Solving Running Muscle Strain – A Stitch In Time

running muscle strain
The quadriceps, or anterior thigh muscles. Image and copyright purchased from Shutterstock, Inc.

I recently described my current training approach to Ironman training with peripheral arterial disease aka PAD (plus being an old fart with an abdominal aortic aneurysm – you should be so lucky). This week I moved on, to a focus on the run, as my swim and bike training was starting to solidify. Last week was my longest bike week, of about 150 miles, heading for 200-250/week. This put a load on plenty of stuff, including, apparently, my right Vastus medialis (Inside anterior thigh muscle – see image, above).

How to fix it?

You might think RICE (rest and ice for the affected area), right? That’s not my approach, as I prefer to track down the cause. I learned long ago that pain can be deceptive. This occurred the night, in the night, of my first more solid run of three miles (I know, that’s nothing, but with PAD?) on a pretty tired body. I rolled over in bed (my youngest grandson says I sleep on a plank, which is kind of true) and that pesky muscle twitched, contracted and hurt, out of the blue. You know, the bad kind of hurt. I knew I had a problem. It reminded me of a warning sign about a week ago, as follows.

I wasn’t thinking, and happened to glance down at my feet, and there it was. Classic lateral hip rotator tightness, causing my right foot to turn out, quite severely. This is related to an old injury.

running muscle strain
Right foot is turned out due to tight lateral hip rotators, of which there are six and the best known is the Piriformis.

I worked on stretching those muscle at the gym, with pigeon pose and other stuff that generally works, but clearly not enough, and forgot about it, until last night. I made a video, a crude video, explaining this relationship, of foot angle to hip rotator muscles, at this link:

I headed back to the gym to do some research, starting with stretching my hamstrings. To my surprise the medial (inside) right hamstring (Semimembranosus) and lateral (outside) left hamstring (Biceps femoris longus) were tighter than the rest.

running muscle strain
The hamstring muscles. Image and copyright purchased from Shutterstock, Inc.

Classic misalignment coming from my hips, an old problem, so back to more serious pigeon pose and other hip rotator stretches, especially for my right side (I’m less aggressive on my left side with pigeon pose, due to my left iliac artery stent within a stent within a stent, but that’s another story). With a little work, the tightness in my hamstrings realigned to become evenly distributed normal tension.

You have to listen to your body! Once again the issue was in my hips, even though the pain was (and still is) in my right Vastus medialis. No amount of RICE on that sore Vastus medialis would have fixed the problem at it’s source. A couple of days of care, more hip stretching and realignment, avoiding guarding of course, and I’ll be back on track on the track.

That’s how I do it, anyway. It’s all in a days work for Ironman training.


running muscle strain
Grey is muscle, white is fat, clear ring around the central white spot (bone marrow) is the femoral bone. Note the loss of muscle and bone mass in the sedentary person.

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Disclaimer: As a veterinarian, I do not provide medical advice for human animals. If you undertake or modify an exercise program, consult your medical advisors before doing so. Undertaking activities pursued by the author does not mean that he endorses your undertaking such activities, which is clearly your decision and responsibility. Be careful and sensible, please.