Diagnosing and treating leg injuries in runners

Abi, who we discussed a couple of weeks ago, also came to me approximately eight weeks back with an ongoing pain behind her right knee when running. Abi has a good coach, Joshua Schofield, who has been working with her to get her up to speed for a PB in her next marathon.

Everything was going well except for this niggly pain behind Abi's right knee, which would get progressively worse the longer she ran. Joshua sent me some videos so I could assess Abi's running style. I have included one of the videos, with Abi's permission, to highlight the issue I identified.

Joshua had all bases covered, with Abi doing some running and a lot of strength training, so she was strong through the core and buttocks. Despite being very strong she appeared to sit back in her stance towards the end of a long run, which suggested loss of pelvic control due to core exhaustion.

When I brought Abi in and assessed her, however, the issue was her right hamstring insertion, not her knee. The cause of her sitting down in her stance was that as the hamstring became sorer, she was unable to extend through her right knee before heel strike, so to get her foot to the floor she was dropping her pelvis.

We could not afford for Abi to stop her training, so we treated the hamstring, inhibited the injured hamstring with K tape and, most importantly, explained to Abi in clear language what the problem was.

Abi was then able to continue training, including running, monitor her right knee extension and override her subconscious when needed to maintain correct knee extension before heel strike, which stopped the sitting back in her stance towards the end of a long run.

Thankfully this has enabled Abi to get back to her full schedule without losing time, and she remains on schedule for a PB in her next marathon.

If you are a runner, walker or hiker and you have a niggle that affects your performance, we might be able to help.

Happy New Year to you all – let's make 2026 a year to remember!