Right-side woes that just won't quit.

My long-time problem is on the right side of my leg and at any given time involves one or more of a sore hip, hurt knee, or pulled hamstring. My two main sports are running and soccer. I play soccer about six months of the year, and have run ten marathons, but none in the past three years. It was then that I originally pulled my right hamstring playing soccer. That same summer, while marathon training, I pulled the same hamstring again, and then a month later developed a knee injury on the right side. In the two years since, I have had problems off and on, all on my right side.

I have gone through a few good months here and there, even running a half-marathon race, but for the past six months I have really been battling. I barely get going, starting, say, with right hip problems, then over the next two months pulling a hamstring, to two months later suffering painful knee problems. I went to a sports doctor and had some physical therapy. While this was effective to strengthen my hip, I still had problems with the right leg. Currently I have been off running and soccer for two months. The knee is getting better; I can do some light biking, but that is about it. Just wondering what might help.

Mark Hovan

Stillwater, MN

I suggest you have your feet evaluated for hyperpronation by an orthotist or podiatrist and it would probably be beneficial for you to concentrate on strengthening your quadriceps and gluteus muscles. You may need to do more rehab exercises with a physical therapist.

You need to focus specifically on the gluteus maximus as I am guessing that this muscle is not working very well and when you extend your hip you are using your hamstring and thus you are overusing this muscle. The physical therapist should be able to use biofeedback to help get the gluteus to start working better. Also, the knee pain is most likely coming from a malalignment of the kneecap on the femur and your inner quadriceps is probably not working well. Further PT can address this as well.

David Weiss, MD

"Pulled" hamstrings that last greater than eight weeks fall into the "season-ending" injury category. Considering that your entire right side is affected, there may be a mechanical underlay to your injuries. First, an MRI is needed to look at the hamstring. Next, a thorough lower back exam is warranted as often times, injuries to the lower back (even if there is no specific lower back pain) can cause hamstring problems. Finally, an analysis of your running mechanics may prove helpful. Often an exaggerated stride length may lead to hamstring injury.

Robert S. Gotlin, DO