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How do you prevent running injuries or get on top a "niggle" fast? 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 his team at Sydney Physio Solutions are excited to partner with Blackmores again for the 2020 Sydney Running Festival, helping everyone get to the line in good shape! Amazingly, this is the 10th year that Brad and his team have helped out by answering your injury prevention and management questions.

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

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Hi Brad,
I have a bit of a history of ITB inflammation and hamstring strains. What exercises should I be doing to strengthen this area to prevent any flare-ups?
Hi There. When I walk down stairs, my right ankle hurts (quite a bit). I can't really put much weight on it. It is worse after running.
Thank you
Hi Brad,

I have regular pain in my glute medius and mid back after running, mostly left side, regardless of distance or pace. I have been running half marathons for about 15 years, and this has worsened in the last 5 years.

I also have an imbalance on my right side of my body, which I've been advised is a result of heavier foot striking on the right foot. I now find it much harder to balance when standing on my right foot, rather than my left foot. The imbalance is likely contributing to the glute medius and mid back pain i.e. left side muscles being over -recruited when running, due to weaker right side

I do plenty of stretching, yoga, massage and lower body strength work e.g lunges, squats, plus some basic balances twice per week e.g standing on one foot and raising and lowering other foot.

Are there any other activities you can recommend to strengthen the right side, improve the balance, and thus hopefully reduce the glute meidus and mid back pain?

Thanks very much
This is my first official run I've ever signed up for (yay!), but have been a recreational runner for years. A little background info, I have sciatica (more pain on left side) but it is manageable.

In June, I went on a run in a pair of improper running shoes and felt something snap in my knee. I kept running until there was a burning sensation. Ever since this, the pain has not quite gone away. I get a stabbing, weak, dislocated feeling under my left knee cap if I run for a long period of time or am not running light on my feet.

I really do not know what is actually wrong with the knee, and would love to know how to manage this pain or how to aid in healing my knee. Also, is there any sort of training that I should avoid with such knee pain?

I would really appreciate your advice, thank you so much.

I am training for the Blackmores Sydney Marathon. I have been following the Marathon Beginner Training Program.

In the last couple of weeks I have started to get soreness along the edge of the tibia in the left leg. This is in the lower section (posteromedial shin splints) of the lower leg probably where the soleus muscle connects to the tibia on the inside of the leg (…but I do not pretend that I have good anatomy knowledge). In the last week this soreness is still apparent after running.

It is a bit weird, because it comes and goes during running. Especially during a long run, it will disappear after a while – I assume once the blood flow to the area gets going good and proper that probably assists.

Anyway, at this stage I do not want to stop training for any extended amount of time given that it is only a bit over 4 weeks out from the event. At the same time I do not want to do anything to make the situation worse. I would like to find a way to manage the situation through until after the event.

I assume that the best way of managing is probably to just ice the area after running. Anything else?

I would appreciate your advice. Thank you.
Hi Brad,

I have for a few years had a slight knee issue. When I was riding a rental bike up some steep hills in Japan I felt a very painful twinge in my right knee. After than I had to walk a lot of miles each day and had to wear a knee grip, the pain seemed to be ok when wearing the grip.

Since then pain started to get better, I have been running often and always wear knee grips. The knee grips seem to give me the support I need and I rarely feel any pain. Yesterday I ran without my grips, I felt good and ran at quite a pace. Within about two hours of running, my knee started to feel pain.

The pain is isolated to the lower inner side. It feels like a tendon running just outside of my knee or something. When I walk and have this pain, under my knee cap feels tingley and almost loose. The pain usually subsides in a day or two and is back to normal.

I am just wondering if you know what this could be? Is this because I have no strength training on my legs in around a year? Could you recommend any strength training to help it out? As I feel no pain during or after with my grips, do you think I should carry or running with them on?


Hi Brad,
I have been running 4 years (including 3 full marathon), presently following Blackmores advance training for full marathon. And weekly running 70-90km. Gradually I am developing a nodule at the mid-range of Achilles Tendons (both legs) and more predominant in left leg, hurt on pressing. Pls advise.
Hi Brad,
I'm training for Sydney marathon which will be my first marathon. I think I have an ITB issue on my left leg. Last October I did a 'long' run of 14kms and I had a niggle on the lower side of my knee-first sign of my ITB issue, it seemed to resolve itself as I backed right off and gradually built up my distance very slowly. So it's been completely fine since then however around 13 July I got new shoes-Hoka-Stinsons (coming from running with Asics 2000/Noosas) I did a 13.5 hill run and didn't feel anything until that night where I noticed my knee pain which I recognized as ITB trouble. So I didn't run that week until Sunday, replaced mid week runs with bike sessions. On the Sunday I ran flat course 25kms- at 12 my knee started to hurt then I ran through the pain for 10kms and walked the rest. I could barely walk that afternoon and it was sore at night, however that week I had no pain. I went to a physio and he told me to do one legged squats and deep squats, lots of hamstring stretches, glute stretching and quad stretches. Which I did every evening. I again replaced runs with rides that week, the next Sunday I ran flat 13kms and my knee hurt that night only. So I again replaced runs for rides, and continued the exercises/stretches, I also added in glute strengthening. Yesterday I ran flat 8kms and stopped because I could feel my knee-it didn't hurt too much as I didn't push through at all-I thought 'what's the point'. I had no pain yesterday or last night.
I've been googling different strategies for resolving the pain/injury and everything is contradicting! Ice it/ don't ice it, foam roll it/don't roll it, stretch it/don't stretch it-Arrrh! Not sure what to believe.
Can I continue to run with this? Do I slowly build up again? Is there time with the marathon so close?
Am I being unrealistic in thinking I can still aim for Sydney marathon? Is there a few things I can do to resolve this issue and continue to train for the marathon? Or should I be realistic and let my marathon dream go for this year...
Thank you so much for your time,