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?

Short Run, Long Story

The grass is a little greener on the west side

I took on a new full-time job a few weeks ago, and it’s been a huge shock to my system. No more sleeping until 8:45am and commuting from the bedroom to my computer in the kitchen. And I’ve had to say so long to my 3:00pm “coffee runs,” which involved me doing a loop in the park, finishing at Starbucks, and then walking home to check email again by 4:15pm. Yep, I’ve got a full on, 9-to-6 office gig with a traditional subway start and finish to call my very own these days.

I’ve managed to keep my training on track (got to be ready for The North Face Endurance Challenge Bear Mountain Half Marathon!), but all of my runs are starting to feel the same. My easy days and my hard days have all morphed into tempo runs—comfortably hard efforts that I rely on to help me deal with my new work-related stress. But while all that speed is great for unwinding my head, it’s made a tight, whiny mess out of my left calf.

Which brings me to yesterday, the final Saturday of March 2012. I thought a nice gentle run on the flat path along the west side of Manhattan would be just the thing to loosen up my leg muscles. It wasn’t. I spent more time pulling over to stretch than I did running, and after 35 minutes of stop-and-go effort I got frustrated and decided to pack it in.

I know that short, easy runs are good for your body from time to time. But part of me still thinks they’re pointless. In the back of my mind I’ve always thought that if I’m not running for at least an hour, I shouldn’t bother tying my shoes.

Still, yesterday did more good than I gave it credit for in the moment. All that stretching loosened up the knots in my calf and I was able to have a mental-stress-busting run today. I ran 7 pain-free miles at a comfortable pace, with a few surges tossed in for fun.

The moral of this long story: I need balance and I need to listen to my body (always tough for me). Sticking to a couple of hard runs per week and doing easy ones on the other days will continue to keep my mind and my muscles stress free.

Do you have trouble keeping an easy pace when you’re stressed, too? Do you wait for sore muscles to remind you to slow down?  

All The Runners In The House Say, Om!

I haven’t been running much, so it’s been a while since I’ve posted. (Have you missed me? I’ve missed you!) I took some time off to finally clear up that lung infection, and now I’m slooowly getting back into my old routine.

I’ve been relying heavily on cross training during my comeback tour, focusing on getting my cardio fitness level back up with spin classes and strengthening weak areas of my body.

Yesterday, I took a yoga class with Lisa Priestly at AS ONE. And today I feel like a new runner. (Albeit a little sore in the back and shoulders—all those downward dogs add up!)

AS ONE, a fitness center run by George Vafiades (Ironman athlete and USA Triathlon Level 1 certified coach) and Mark Merchant (founder of ALTA Physical Therapy and a 2011 Death Race participant), offers up a program of high-intensity training that builds strength, stamina, and flexibility over an 8-week period. It’s perfect for runners, triathletes, and others looking to get stronger and faster, and to circumvent injury and muscle imbalance.

Lisa guided the class through a series of hamstring stretches and hip opening poses that left me feeling limber. And she explained that yoga is the perfect companion to cardio and strength training, because it lengthens muscles, opens up joints, and works the kinks out of other tight spots. I’m sold—again.

I’ve talked about yoga before, but I’m certainly guilty of skimping on the stretching—I mean, who hasn’t heard me whine about my hip flexor? So it’s time to do something about it. I’m heading out now to tackle a few miles in the park (running again feels so good!), and before I go I’m rolling out my yoga mat. This way it’s ready for a quick toe-touching session when I get back!

Do you stretch regularly? How often do you incorporate yoga into your routine? 

In The Home, Stretch

Last night I was planning to do a few mile repeats at my marathon goal pace, but my legs felt like going faster so I went with it. I crushed those miles, running over a minute faster than planned! It felt incredible to push my body hard and realize I didn’t lose any speed over the past few flu-induced easy weeks. But my legs were a little stiff this morning, so I spent some time stretching on my living room floor.

Experts still can’t agree on whether or not stretching reduces a runner’s risk of injury, and no one can give me a straight answer on when to do it—before a run or after? But it feels good and I like to incorporate it into my routine on mornings when I’m not doing cardio. I prefer active stretching, using a yoga flow technique that keeps my muscles moving—as opposed to just reaching and holding, which can lead to cramps. A couple of sun salutations and a pigeon pose or two really works out the tightness in my quads, hamstrings, calves, and hip flexors.

For those of you who read yesterday’s postand are now wondering if I wear underwear when I stretch at home: Yes, I do. But that’s all I have on. Yoga is about moving freely, and clothes just get in the way. ;)

Countdown to the Boston Marathon: 10 days!

What are your favorite stretches? Have you ever tried yoga?

Originally posted in Running With It on Shape.com.