You have run the SunTrust Richmond Marathon or the McDonald’s Half Marathon and now five days later your legs are still protesting that decision with every step you take.  What is a body to do?

According to Steve Butler, senior therapist and orthopedic certified specialist at CJW Medical Center, the most prevalent injuries involving marathoners or half marathoners are ilio tibial band syndrome (ITB); heel pain, also known as plantar fasciitis and runner’s knee.

These are the injuries that are clearly a step beyond your general marathon aches. These are the hurts that stop you in your tracks, the ones that vibrate on into your sleep. And according to Butler, people get them for a variety of reasons.

“With regard to the ITB syndrome I believe inadequate core control is the most common cause,” says Butler. “I see this often in new runners who were relatively sedentary up to the point of initiating the marathon training. Poor control of the pelvis during the loading phase of running causes the pelvis to drop excessively putting undue stress on the outside of the support leg. This stress can also cause tension down to the knee leading to excessive stress on the ITB fibers.”

So in other words, if you sat around a lot and then started running a month or so ago, you may be feeling it.

Butler also observed another possible cause for soreness -- road slant.

“Sharp camber or slope of the road can also cause stress down the outside of the leg and a lot of roads around Richmond, particularly the scenic ones along the James have a sharp slope.”

So what’s the cure? Butler recommends “manual therapy to address areas of tightness, modalities which decrease inflammation and strengthening exercises targeting core muscles.”

In other words good doctoring with a sports medicine physician of which there are many in the area. If it’s been five days and you are still moaning and groaning, think about it.

Another recommendation is a coaching program to eliminate injurious habits. And by all means avoid over training because that can lead to a chronic condition. “Chronic inflammation over time causes permanent changes to the soft tissue which itself becomes part of the problem,” he adds. “The tissue becomes less pliable which makes it vulnerable to chronic pain.”

And lastly, Butler says: “Don't neglect the legs when strength training, in particular the outer gluteals. I wish I had a dime for every runner that has said "I don't work my legs in the gym since I run" I tell them, you NEED to work your legs because you run. Also, it is never a good idea to run through pain. When your gait actually changes because of pain it is foolish to continue. A short break in running to allow healing can permit running in the "long run" throughout your life.”

Bottom line, when your run hurts you bad, go to the doctor.