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Chasing Pain: The Injury Domino Effect

Over the past several weeks I’ve had an interesting experience that I thought I’d share as I found it somewhat informative about the nature of running injuries.

I’ve been taking Taekwondo lessons with my kids since January (a story for another post), and I’ve come to realize that in most ways Taekwondo has been a fantastic supplement to my running. However, the workouts can get pretty intense on occasion, and about a month ago we did a drill that involved doing rapid fire roundhouse kicks against a pad, three sets of twenty reps on each leg. It was a killer workout, and the next day I noticed that what felt like a case of medial tibial stress syndrome had set in on my right leg.

Over the next week, I noticed that following the appearance of the MTS, my left knee was hurting during my runs. My suspicion is that I was compensating for the medial tibial stress pain in some way that was messing with my opposite side knee. The knee would calm down once I was warmed up, and I found that by exaggerating a forefoot strike on the left side I could reduce the knee discomfort over the first mile while I got loosened up.

Sure enough, shortly after the knee pain appeared I started to feel left heel pain both during runs and in the mornings. I’ve had some left heel pain off and on for quite a long time, but it has never really progressed beyond minor discomfort in the mornings and often it goes away and I don’t notice it at all. It sounds like a classic case of plantar fasciitis, but it seems to be more linked to tightness in my soleus muscles (another story for another post!). Exaggerating a forefoot strike does a number on the soleus!

Anyway, as of about a week ago the right side medial tibial stress resolved itself, my knee no longer hurts, and the heel pain seems to have reverted to it’s normal first “few steps in the morning until my calves stretch out” type of annoyance.

So what’s the point here? I guess it would be that compensatory behaviors in your running form can lead to pain appearing in places distant from the original injury source. In my case, medial tibial stress triggered by a Taekwondo workout initiated a domino effect through my opposite side knee to the opposite side heel during my runs. But, once the source of the problem healed, the other problems went away. Just goes to show that the source of the pain is not always the source of an injury!

About Peter Larson

This post was authored by Peter Larson. Pete is a recovering academic who currently works as an exercise physiologist, running coach, and writer. He's also a father of three and a fanatical runner with a bit of a shoe obsession. In addition to writing and editing this site, he is co-author of the book Tread Lightly, and writes a personal blog called The Blogologist. Follow Pete on Twitter, Facebook, Google+, and via email.


  1. Lannette says:

    My son is in taekwondo and they keep trying to get me to join but the ball of my feet tend to hurt and there is no way I could do taekwondo with no support for my feet. Maybe that’s just an excuse I am using to not join! :o)

    • Pete Larson says:

      I’ve found taekwondo to be amazingly good for foot and leg strengthening! You’ll build the support you need.
      Sent from my iPad

  2. Beth (Run Traveler) says:

    So very true. Last autumn I had hip pain. It turned out that the pain was really a symptom of a low back strain. (Thankfully both problems are now solved.)

  3. I don’t know why but this is my favorite article. This domino effect explains a lot of the pains I have had during my year as a runner. Great post!

  4. Steve K says:

    Great update on compensatory/related injuries. I have resolved a persistent knee injury that appeared during triathlons after the bike section. McKinsey-based back stretches have helped during runs and keeping posture top of mind throughout.

  5. Jennifer says:

    You can say that again. 😉

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