Running Reader Q: My Knee Hurts When I Run. Should I Get a Brace?

Happy Knees Happy RunnerLaurel has recently returned to running after taking some time off to focus on getting a masters degree. “I was really into it, but I kept getting shin splints,” says Laurel. “When my schedule got tighter with classes, I sort of stopped working a run into my day because it was painful anyway.”

Now, she’s back—the diploma is on her wall and she’s moved to a new city where running routes abound! “I’m excited about running again,” she says. “I’m ramping up slowly, but now my left knee is starting to bother me. Should I start wearing a brace?”

I’m a big believer in listening to your body. Pain is a message that something is wrong. Rather than trying to mask it with a brace, I think Laurel needs to figure out what’s really causing the problem—especially since she’s had injuries in the past. To double-check my diagnosis, I reached out to New York City-based rehabilitation specialist Nadya Swedan, M.D.

Dr. Swedan, what could be causing Laurel’s knee pain? “It sounds like she’s experiencing patellofemoral knee pain, also known as runner’s knee. The associated pain could be stemming from a couple of places—she may have injured the cartilage beneath the kneecap, or it could be tendonitis. Everyone runs differently, so depending on her gait Laurel could have gotten runner’s knee because her leg muscles are weak or imbalanced, or the muscles and tendons connected to the knee have become tight from overuse. A tight IT band, or tight quads and hamstrings are often the culprits.”

How do you feel about braces and compression bands? Would they help Laurel? “Those braces and bands are sporting goods store solutions, and I would never recommend them. Sure, using one takes the tension off the power tendon around the joint, but it would be dangerous to slide one on and continue running. It would become a crutch for Laurel—soon she wouldn’t be able to run without it, because it would change the alignment of her knee and lead to injuries elsewhere. Her best bet is to focus on fixing the root of the problem with strength training and stretching.”  

What should she do to alleviate the pain? “Ice is her knee’s best friend. It will alleviate any swelling, decrease the inflammation, and help her body’s own healing mechanisms kick in. She could also take some ibuprofen, but I definitely don’t want her to pop a couple and then head out for a run—that might make her knee worse.” 

Can Laurel keep running? “She can run a little bit, nice and easy, but if the pain continues she should get off her feet. Cycling, with the bike seat raised a bit higher to take pressure off the knee, and the elliptical machine would be good cardio options for her. Rollerblading would also be really great right now, because it strengthens the inner and outer thigh muscles—areas that tend be weak in runners.”

Thanks, Dr. Swedan. I think Laurel will be happy to hear this!

Laurel is a smart cookie, so I’m pretty sure she’ll listen to her body and follow the doctor’s advice. (I just hope she doesn’t sign up for roller derby and find herself with a whole new set of injuries!)

Runner’s knee is super common—have you ever experienced it? What did you do to get rid of it? 

Running Reader Q: I Cross-Trained And Still Got Injured—What Gives?

Regularly rolling out your legs after running helps ease tightness by breaking up the fascia around your muscles and can prevent injuries down the road.
Regularly rolling out your legs after running helps ease tightness by breaking up the fascia around your muscles and can prevent injuries down the road.

Emily P., a regular Some Kind Of Runderful reader, is dealing with her first running-related injury. She’s fairly new to pavement pounding, and she was smart with the build up. She ran an easy pace three days a week for the past five months, “Plus, I did two days of exercises with weights in the gym,” Emily says. Despite her careful routine, she still managed to pull a hammy. “It was during my very first 5K two weekends ago. I was a few feet from the finish when something in the back of my leg popped. I practically had to limp to across the line,” she says. A quick trip to the doctor confirmed a strain and, luckily, no major muscle tearing.

Now, Emily is nursing a sore hamstring and a bruised ego. “I just don’t get it,” she says. “I’ve been cross-training and I thought I was doing everything right. Where did I go wrong?” To help me find the best answer for her, I reached out to Dan Trink, a fitness trainer and director of training operations at Peak Performance in New York, NY.

Dan, what do you think brought on Emily’s injury? Most running injuries are not acute, meaning someone doesn’t run out from behind a tree and hit your leg with a stick when you’re in the middle of a 5K. The injuries incurred from running are caused by overuse or muscle imbalances.

But Emily’s been hitting the weight room to build muscle. She may have been focusing on the wrong types exercises, or ones that use the same muscles and motions as running. Too many people mimic the energy system that they utilize in running in their strength training, which means that they try to build strength-endurance by only doing high-rep sets or metabolic circuits. Most runners are better served by increasing their strength with high-weight, low-rep sets in the weight room. Logging miles gives you plenty of endurance for running, but you’ve got to rely on your strength training to help you get stronger and keep injuries at bay.

What’s the best way for Emily to work through this injury? Very often overuse issues and muscle imbalances can be resolved with a smart strength-training program that not only builds foundational strength, but also incorporates foam rolling and soft-tissue work, dynamic warm-up and activation drills, and pre-hab or rehab movements as well as strength movements that will give you more stability and reduce your chance of the injury recurring when you return to running.

What should Emily do when she’s done with rehab and ready to run again? The key is not to get carried away, thinking she can drop everything else now that she’s running again. She should maintain a strength-training program that still includes all of the factors I mentioned before.

Thanks, Dan. This is great advice. Any time! By the way, how are your arms? Are you still working on your upper body strength?

…Um, no comment.

I’ve been through my fair share of injuries and I know how frustrating the recovery period can be. Your body will tell you when it’s ready to run again—but you have to be gentle with yourself and listen. Wishing you many more happy miles, Emily P.!

What’s the worst running injury you’ve ever been through? Got any rehab tips to share?

The Diagnosis: Strained Gluteus Medius (a.k.a. A Pain In The Butt)

8 miles at warp speed on the Alter G—engage!

The fix: Cancelling my marathon plans and diving head first into rehab. (Cue: Amy Whinehouse, “They tried to make me go to rehab.”)

I mentioned last week that my marathon training wasn’t going well. I’d been plagued with pain, and I was debating whether to push through and run the marathon anyway. To help me make the best possible choice for my body and future running, I made an appointment with physical therapist extraordinaire Michael Conlon at Finish Line PT. I picked him for three reasons: 1. He and Michael K. Farrell are buddies. 2. He takes my insurance. 3. He has the most adorable golden retriever, Miles, who sometimes hangs out in the office. (I’m a sucker for a cute pup!)

After a thorough evaluation that involved me standing on one leg and leaning awkwardly in several precarious directions, doing moves reminiscent of a hula dancer, and getting a torturous psoas massage, Michael diagnosed the problem: left gluteus medius strain. (I would like to formally apologize to my hip. I’ve been complaining about the poor thing for weeks, when it was a broke-down butt muscle causing the problem the entire time.)

I didn’t decide to cancel my marathon plans right away. Nope, instead I attempted to run a half marathon four days after being diagnosed. I dropped out when the pain set in at mile three—my first, and hopefully last, DNF…did not finish. I cried the whole walk home and I didn’t even feel better when a plate of banana and Nutella crepes showed up in front of me.

My legs are in outer space and my head is in Shasta County, California—I’m watching game wardens bust poachers on NatGeo’s Wild Justice.

I’ll be spending time with Michael at Finish Line PT for the next 4 to 6 weeks. I’m pretty bummed about not running the NYC marathon in November, but the gadgets in this high-tech treatment center should keep me distracted. And I still get to run—at 75 percent body weight on an Alter G treadmill! It’s not Central Park, but at least I don’t have to completely cut running out of my life.

Have you ever run on an Alter G treadmill? What’s your “pain in the butt” running story?

Running And Heels, For Me They Don’t Mix

Yesterday my quads were sore again. It felt like I’d run another marathon over the weekend—only I hadn’t. I’m being good about sticking to my recovery plan and easing back into running. I did my scheduled light run last night anyway, thinking maybe the muscles needed a little exercise to loosen up. Three miles of trails later (soft ground is easier on your body than pavement), my legs still hurt and going down a flight of stairs was no picnic.

This morning, I was reaching for a pair of pants I haven’t worn since last summer and remembered they were hemmed to be worn with heels. That’s when and it dawned on me—I wore cowboy boots that make me an inch and a half taller all day on Sunday. That’s why my quads are so sore!

 High heels throw your body out of alignment. To be able to walk in them without falling, you have to thrust your pelvis forward, which puts stress on your lower back and engages your legs muscles, from your calves up to your quads and glutes. I’d given them up during marathon training when I started having shin pain. So now, my body is used to being in flats and even walking around (and standing in a museum for a few hours) with the slightest lift gave my thighs a major workout.

Still, heels make my legs look hot! So I have two options: I can walk around in flats for the rest of my life, or I can go into training to be able to wear high ones again. (I’ll be wearing the ones in this photo to a friend’s wedding in October, so the choice has been made.)

Would you give up sexy stilettos and kitten heels to improve your running?

Originally posted in Running With It on Shape.com.

Not Running Is Harder Than Running

I’ve taken the past three days off from running, since I just put my body through 26.2 miles of mega hills, and it’s driving me nuts. This morning I took a walk to Central Park and longingly watched others jog past me. In a moment of weakness I decided to run—just to the next lamppost, which turned into the one beyond that, which turned into half a mile. And now my knee feels funny. Oops.

Recovering from a marathon can be tricky. Experts say it takes about four weeks to fully bounce back—but you don’t want to completely stop exercising during that period and you also don’t want to put too much pressure on strained joints and muscles. So I’m filling the next two weeks with walking, spinning, and light running on trails and grass. And then I’ll ease back into running on pavement.

In the meantime, I’m going to stay as connected to the running community as possible.

Will you be in NYC tomorrow? Meet me at the Jack Rabbit New York City Running Show at the Metropolitan Pavilion (123 West 18th Street, between 6th and 7th Avenues). A $10 ticket gets you into the event, plus $15 off any purchase you make. I’ll be at the Achilles table on the 2nd floor from 3pm to 6pm. Come learn about the Hope & Possibility 5-miler and upcoming volunteer opportunities.

Originally posted in Running With It on Shape.com.

Here Comes The Pain Again

OK gang, I’m excited! So excited that I’ve been pushing the speed a little too much since last Thursday. The result: An angry left shin. But I’m confident that it won’t prevent me from finishing Boston—in 4 days!

This morning I attempted to do four 1-mile repeats at race pace, but I’m so keyed up that I was about 10 seconds too fast. To circumvent the post-run throbbing in my shin I tried something new; I pulled on a pair of Vitalsox Performance Graduated Compression socks (seen here in this lovely photo provided by the company). One run certainly isn’t a scientific study, but I think these things really do stimulate circulation and improve muscle recovery—my legs felt springier, and my feet were super comfy.

And even though they make me look more like a soccer player than a runner, I’m planning to wear them on the big day. My marathon photos will all be keepers!

Countdown to the Boston Marathon: 4 days!

Have you ever tried compression socks? Are you as psyched as I am for Monday?

Originally posted in Running With It on Shape.com.

It’s Time To Be A Goal Setter

This morning I had coffee with Neil Cook, a running and triathlon coach at Asphalt Green in NYC. I wanted to pick his brain about Boston—he’s run it in the past and has coached several athletes to victory there. I also wanted him to tell me that I could finish in my original goal of 3:45. Instead, I came away with a caffeine buzz, a Starbuck’s napkin full of notes, and a head swimming with numbers. It’s time for me to smell the vanilla latte and be a lot more realistic.

I’ve had a few setbacks during training this season—the flu, shin splints, crazy winter storms—but I’m not going to make excuses. I haven’t put in the mileage or the effort to hope for such a speedy finishing time. Coach Neil wants me to create three new goals for myself: 1. The one I can hit only if the marathon gods are smiling upon me (perfect weather, my legs feel incredible, complete mental focus); 2. The time my current level of fitness and training predicts; and, 3. An at-all-costs number that I’m guaranteed to reach. Which means I’m looking at: 3:55, 4:06, and just plain finishing.

If I were the type of person who set the bar low, I could be happily surprised by how well things turn out when the outcome is better than anticipated. But I’m not; my expectations have always been too high—for racing and everything else in life. It’s going to be tough to accept something as practical as 4 hours. Still, it’s what I need to do.

Countdown To The Boston Marathon: 19 Days!

Do you set realistic goals for yourself? Or do you aim too high or low?

Originally posted in Running With It on Shape.com.