Run Well by Juliet McGrattan (reading books for 5 year olds .TXT) 📕

more risk is open for debate and needs more research. Similarly, it’s not possible to say whether cushioning in shoes is definitely protective either.

Stress fractures don’t always show up on an x-ray so may require more detailed scans, such as CT, MRI or bone scans. If a fracture is confirmed, then rest is essential. It will usually take around eight weeks for it to heal up. Going back to running too soon can cause more damage and lead to a more prolonged time off. Cross training that doesn’t trigger pain is allowed, so you can still maintain your fitness, but do check with your doctor what is suitable for you and when. A gradual return to running is essential and it’s advisable to see a physiotherapist for a biomechanical assessment, strength exercises and a graded return to exercise.

Knees

Q What is runner’s knee?

A Rather than being a single diagnosis, runner’s knee is the term given to a variety of conditions that cause pain in the knees of runners. You may hear it called patellofemoral pain syndrome (PFPS). It tends to affect beginner runners or those who are increasing their distance and frequency of running. The pain is felt in, behind or around the knee cap (patella) and is often worse when running downhill or squatting. Despite the location of the pain, the problem isn’t usually from the knee itself. Hip, thigh, calf, foot and even core muscle weaknesses, tightness and imbalances all affect the alignment and function of the knee, and can result in knee pain. For example, if you are sedentary for large parts of your day then you will probably have weak glute muscles, which can result in the knees moving towards a knock-knee position when you run. This is particularly true for women. A weak core and poor stabilisation of your pelvis can lead to your hip dropping when you land, which puts an uneven stress on your knee too.

Treatment initially focuses on letting the acute pain settle and then correcting the underlying problem. You may need a physiotherapist assessment to instruct you. Working on core strength, and hip and leg muscle strength, is vital. Try exercises such as squats, glute bridges and clam shells, (see figure below) either with or without a resistance band.

If the issue is more to do with your foot mechanics, then get fitted for running shoes in a specialist store with a video analysis of your gait. Runner’s knee can be overcome, but it may take some determination to solve it. Don’t give up, though, and keep doing your strength exercises as part of a weekly schedule to stop it recurring.

Feet and ankles

Q I get pins and needles in my feet when I run long distances and they sometimes go completely numb. Why is that and how can I stop it?

A Pins and needles and foot numbness, either whole or partial, are surprisingly common complaints. Thankfully, the cause isn’t usually anything to worry about, but it’s a very odd sensation when you’re running and can’t feel your foot. The first thing to consider is how your shoes are laced. Tight lacing will stop your foot moving in your shoe and help prevent blisters (see here), but it can cause problems. Superficial skin nerves easily become compressed, resulting in tingling and numbness, particularly when feet swell on long distances. It may simply be a case of loosening your laces slightly or investigating different lacing techniques.

Sometimes going up a size in your trainer or choosing a wider fit will help. A complete change of trainer brand and style might also be the answer. It can take time to find the perfect fit and our feet do change over the years, so it’s not necessarily one brand and size for life.

Nerves can also be compressed by the surrounding structures, such as swollen or tight muscles, cysts or bony overgrowths. Often the place where they are compressed is higher up the body than where the numbness is felt. A good example of this is a numbness under the foot which comes from a slipped disc in the lower spine. Sometimes a foot numbness can be due to a thickening of nerve tissue called a Morton’s neuroma (see here).

Rarely, foot numbness, also called peripheral neuropathy, can be due to an underlying medical condition. Peripheral nerves (those in the extremities of the body) can be damaged and not function properly due to a range of underlying causes, including diabetes (most common cause), an underactive thyroid, excessive alcohol and deficiencies of certain vitamins, particularly vitamin B12. If both feet are numb, then this makes a medical condition more likely. If you’ve tried to solve your foot numbness yourself with no luck or you have other symptoms alongside it, then you should see your doctor.

Q Why do my feet hurt when I run?

A Pain in the feet can come from a variety of causes depending on which structure is the source. Here are some of the commonest causes:

• Muscular pain Pain from strained or over-worked muscles. It’s common if you’re building up distance, running on uneven ground or in the wrong shoes. Pain and tenderness is usually felt over the affected muscle, and pain is aggravated by using and stretching the muscle.

• Plantar fasciitis Pain in the heel and sole of the foot (see here).

• Tendonitis Pain from inflamed or strained tendons from over use or injury. Pain at the back of the foot may be due to Achilles tendonitis. The tendons running just below the knobbly bits on the inside and outside of the ankle (medial and lateral malleoli) are common sites too, resulting in pain in the side of the foot arch where they attach to the foot bones.

• Metatarsalgia Pain in the heads of the metatarsal bones. Felt in the ball of the foot, this may give the sensation of standing on a pebble, and is usually due to increased intensity and volume of running. There