessened arch on the medial aspect of the foot, consider orthotics or runners with arch support, if you have a high arch, consider joggers with greater support on the lateral aspect of the foot as this is the weight bearing portion. Make sure you stretch regularly, both static and dynamic. Research has shown static stretching of 3 x 30 seconds allows a person to become accustomed to the stretching sensation, it does not however prevent injury. Dynamic stretching, i.e. dynamic lunges, etc, will increase power. Gradually increase you're workload, i.e. dont jump into 10km runs at fast pace straight away, ease yourself into it. Start at a pace where your moderately breathles, i.e. 7/10 on the RPE scale, and increase the intensity by approximately 10% per week, i.e. if your running at 10km/hr week 1, run at 10.1km/hr week 2, etc. It may not seem like much, but if your completing a 20 to 30 minute run, increasing the speed by 0.1 will provide a cardiovascular training effect.

[heather7131]

I have a nasty one for ya! In 2006 I dropped a 10lb free weight on top of my bare foot and broke one of the bones in my foot. I was fresh out of college with no $ or insurance so I did not go to to the doctor. The pain was so bad by 2010 I started physical therapy. The guy told me that my bone had healed in a "V" shape. He tried to manipulate it back but the pain was so excruciating I was screaming and crying on his table 3x a week for months. Quick stepping off that foot for 4 years also caused extra wear and tear on my opposite knee (it grinds and pops bad now).
My foot hurts if anyone, even my dog (85lbs), steps on it or when I get a pedicure and the people are massaging it. I can't run...it's just out of the question. Usually I don't have an issue walking but just today I was walking, felt something kinda pop and then pain. I had to stop walking. Now it doesn't hurt bad enough for Tylenol or anything like that right now but still feels strange...kinda stiff.

[gymJUNKIE]

When you fractured your foot, were you placed in a CAM boot or a cast for immobilisation ? Or was it a stable fracture ? If the fracture was unstable, and you continued to walk, etc, the malalignment and lack of manipulation over the 4 years or so would have resulted in bony union, however, not in the correct biomechanical and anatomical setting. As such, the biomechanics of the foot will be altered, but this depends on the fractured bone. Some smaller bones in the foot, particularly the mid to forefoot, can get injured and have no bearing on function and activity. If it is one of the bones responsible for supination and pronation, i.e. the rolling in and out of the foot, then this is where it becomes a problem. As we walk and run, and go from heel to toe, our foot moves from a predominantly supinated position to a predominantly pronated position, and as such, if the biomechanics of the foot are not as they should be, it can be quite painful. You did the right thing by going to physical therapy, however the bony union may be so severe that it may not be able to be rectified through physiotherapy. Have you consulted an orthopaedic surgeon ? Unfortunately if the foot biomechanics are not as they should be, you will compensate elsewhere, such as your knee. What you need to do is target your gluteal muscles through bridging, clam shells, prone leg curls, etc, and your vastus medailis oblique component of your quadriceps muscle to stabilise the knee. The simplest way to start is sitting in long sitting, place a towel underneath the knee, slightly externally rotate the foot, and push the heel of the foot into the floor and back of the knee into the towel and hold for 10 seconds ors so or until you cannot hold the contraction. This is the basis for VMO strengthening. As you get better there are more advanced exercises. My advice would be to consult an orthopaedic surgeon.

[heather7131]

Wow, thanks for that assessment!
Never went to see a doctor so I was never put in a boot or cast. I was always afraid they would say surgery. I will try some of those excercises to see if they help! Thanks!

[heather7131]

Wow, thanks for that assessment! The bone broken is the metatarsal next to the little toe.
Never went to see a doctor so I was never put in a boot or cast. I was always afraid they would say surgery. I have a friend who broke her foot and she's undergone 2 surgeries so far with at least 1 more to go and her experience sounds terrible. I will try some of those excercises to see if they help! Thanks!

[gymJUNKIE]

The second metatarsal will be loaded as you move from the heel to toe off position, i.e. as you move from supination to pronation. The supination phase will load up the second metatarsal to a greater degree. Do you experience most of your pain when your heel is about to lift off the ground, i.e. just before the toe off component ? This would be typical of your problem. If there is malalignment and stiffness, walking and running will be painful. The Physiotherapist needs to manipulate the joint to alleviate the stiffness. Like I said before there is no guarantee it will work, especially is there is faulty bony union. So try the exercises I have given you to prevent compensatory injuries, however an orthopaedic consult is needed.

[gymJUNKIE]

Btw ... Join my group PhysiotherapyFITBIT 🙂

[tdfischer]

So...I picked up ultra marathon running about three years ago.  I use a 32 week training plan with the highest mileage weeks totaling about 80-90 miles per week including a long training run during that week of up to 50 miles.  For whatever reason, about two weeks after that week, my left piriformes becomes quite a problem.  I usually end up going to my massage therapist who works it out after three appointments.  She always notes that the "fascia is constricting" and reminds me to keep stretching and use my foam roller (which I always do).  It never becomes a problem again until my next "round" of training at the same exact time point in my schedule.  Any ideas or pointers?  Thanks in advance!

[gymJUNKIE]

Do you do any specific glut strengthening exercises ? If your running long distances regularly per week, you need to make sure your gluteal muscles are strong enough to withstand the demands of your routine. If your glut muscles are fatiguing, your piriformis will try to compensate. You can do clam shells, prone leg curls, single leg vs double leg bridges, isometric gluteal exercises with swiss ball, etc. If your piriformis is tight, it can be a biomechanical issue, which can potentially be stemming from gluteal weakness.

[tdfischer]

No real specific glut strengthening exercises which may be the problem.  I'll give some of your suggestions a shot on the next go round and keep you posted.  Likewise, I'll keep tracking other posts in case other piriformes issues show up.  Thanks for the feedback - much appreciated!

[SuzieC]

Hi there. Back in September, after what seemed like a boring working on the elliptical, I woke up with a slipped disk in my neck and sever pain in my neck and left shoulder. I went to a chiropractor for 3 months 3x a week, but ever since the injury I've been scared to push myself in my workouts because I never want to feel that type of pain again.

What do you recommend for rebuilding shoulder strength and getting over the fear?

[LaTonya]

Hi,

Experience increased and more frequent pain and inflamation in left foot. Left leg is shorter. Minor knee surgery in 2010. Foot has never been the same. Used to jog but even too frequent brisk walking causes swelling in foot. I have arthiritis in foot and knee. I am flat-footed. Carrying more weight than I have in 3years.

Should I see a podiatrist or therapist? I gave up heels after surgery. Never wore high heels but any evelavation now that shifts weight around my big toe causes discomfort so I'm not putting uneccessary stress or foot with shoes.

[Ukase]

Here's a nifty story. Back in '88, during basic training, I had to go through the "gas chamber". No biggie, we all had to do it. Silly me, I think I was the only one who was foolish enough to actually listen to the drill sargeant when he told me to recite my social security number. I got half way through - and was told I broke ranks, knocked someone down and ran out of the chamber and ran into an oak tree, knee first.

My knee swelled up, easily to 3 times the size, filled with fluid. When I went to the doctor, he told me that 3 of four bursar sacks had burst.

Well, I was off my feet, other than going to chow for a few days, until a drill sargeant suggested I just tough it out, lest I get "re-cycled" and have to go through the whole 8 weeks again, after I'd already survived ...5 or 6 weeks. So, I did, and the swelling went down and never bothered me again - until about 20 years later, in '08 when I was playing basketball on a very bad court - broken blacktop, uneven - in a pair of shoes that were past needing replacing, as far as tread wear went. While playing, I slipped, and I heard my knee pop - and actually - it was both of them that felt very painful. I couldn't put any weight on them at first. And then my left knee ( the one injured in basic) made an audible pop as I tried to put weight on it the second time. It hurt like crazy, then subsided. The other knee just seemed sprained and kept hurting for about a week, and then slowly returned to normal. I'd gone to see the doctor, where x-rays determined nothing was broken, and was told to do some simple leg exercises. I did them, as instructed, and eventually my knees returned to normal. Now, 6 years later, I'm trying to squat with weights and when I do a full (go low or go home!) squat, my knees give me pain. I'm 47 now, so I suspect a little discomfort is to be expected when lifting heavy weights - but I can't consider 135 pounds heavy if I weigh 220.

I've tried to stretch and warm up more before I do squats, and that does help a little, but my knees still bug me. If I try lunges of any type, my knees scream at me to go back to the house and eat junk food. I don't listen, but I don't do lunges, either.

Is there a way to strengthen my knees and the surrounding tissues so I can do lunges and full squats? I'd hate to injure myself by pushing past pain.

[Miss_Primrose]

Does the foam roller help the compartment syndrome? I have shin splints only in my left calf when jogging. This goes away when I stop. It's put a bummer on anykind of jogging that I was doing (3miles X3 weekly). I guess I cant go for the 0.5 marathon in October. But I will continue to try as long as I am not in pain. Thanks for your reply.

[Miss_Primrose]

---

@SuzieC wrote:

Hi there. Back in September, after what seemed like a boring working on the elliptical, I woke up with a slipped disk in my neck and sever pain in my neck and left shoulder. I went to a chiropractor for 3 months 3x a week, but ever since the injury I've been scared to push myself in my workouts because I never want to feel that type of pain again.

What do you recommend for rebuilding shoulder strength and getting over the fear?

---

That happened to me also. I quit the chiropractor because it did not help. I had an x-ray that showed my neck alignment is off. It's a hypolordotic curvature probably due to spasms.  I googled this and the answer is physical therapy to re-align it. I did not go back to the MD for a script to the PT. Yet I still feel the pain when turning my neck left. Much like arthritis...

[Nick17]

Personally, I think if you are suffering or recovering from an injury, you should seek help IN PERSON with a physician or specialist.  No disrespect intended to the OP, but there is alot to be said about seeing a doctor in person rather than getting a diagnosis and treatment online.

[Cookiebun]

Thanks for this post!

I have lost about 130 pounds and still would like to lose at least 50 more.  I recently started adding running to my walks.  I thought I would be ok since I am MUCH smaller than I was before, but my right knee does not seem to like the running.  Also my feet feel like they are being punished when I am done.  Some days the skin starts to just peel right off my toes and the soles of my feet.

My knee is my biggest concern though, I do not want to stop running, but I don't feel the pain much at all if I just walk, but I feel more accomplished if I run.

Any suggestions for ways to help my knee cope with running?

I have a half marathon in September and I would prefer to run most of it rather than walk, so I can cross that finish line in decent time!

Thanks again 🙂

[sjcostanza]

What do you call it when your knee makes a velcro-like tearing sound when you flex it? I've had it for years. Every once in a while it will flare up and cause a dull ache (which is occasionally painful) and a feeling of instability, but only minimal swelling, and it goes away after a few days of rest. Usually caused by overuse, and I'm not overweight. The symptoms point to arthritis but I'm only 25 and have never actually injured the knee.

Any thoughts? I never remember to ask the doc during my yearly physicals and it's not bothersome enough for me to make a special visit.