Ask a Physio

Hi Brad,

I am currently trying to manage recurring ITB syndrome.
Symptoms first started in June, when I began training for the � Marathon ( I have now changed to the 10KM run due to injury). I sought physio advice and backed off on running to help assist the ITB. The past couple of weeks I have slowly picked up my intensity & training and after a great couple of weeks of feeling good, I managed a fast run on the weekend and felt great.
BUT, 3km into a run on Tuesday, my ITB symptoms returned and I had to stop my run and walk. In the lead up to the recent ITB symptoms, I was averaging between 20-30KM per week.

Looking for some advice on how manage ITB syndrome and avoid the recurring symptoms.

Thanks,
Kelly

Hi There,

I am currently trying to manage recurring ITB syndrome.
Symptoms first started in June, when I began training for the � Marathon ( I have now changed to the 10KM run due to injury). I sought physio advice and backed off on running to help assist the ITB. The past couple of weeks I have slowly picked up my intensity & training, after a great couple of weeks of feeling good, I managed a fast run on the weekend and felt great. 3km into a run on Tuesday, my ITB symptoms returned and I had to stop my run and walk. In the lead up to the recent ITB symptoms, I was averaging between 20-30KM per week.

Looking for some advice on how manage ITB syndrome and avoid the recurring symptoms.

Thanks,
Kelly

Hi Brad,
I run between 35-40km a week (5-10km runs). Recently I developed a pain in my right knee, it feels like it is in just under the knee cap on the right hand side of the knee. The pain usually occurs when the leg is elevated and bent, so usually on the downwards motion of returning the foot to the ground. Not sure if it is from relatively new shoes or cold morning runs (I did warm up and wear rights). It is starting to feel better, but what are the best exercises to rehab it, prevent it from reoccuring and keeping my body balanced during a run?
Thanks!

Hi there! Currently training for Marathon but 3 wks ago tore my tibulis posterior tendon. The pain has gone after 3wks no running. I have cross trained & water ran in that time. If pain has gone can i ease back into running? My podiatrist said my joggers were gone so bourght 2 new pairs to alternate. Whats your advice concerning my injury & preventing it re occurring? Cheers Kristy

Hi Peter, I understand your concerns especially being so close to the event. It sounds like the calf has become overloaded. From your description it’s hard to know if it is the tendon or muscle. However, my advice would be:
- Use discomfort as a guide to how much you can exercise – No more than 3/10 pain during or after. This should resolve the next day.
- Reduce your training load so the calf has minimal irritability – less runs or less distance. Once calf has settled gradually increase load to only 1 run per week ( don’t increase load and frequency at the same time).
- Ensure to add a warm up prior to running due to the colder weather.
- Walking and cycling can be a good ways to keep your fitness however it still requires a lot of calf demand so monitor load during those.
- Incorporate some calf strengthening during the week – Double leg and single leg calf raises on non-running days. You can do raises through range or incorporate some holds to add more tension into the tendon
- Stretching/Massaging the calf and other muscles of the lower limb can be helpful. When stretching make sure its pain free.

Hope these tips have been helpful. If symptoms don’t change I recommend you seek further advise from a local physio. All the best for the Marathon.

Kind Regards

Denise Garcia
Physiotherapist – Macquarie St

“This is general advice only & shouldn’t take the place of a consultation with your healthcare provider. For private consultation with our expert team of physiotherapists or massage therapists, please contact Sydney Physiotherapy Solutions on 9252 5770 or sydneyphysiosolutions.com.au “

Hi Brad, Im running the Blackmores Marathon and up until a week ago training was going well. For three consecutive weeks I had run circa 25km long runs. However, out of no-where I've just had this niggle develop in my inner calf muscle (perhaps the medial gastrocnemius?) I rested it for a week, and then tried easing back in (a long walk, a bike ride), but its inflammed again. It only feels like a small niggle - not sure how long I need to rest for to make sure it gets better. If I rest it too long, ill lose my fitness, if I reinjure it again in a week, thats no good either. Any advice you have would be appreciated.

Hi Brad and team,
I'm 31yo, run generally a few times a week (often not terribly far), and walk at least a few km every day getting to work, but sometimes in the morning as I get out of bed I get searing pain under my right foot around where the heel would come in contact with the ground if not wearing shoes (so not directly beneath the heel bone, but in the softer tissue just surrounding that, particularly near the middle of the foot). I have a sneaking feeling it started after playing a social game of indoor soccer about 2 months ago... I have added inserts into my every-day shoes to help cushion my heel for walking (helps a little), and massaging seems to help it, but I was hoping there might be a more long-term solution to stop the pain from coming back. It doesn't hurt when I run, and only occasionally when I walk. Any tips would be most welcome!
Another thing is I get a feeling of tightness/insecurity behind my right knee sometimes when I run. Could this simply be a lack of flexibility that is now compromising my muscle strength and feeling of muscle security? Also (and/or) could starting ballet classes earlier this year be a contributing factor (all that pointing of toes..)? (I really enjoy ballet class, so I'm keen to work out how to continue both running and ballet without pain)
Are there any strength or stretching exercises (or other things) that might be good for either of these concerns? Thank you in advance for any help you may be able to provide!
Cheers,
Helen

Hi Brad
I seem to have developed tendonitis in my Achilles. What would you suggest as a recommendation for treatment & to avoid further instances?
Thanks for your advice
James