When your knees go on strike

It’s that time of year again when our clinic is inundated with runners of all distances – the 100km trail runners, 42.2km BMO marathoners, and the 10km Vancouver Sun Runners.  We thought we’d share with you a recent blog post of a sun runner, Tara Carman, and how she’s been managing her knee pain during her training.  Her original blog post can be found here, or just read below!

It’s getting down to crunch time and my body is starting to protest these longer and more strenuous runs.

I was happily jogging along on a recent run when Right Knee, always the problem child of my body whenever I try to do anything remotely athletic, decided to pipe up.

Right Knee: Hey. I’m not sure I’m up for this.
Me: Really? Now? We’re less than a month from the Sun Run.
Right Knee: I don’t like these 30-minute running stretches.
Me: I can’t really argue with you there, but you’ve been so good all this time.  Surely you can stick it out another few weeks. Then you can have all the ice packs and physiotherapy you like.
Right Knee: Nope, sorry. You’ve jogged down one too many slight inclines and I’m not going to take it any more. I’ve decided to become mildly irritating while you go about your daily business and if I have to walk down any stairs or jog down hills, you are going to know about it.
Me: Don’t tell me what to do. F*** you.
Right knee: Remember what happened last time you ignored me? How you couldn’t bend your knees or squat? The swelling? The months of physiotherapy?
Me: Left Knee is so my favourite right now.

Confronted with this blackmail, I decided to approach physiotherapist Timberly George, who has helped many a Sun Runner through similar situations in years past.

Runner’s knee, one of the most common jogging injuries, is something I’ve experienced before. For me, it manifests as pain around the kneecap that gets worse when going down hills or stairs.  There are a bunch of things that can cause it: the wrong shoes, improper running technique, weak hamstrings. I went to physio last time this happened and was given exercises, including a really painful one involving a foam roller, which I did religiously until my knee got better. Since then, I’ve been, well, less religious about them.

If you’re a fairly new runner starting to experience knee pain now, it’s a good idea to see a physiotherapist to get it properly diagnosed, and get some exercises that will help. (Including the really painful foam roller one.) It’s important to keep those exercises up as long as you continue to run, George said.

It’s also important to warm up well before your runs.

“Warming up meaning not just a brisk walk but also actually doing some big, dynamic leg swings … maybe marching, high knees, walking sideways to really warm up the system first.”

Many people say they warm up by jogging a little bit slower at the beginning, but “warming up the system more, warming up all of the ligaments and the joints … you’re not just warming up the muscles, but you’re also warming up your nervous system a little bit, which actually gets muscles firing that need to be firing in order to protect your knee while you’re running,” George said.

Also, turns out not everyone’s knees respond well to 30 or 40 minutes of constant pounding. Knee pain at this point in the training could be a signal to ease up, George said, noting that the Learn to Run 10k program has two streams: running continuously and run/walk.

“If you’ve chosen to take the run continuously stream, then this is probably a good point to say that maybe that’s too much for you and you actually need to go to a run-walk because your body is clearly telling you that it’s not really adapting to the load that you’re putting on it,” she said. “So you may still need to incorporate more frequent walk breaks that might only be a minute, but maybe incorporating those every 10 minutes, or every eight minutes or whatever your body feels like it needs.”

Other advice from George for people whose knee(s) are acting up:
Walk the downhills
Shorten and quicken your stride, especially on downhills

George knows what she’s talking about. I’m happy to report that Right Knee has piped down since I started doing more vigorous warm ups, walking the downhills and bringing the dreaded foam roller back into my life. I even ran 40 minutes straight yesterday with no pain until the very end. Onward and upward!


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