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I like sun:

 

Sounds a lot like what a past friend/physical therapist told me. I have had my feet looked at and have no supination or pronation. And I have had my gait analyzed, the only "deformity" was that my hip dropped at certain points in my stride. Which of course, are due to muscle imbalances, and as you said, when the muscles get fatigued my biomechanics go to shit. However, after taking seven months off from running, I returned to running maybe 3-5 days a week between 20-60 minutes, way less than my normal 50-60 mpw, and the pain returned within one or two weeks...Which is when I went a saw another doctor and ruled everything out and agreed, my tibial tuberosity is def. inflammed, but what exactly is causing it...he was unsure. And said the usual, well do your PT exercises and don't run as much.

 

I've since stopped running for my college and only run 2-4 days a week when I feel like it and when there is no pain. The pain can return during periods of long walking downhill (ie descending from a mtn climb), but not always.

 

 

Do you do any strength training for your legs? I'm not a practicing PT yet, but I do know that many times these problems can be solved through specialized strength programs.

 

I've been pondering your thread since this morning, and have another idea:

 

What if (for the time being) you changed your running routine to be more focused on explosive running power, rather than the long, slow distances. If you are going out and running for 60 minutes, there are probably fatigue issues effecting your biomechanics that you are unaware of as early as 25 minutes into your session.

 

What I'm talking about would be to go find an olympic size track, and practice exploding out for no more than 100 meters (perhaps even shorter distances, like 40m). What you want to do is activate your fast twitch motor units (which have more likely than not been dormant for a long time) and re-wire the way your brain controls your running movement patterns. If I were your therapist, I'd want you to practice the running/sprinting patterns as much as possible, without fatiguing your lower extremity to the point of altered biomechanics.

 

I used to get infrapatellar pain, and inflamation and pain in my hamstrings tendons. What helped me the most was to actually view running as its own "sport", or "specialized movement", which it is. I started training with my track buddies, and they said "dude, your all F****ed up".

 

So I put my mind into getting good at this, and now I can run nearly as long as I want without pain (I am getting over shin splints). Just look at how much time olympic sprinters spend perfecting their gate pattern!! Before I just viewed it as a training method for climbing. Now, it's its own activity.

 

Anyway, I wish I could give you more...

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