Quality, evidence-based videos on running injury management. PLEASE NOTE: Our content is aimed at health professionals who treat runners and is not intended to replace medical assessment or advice.
Tom, THANK YOU for the work you've done around this. Seriously. I've had insertional Achilles tendinopathy for 3 years now with no luck with PT. I've been following your advice with HSR for the last two weeks and my morning pain and stiffness has gradually been decreasing FINALLY! My only difficulties with HSR right now are figuring out the 15/12RMs - and wondering if I should be increasing my weight even within the same week if the previous 12RM is now more like a 15RM?
Part of my rehab for a total hip replacement I began walking then running (I have never been athletic in my life) and really enjoyed it. At 27 months and age 61 I completed my first marathon.
What do you think about limiting out of boot active plantar flexion into week 6? Lots of protocols start this at week 3 as long as not past neutral dorsiflexion
Mine is sore to start and then goes away after a warm up. Then is sore in the morning. I dont notice it walking normal but its sore on stairs. I ran an ultra and had no issues. They actually seemed better afterwards lol. Then training for my next race they got sore so probably went too hard after the ultra. They almost feel like sore muscles. they dont feel like an injury. I just assume its gonna take a year or so to resolve. I cant increase my mileage to peak amounts but i stay fit enough to run my ultra marathons. I took 2 months off and i believe that was a mistake. I believe the tendon became more dysfunctional from rest than active recovery with some pain. I had achilles tendonitis and that sucker took a year to get to full strength. Now i know the signs leading to tendonitis so my goal after this is healed is to listen to the signs immediately so i can be healthy.
Great Channel…I’ve had both my left and right hips Total hip replacement as they wore out from carry heavy weight in the infantry. I’m 50 years old and doctors, friends and family all said I would be a fool to run again. I rehabilitated and kept my faith and resilience and I’ve ran the London Marathon, Ultra Marathons ( my biggest so far was the fox ultra of 38 miles) and other events for charities raising thousands and had no wear or tear. No one calls me a fool anymore. I would advise you to be lighter in build for less impact and have a good running technique ( no heal striking styles)and to train clever. But above all be strong in mind…you can and will do it…but everything comes at a sacrifice…I wish you all well and the best for the future.
Hi, im currently seeing a chiropractor. Had lots of sessions, but the more everything else seems to get neutral, the larger my gait deviations and instability seem to become. I will be having imaging done soonish. I seem to have no way of gaining stability regardless of what i do and i seem to switch between various different gait patterns. The main things that really screw me over and cause pain, general misery, and an increase in shitty mechanics are: Walking (the main thing), other movement activities specicifically those with twisting or sideways movement and walking on different levels of elevation, including stairs. I hate going up or downstairs, not because of any pain really, although i do get pops and cracks in many areas and it does seem like its far more effort than it should be. Here are the various notes ive taken on things i believe may correlate to hip dysplasia: Hospitalised with fluid on the groin (left hip) which i now suspect to have been a torn labrum caused by left hip dysplasia. Reluctance to have parallel legs, most comfortable with feet splayed apart and femjrs externally rotated. When seated and trying to keep hips neutral, all i can feel if my left butt bone but as i type this im realising it might not even be that, that im feeling especially since it is quite prominent and i have a quite prominent swayback posture so the IT's should be more tucked under with me sitting on the back side more than the point. Leg length discrepancy with multiple compensations When i walk or stand i corkscrew the boxer shorts im wearing between my left groin and left leg and the center line/ buttons ends up shifted left and also facing left Toe walking to mitigate downward pressure into the floor. Multiple diff compensatory walking patterns, most prevalent (chiro oppinion) antalgic gait. Left leg despite feeling smushed up and in and being the lower hip has almost no internal rotation at the femur. 5 degrees at an absolute maximum most likely about 2°. Right side is slso poor but its at least 20° or so despite the fact my hips are twisted to the right (my left) meaning that side is already biased into internal rotation. The left leg is biased into external rotation and despite that appears to only get to fully parallel, so if we factor in the hip twist 5-8° max and thats being generous. Physical exam on myself. It is very easy to locate the greater trochanter on the left side and hard to lose track of it. Right hand side, hard to even locate without a lot of external leg rotation and easily lost track of under muscle. Left GT i can feel it raise and turn in a bit then it just stops entirely. If i really push for more internal rotation it starts to actually push out becoming more prevalent and will continue to raise up to max 5mm. The leg will not gain any extra internal rotaion regardless. If i force myself to shift out of my right leg i can feel the leg raise and twist and there is a sense of security and a subtle locking similar to the ankle joint. The movement is smooth and the rotation doesnt jump or feel restricted. The left leg however drives to a point being stiff the whole way and at the end of ROM theres a very ridgid bone on bone jamming feeling. Whilst in this internally rotated femor 'loaded' position both legs can only move across via hip and back twisting but the left leg moves outwards in a very ridgid arc similar to the curvature of a rainbow whereas the right leg still has a pretty good degree of range of motion anywhere from neutral outwards. Right foot twists out. This helps with the leg length discrepancy and might be my bodys way of looking for a way to drive internal rotation. However after going over things a lot i think it may actually be a mechanism to stop me shifting out of my right side. I cannot fully shift out of my right side and therefore the twisting propulsion would only load extra weight onto the displaced hip and since it can only push partway out of right stance, it doesnt fully activate the right aic muscles or fully let go of the left aic contractions. This therefore only causes varying foot to floor landing positions and leads to balance issues and joints on the right side colapsing in. I therefore believe i developed the outward foot position to actually inhibit the leg twist motion and stop me from attempting to shift weight onto the left leg. If you end up seeing this comment, please let me know if this sounds like it is hip dysplasia or if it sounds like any other issue to you. Thanks
Yeah? But you are a physio only and surgeons say no, no hard surface running. But beach sand and grass running - to an extent - is okay if you can handle it. So be careful what you are saying in lieu of surgeons knowing better.
Tib ant and glute strengthening to take deceleration and rotation strain off the knee; quads may already be too dominant thereby putting extra stress on the knee through the quad/patellar tendon especially among hill/trail runners and hikers. Also intrinsic foot mm and tib post strength for balance and control.
I had a MTSF it never really got 100 % better it was so bad I couldn't walk and at night I had to wear a birkenstock sandal in bed even the weight of the covers was too painful I still get swelling on my upper foot and sometimes pain after a long walk it's been 3 years I never had any treatment just a plain xray which confirmed it was this kind of fracture the ortho consultant said just leave it and it will get better on it's own but it really bothers me and I am reluctant to walk on it on bad days
Do you want the patient to have no pain with ADLs prior to progressing back into running or do you think it’s ok to get them started with running with 1-2/10 knee symptoms ?
Thanks for your work. I am 38 and have just been diagnosed with HD on both sides. LCEA ~20° This happened after I saw 2 orthopedic doctors and different PTs before and came out, after I literally "harassed" the last doctor to make an x-ray. He looked at the CE angle but misdiagnosed and said everything is fine. I sent the same X-ray material to two different hip experts and they finally diagnosed an HD. Pain in the butt, pain in the back, pain in the hamstring... that was a journey
Great video. I was diagnosed with bilateral hip dysplasia at the age of 14 as I developed a marked limp (later ascribed to a labral tear) but I was never given any of this information nor was I given any advice in how to manage the condition. I am now 55 and am facing a bilateral total hip replacement this year. My X-rays have always been described as showing “minimal changes” and a number of PTs have said I have an excellent range of motion but a recent MRI showed severe OA with significant acetabular sub-chondral cysts in both hips. I wish your channel had existed 40 years ago!
Thanks Tom. I'm starting to understand why all these endless stretches are just increasing my discomfort. I've told each of my 4 chiros that I can feel my left leg instability with my hand as I take each step, but each one has just added more stretches. Your explanation makes a lot of sense, so I'm going to try basic core strengthening - cheaper and a lot more hopeful. Isn't RU-vid wonderful!
@littleo353 0 seconds ago I tore my right medial meniscus "95% of it's length" 6 years ago. I declined surgery and read everything possible. By far the most important thing I did was I stopped eating after sundown. See the RU-vids of Dr. Satchin Panda interviewed by Dr. Rhonda Patrick as far back as 7 years ago. Panda said this to a hypothetical question from Patrick: "Sadly it is BETTER to eat an UNHEALTHY meal during the day because eating later in the evening turns even NUTRITIOUS food into JUNK - inflammation caused ALL THROUGH THE NIGHT first to the one-cell-thin endothelial lining inside all blood vessels (arteries, veins, capillaries). If one's body is GENERATING inflammation all through the night, one cannot heal. I am able to run competitively and play golf competitively - and it was the right knee which is VERY BAD for a golfer. WORST THING. Our bodies can heal IF and ONLY if we know what to do and what NOT TO DO. NEVER EAT AFTER SUNDOWN. PERIOD. NEVER. As you shift your last meal time, your body catches on to the new routine and you are no longer hungry after sundown. Make sure you start your day with a high mineral salt (Celtic) on the tongue and a good amount of water the first thing in the morning. You must restore minerals and water lost during the night OTHERWISE, the pancreas will release insulin which causes "hunger sensations" to encourage you to eat to restore the minerals and water. Panda advises NOT to eat in the 45+ minutes each morning because one still has melatonin in the blood stream. Don't confuse the body with "Sleep" or "Eat".
I am in a decision making process: surgury or physio activity. Going to have a second analysis with my doctor (who suggested surgery) but I want to know detailed descrition of my tear condition first. But I can move my knee quite freely. I dont know if there is a piece torn away totally it can stay there or should be removed.
I tore my right medial meniscus "95% of it's length". I declined surgery and read everything possible. By far the most important thing I did was I stopped eating after sundown. See the RU-vids of Dr. Satchin Panda interviewed by Dr. Rhonda Patrick as far back as 7 years ago. Panda said this to a hypothetical question from Patrick: "Sadly it is BETTER to eat an UNHEALTHY meal during the day because eating later in the evening turns even NUTRITIOUS food into JUNK - inflammation caused ALL THROUGH THE NIGHT first to the one-cell-thin endothelial lining inside all blood vessels (arteries, veins, capillaries). If one's body is GENERATING inflammation all through the night, one cannot heal.
Plyometrics & lunges can be a resistance training for the beginners, true? And what do you mean by (improving) running economy? It will improve or it will make you ready to run with your current economy? And if will improve, doesn’t improve acutely or chronically?
This rehab protocol lies mostly in line with your recommendations and includes significant information beyond week 12. My physio and I are working with this at 16 now. I'm ahead on some elements and behind in others. Note the significant specifications for milestones- these seem quite rigorous. www.massgeneral.org/assets/mgh/pdf/orthopaedics/sports-medicine/physical-therapy/rehabilitation-protocol-for-achilles-tendon-repair.pdf
High BMI is a contra indication for running without joint replacement - let alone with. I had partial knee replacement in May, used swimming , stationary cycling and walking as well as rigorously doing all the exercises I was given 4x a day initially and then much less once I was doing other exercise. Have had one physio appt on the phone. I was a fit 60+ cyclist (no running since 2010 due to knee pain which was osteoarthritis) and all indications are with my knee now ‘balanced’ that I’m riding better and I’m planning to get back to some running from Feb/ March. I’m also retired which has enabled me to really focus on the rehab. Thanks for this as it’s reassured me that getting back to running is doable.
Hello, can you help me? I spoke to a friend today and because I am always injured. He told me not to stretch before I go for my run only stretch when I come back is that true or not true? Arthur
I had both Achilles tendons treated after years of suffering - I am a trainer and coach with over 25 years of experience in functional training including working with some of the best trainers - I now have fully recovered and am playing Futbol again and I not only am pain free but the fact remains that both my tendons no longer have any noticeable signs of tissue degeneration - in fact I no longer have any fascia or adhensions in either one. I can move at every velocity spectrum and play at intensity levels as if I never had an injury. I was treated with a specific protocol developed by Regenexx which is far more detailed than others. How do I know this: 6 years ago I tried PRP using a different protocol with sub-par results. In fact, the biggest issue facing the PRP is the lack of standardization of protocols - thus there are varying results. Multiple meta-studies have pointed this fact out and have led many to look at PRP - as not a good option. That would be a shame - because if you can be treated properly - you will see full function return - and be able to continue to move in ways that keep your entire body healthy - pain-free - and improve your overall health.
I'm 60, 6'2" and 172 lbs. I had a total hip replacement 4 months ago. I run a couple of miles on trails with no difficulties or pain at about 7-8 minute mile pace. Can't wait to start pole vaulting and high jumping again next spring! ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-L37tOj511kk.html&pp=ygUPbWlrZSBqYXF1YSBwb2xl
you present content as if 'protocols' can apply to all people who walk into hospital. sorry but spreading a lot of information but that is not clearly structured, and lots of 'general statements' maybe you could start by having 2 parts of the video: people who practice sports and want to stay active / and the rest (they were never too active) conservative approach does not bring back previous performance. actually 30% less power and function vs. before rupture. surgery (mostly) does bring back almost 100% previous power and function and it's preferred by most athletes. top athletes take 8 EIGHT months minimum to restore performance and in some cases to return to competitive sports. maybe a link to Kobe Bryant recovery video could clarify this. the 'protocols' you show here are based approaches that are applied to people who do not really practice regular sports. they probably just want to return to what they were doing before - but certainly not running 5K a week.
59 yr old female. I’ve had clicking in my right hip my whole life.I was hyper mobile as a child . The past 4 years the pain has become unbearable. I’ve gone to three different specialists and had so much imaging. They have all thrown hands in air, acted puzzled as to why I’m in pain…. Said X-rays looked fine….Blamed it on needing weight loss and thrown me to physical rehab where it hurt me further. I’ve taken loads of NSAIDs and my life has gotten smaller and smaller. Last week a physician’s assistant really took time with me as I was in desperate tears to get help. She studied my X-ray and said it showed textbook dysplasia that was confirmed with my doctor. MRI w contrast this week to see what shape labrum is in, and plan for surgery after that. I’m so hopeful I can get my life back. Thank you for this video. I want to be as educated as possible .
I'm curious to know how you're doing now. I thought once the hip was 0:41 in alignment, all of the pain would go away. I've read comments mentioning that the pre op pain remains post op. I'm more than concerned. How are you doing now?
I believe eccentric slant board ex. is better when you suffer quad tendinopathy. Heavy slow resistance with isometrics suits more the patella tendinopathy
As a THR over year ago, the question I asked myself was what would the quality of my life be like without running. Dedicated runners know the answer to that question. I have returned to running, with some limits and precautions and my experience after a year of running has been absolutely fine.
Hi, I hv some hamstring problem. I hv ate medicine and did physiotherapy, acupuncture, shock wave. I can only run 5 k now, but need to run full 42.195 on Nov and Jan. Thank you for your clear and informative presentation and case study. It gives me hope to complete them. 😊
when you talk about rehab strains, tears what about nerve damage in legs from low back opperation drop foot, numbs in legs thigh muscle not engaging properlyAny good excises to help
Thank you for posting this valuable information. Would you say it’s possible to have MTSS in addition to MTSF? In other words, your area of pain could be larger than 10cm indicating MTSS but also having an additional area of focal pain around 1-3cm? I find that when I rest, and my tib-post settles down, I still have this one small sore spot just below the inside of my tibia, about 3-4” up from my medial malleolus. Also how would we differentiate between MTSF and irritation/inflammation of the periosteum?
