Avoiding injury while running

[Spambot5546]

I got it into my head to run a marathon a few months ago. I'm not new to running, but I'd never run a marathon and wanted that challenge. I took up Hal Higdon's training plan and for the first 13 weeks or so I hardly missed a day.

Then, starting sometime in November, I started getting knee pain while running. Fearing injury, I took a few weeks off to let whatever the pain was heal up. Today I got back into it. Not only was my run time shit (I was doing four miles in under 30 minutes before, today I crossed the two mile mark at 16:24) but I still had to stop early because my knees were hurting. My left knee actually nearly buckled when I stopped, which was alarming.

I know people with less running experience run more than me without injury, so I must be doing something wrong. I have nice shoes I got from a store that specializes in shoes for runners, I try to roll my feet, and I'm usually well hydrated for a run (though today I kind of half-assed the hydration). Any runners have pointers on how I can get into marathon shape without constantly hurting myself?

[Izawwlgood]

How old are you? For what it's worth, my ability to recover from injuries, as well as my ability to remain uninjured, has drastically dropped as I've gotten older. At 27, it took me about a week to recover from a pulled muscle that never would have happened 5 years prior.

So, stretch. Stretch a lot. Where specifically do your knees hurt?

[Spambot5546]

How old are you? For what it's worth, my ability to recover from injuries, as well as my ability to remain uninjured, has drastically dropped as I've gotten older. At 27, it took me about a week to recover from a pulled muscle that never would have happened 5 years prior.

So, stretch. Stretch a lot. Where specifically do your knees hurt?

I will be 27 in April. I know age can make it tough, but I also know people who run well into their 50s so it has to be possible.

I usually feel the pain in the space behind the patella. Perhaps a bit lateral to the patella as well.

Any particular stretching you would recommend? I usually to 10 seconds each of flamingo, groin, hurdler, and calf.

[Izawwlgood]

Is the pain by any chance localized to a side? If yes, it could be IT band issues? If it's internal, does it hurt more or less as you bend your leg?
Running is one of those neat things that if you take care of yourself and avoid injury, you can do well into old age, but your likelihood of getting hurt just keeps getting higher and higher.
I don't really have joint issues, but my suggestion is to stretch, stretch, stretch.

[Nath]

How much do you weigh? Do you run heel-to-toe or balls-of-feet? Do you wear conventional running shoes or minimalist footwear?

[Spambot5546]

How much do you weigh?

I lost a lot of weight this summer and am down to about 165 lbs.

Do you run heel-to-toe or balls-of-feet?

My natural stride is actually flat-footed, but I have been trying to get into the habit of running heel-to-toe.

Do you wear conventional running shoes or minimalist footwear?

My shoes look like this.

[raike]

My natural stride is actually flat-footed, but I have been trying to get into the habit of running heel-to-toe.

Do you strike the ground particularly hard? Are your legs the same length?

[Spambot5546]

Do you strike the ground particularly hard?

I'm not as bad about it as I used to be, but sometimes, yes.

Are your legs the same length?

I just held them up next to each other and it looks like they are. I've had enough physicals done, including when I first enlisted, that I imagine if my legs were off significantly it would've been diagnosed. But then...military doctors...

[Nath]

Do you run heel-to-toe or balls-of-feet?

My natural stride is actually flat-footed, but I have been trying to get into the habit of running heel-to-toe.

Do you wear conventional running shoes or minimalist footwear?

My shoes look like this.

The conventional wisdom is that heel-to-toe running is harder on the knees, and ball-of-foot running demands more from the calves. Those shoes are designed for heel-to-toe running.

[ewomack]

Hm, I can sympathize. Years ago I was running like a hyped-up gazelle around lakes and neighborhoods and noticed pain forming in my arches. The pain became so intense that it even compromised my walking. The doctor told me I had plantar fasciitis and that I should not run again. This obviously irked me because, as you said, I see older people running all of the time, some of them WAY older than me. I waited at least a year to try again and the same pattern repeated. On the verge of giving up and thinking the Doctor was right, I told a running friend about my issues. He asked how I ran and I told him heel to toe and he immediately winced. Then he referred me to a book called "Born To Run" by Christopher McDougall that traced the author's frustration with running related injuries. He compared his experiences to the Tarahumara who run all of their adult lives with little to no injuries. My friend and the book heavily suggested toe-first running. After a month or so of adjustment and well over a year later, I'm still running toe-first without injury (so far). The arch pain has not recurred and I have had no pains in my feet since the switch. My calves did need to adjust, but that only takes time. That was my experience with running pain. We'll see how it goes.

[Fossa]

Hi spambot, I can definitely sympathize. Knee pain is no fun, particularly when you don't know what's causing it.

From what you've told me, I suspect it's tension in your IT band. Your IT band is a very long band of fibrous connective tissue attached to a very small muscle (TFL) just below your hip and the lateral side of your tibia. It crosses your knee on the front, just to the lateral side of the patella.

It's a somewhat common injury for people who are ramping up their activity level and is particularly common for people who over-pronate since this misaligns your lower leg and places additional stress on the ITB. The typical presentation involves pain in the band itself above the kneecap, but I've seen quite a few cases of pain where you're describing where it was actually the bursa in the joint that was being inflamed by the ITB pressing on it.

If I'm right, it isn't particularly serious, but it isn't fun either.

RICE is usually helpful. You'll want to ice/compress the joint itself since that's where the inflamation is. I'd also recommend massaging the TFL muscle which is on the lateral side of your thigh from the crest of your hip to about a third of the way to your knee (it varies person to person). Massaging it with a foam roller (or a tennis ball if you're a sadist) is a great way to do this. Definitely extend your warm up and cooldown as well and stretch it more.

The stretch I normally recommend is this one because it's easy to do and hard to get wrong.

Spoiler:

Lie on your back (resist the urge to try this one sitting, the muscle is partially pinned by you sitting on it) and cross the afflicted leg so that its ankle is on the good leg's knee. Grab the good leg's thigh and pull it towards you. You should feel the stretch on the outside of your bad leg's thigh just below the hip.

Hold the stretch 30 seconds, relax a minute, then stretch it again for 30 seconds. Do this every day, though don't do it immediately before running. Long static stretches immediately prior to a workout do more harm than good. Studies have repeatedly shown that the short-term benefits of stretching go away in 3-8 minutes depending on the quality of the stretch, whereas the effects of restricting the blood flow last significantly longer and increase the chance of injury. This applies to all stretches.

Please take all of this for what it is, advice from a stranger on the internet. If symptoms do not improve, get worse, or you want to do the smart thing get a referral for an orthopedist who can actually examine you in person and get a much better sense of what's going on and how to treat it. I'm a certified trainer, but without being able to see you in person... well, for legal reasons none of this should be considered professional advice and I accept no liability for how you handle this whether or not you listen to anything I've said.

On an anecdotal note... don't accept your age as a limiting factor. There are hundred year old marathon runners out there. What you're dealing with is the growing pains associated with getting in shape. Once you're in shape you'll be able to maintain it and be healthy long term. I know so many people (family included) who give up at the first sign of pain and write off their health as a loss.

It's heart breaking to watch because it's almost never true.

You need to properly habilitate your body. If you do, short of major trauma or a condition such as rheumatoid arthritis you don't ever have to give up on your bones, joints, or muscles. I'm about your age. A year ago I fell 20 feet and landed on one leg destroying my knee in the process. After no surgery but some long and very difficult rehab I'm at 100%. Full range of motion, full strength, no pain.

Never give up.

[Spambot5546]

It's 60 degrees Fahrenheit in southern Illinois today (god bless global warming!) so I went for my first toe-first run.

Holy balls, people run like that? It's so unnatural! No particular muscle group is sore (though it's only been 20 minutes), but I was completely winded doing a 8:40 mile. That's 45 seconds slower than the first mile I did when I created this thread. I feel like this stride is forcing me to shorten my gait. I'm not sure, I'll keep working on it.

I also didn't feel any particular muscle, joint, or bone pain so that's hopeful. I'll stick with this and see how it goes. I also tried Fossa's stretch. It's very similar to another stretch I do, but that one is seated so I'll switch them out. Thanks for the advice, guys, here's hoping it works out.

[Izawwlgood]

As an easy transition into it, try running on the sand. I dunno where in Illinois you live, but if you're near Chicago, there's plenty of beachfront.

Also, the stretch Fossa suggested is a must before and after any good run.