Ask a Physio

Ask a Physio

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How do you prevent running injuries? Ask our expert Physiotherapists.

Got a question for Brad and the team at Sydney Physio Solutions? Ask them in the comments section below!

Dr Brad McIntosh and the team at Sydney Physio Solutions have partnered with Blackmores again for the 2019 Sydney Running Festival.  This is the 9th year that Brad and his team of experienced running Physiotherapists have helped out by answering your injury prevention and management questions.

Sydney Physio Solutions is a group of leading Physiotherapy clinics, based in the Sydney CBD and Chatswood.



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Hi team,

I ran the half marathon last week and am aiming to run the full marathon in September. I always stretch and warm up appropriately before running, however towards the end of the half marathon I found my knees were in pain, my calves in particular were incredibly sore, and my left ankle/heel (on which I have suffered a supination sprain years ago) was aching heavily.
Could you recommend any specific stretches, strapping, or warm ups to alleviate these symptoms?

Hi Brad,

I've registered for my first full marathon this year (with a respectful sense of fear).

I've just completed my 3rd half marathon on the weekend. However, I've found that ITB pain seems to plague me from around 15k. Once it starts, it seems to progressively worsen to the point of needing frequent walk breaks.

I feel this is a potential showstopper for the full unless I start to address the issue now. I would appreciate any suggestions you may have.

Hi Ham,

It sounds like there could be a few reasons as to why your toes are aching or you are beginning to feel cramping set in. Cramping has historically been associated with dehydration and/or an imbalance in electrolytes; but the current thinking has derived itself more towards muscle fatigue.

Muscle fatigue can be caused by many factors like dehydration, overtraining, or lack of circulation. Magnesium and increasing fluid/electrolyte intake help in reducing an effect of any role of dehydration. Making sure you are drinking at your 2L of water/day.

Other possible fatigue factors would be your increase in training and mileage. Are you doing too much, too soon? Have you increased your mileage or added speed work recently? In general you should be following the rule of increasing weekly mileage volume by no more than 10 percent a week.

Another factor that can contribute to muscle fatigue are your shoes, both your running shoes and your day-to-day shoes. Be certain your shoes are not limiting your circulation in any way. Ensure that you are not tying the laces of your running shoes too tightly. For your dress shoes, be sure the shoe and the toe box are wide enough to accommodate your foot.

I think the most basic way to attack this issue before the race on Sunday would be to use a spikey ball (trigger point ball) to roll under the arch of your foot. There are a vast array of muscles which could be working too hard to control your running style. You may be over pronating (rolling in) or gripping your toes too much when you run to help propel you forward. All of which require the body to work harder during those longer runs. Spend at least 5-10mins at the end of each day rolling out the arches of your feet and look into getting your running properly assessed if you wish to continue running longer distances without pain/ache.

On a final note, it is important to keep in mind that frequent toe ache or cramping may be a sign of other, more serious, medical issues. If your aching persists or worsens, be sure to consult your physician to rule out anything more serious than muscle fatigue.


“This is general advice only and shouldn’t take the place of a consultation with your healthcare provider. For a private consultation with our expert team of Physiotherapists, please contact Sydney Physiotherapy Solutions on 9252 5770”
Hi Brad, I have been training for the 10k run on the weekend and over the last few days my toes have started aching. not painful per se, more the pain before a cramp sets in. I am taking magnesium and have never had this issue before...any ideas?
Hey Physio Guru....

I have a few questions for you today....maybe you will be able to help me figure out what I should do. I am due to run the marathon on Sunday.

Here is a summary of my 'issues':
* I had a right calf strain which I have received treatment.
* I am pain free and seemed to have recovered from said injury.
* About 3 weeks ago I bought new running shoes as part of 'fixing' my calf problem.
* I have returned running with tape on my calf. Initially this helped but in the past week it doesn't seem to make a huge amount of physical difference. In saying that I have not put in any long km in the past week.
* Prior to injury, I used compression sleeves on my calves for all long runs.
* Right toes are getting pins and needles after approx. 3km in new shoes.

* Should I wear the old shoes or new shoes?
* Wear compression sleeves or get calf taped?
* Any other suggestions?

Hey Brad,
So about two weeks ago I had a grade two tear in my soleus down near my achilles. I've been to my local physio about four or five times since, and have gone from barely able to walk to having my first tentative jog today.
Here we are about ten days out from event day, and I'll hopefully get another one or two training runs in, hopefully without hurting myself!
My physio thinks I'm a good shot at still competing in the half marathon, but it's a long distance (for me) with muscle fatigue a big factor. Just not sure if it's complete folly to try or not.
What are your thoughts?
Hi Brad
I have been running without injury or pain for the last five years and have completed three half marathons without any concern. In the last two months I have changed my running shoes and also done some trail running - not sure if either of those has anything to do with it but lately after running a few KMs I get pressure/tightening in my right knee and then it is very stiff and painful (not agonizing but not right either). Any advice on the cause and what I should be doing between now and the race would help...
Hi Brad, I am currently training for the half marathon in a couple weeks time, this will be my first half although I have done a few city to surfs. lately after my run I have had a dull aching pain around the ankle upwards on my right leg.. Not enough that I feel I can't run but enough to make me aware I have something not wrong. Is there something I can do to help the healing so that I can keep running up until the half, currently I am doing a 6.5km run on tuesday, same again on thursday and saturday an 18km run. Any advice would be helpful. thank you