Knees and Running

April 15, 2005 1:26 PM

I need to start running again, but I haven't done it for almost half a year. In that time, I've gained a few pounds, and the last time I tried running after such a long delay, my right knee was in pain for months. How do I rebuild strength in my knees and when can I start running again?
posted by brownpau to sports, hobbies, & recreation (10 comments total)

You should start by doing a program that alternates walking and running and gradually increases the amount of time spent running. This will give your body time to shed the extra pounds, which will reduce the stress on your joints, but will also get your knees ready to withstand the impact of longer running sessions.

Runner's World has some excellent beginning runners' programs available online. I used one of them when I started again after a 2-year hiatus and a situation much like yours. Now I'm in triathlon training and running 4-5 miles in most workouts.
posted by Miko at 1:33 PM on April 15, 2005

make a plan beforehand AND STICK TO IT. i've had the same problem. i plan to start slowly, improve rapidly, push myself, and get injured. instead, you have to continue to take it easy even when it feels like you're not doing enough work. imho.
posted by andrew cooke at 1:33 PM on April 15, 2005

It's always good to start with walking, and then a good run-walk combo until you feel strong enough to run. In other words, run 2 minutes walk 8, then run 3 walk 7 etc etc until you get to full time running.

Knee strength is a tough one, but there are easy exercises for strengthening the quads which is a good way to stabilize the knee. The best quad exercise if your knee is already compromised is simply a straight leg lift. You can do it resting against a table, simply use your hip and quad to raise your straight leg in front of you. Weight machines tends to do this by having you sit and straighten your leg at the knee (instead of at the hip), which can be bad if you have bad knees. Leg presses and squats can be very good for the quads, but are best done after you feel like your knees are back in shape.

Biking can also be a good way to lose weight/strengthen the quads. Just be sure to keep the gearing low and spin the pedals.

If you stretch your quads, make sure you don't mess your knees up at the same time. The most common quad stretch is to bend your leg behind you while standing and grasp your ankle. Sometimes one needs to hold onto something to stay upright, but is actually really good for leg strength and proprioception (balance etc) to get in the habit of doing the stretch while simply standing on one leg. It can be done with either hand, in other words, your right hand holding your right ankle, or your left hand holding your right ankle. Many people with painful knees find that using the opposite hand eases strain on the knee.

Finally, don't forget to check into the mechanics of your running, if you have not before. Go to a specialty running store where they will watch you stand and walk and run and determine what your personal biomechanics are. There are three major classes of shoes-for neutral runner, moderate overpronators, and severe overpronators/underpronators. You may need one other than what you currently use. All three types can be quite reasonably priced.

Also, try to run on dirt, asphalt if you have to, and concrete as a last resort. Hard surfaces can lead to all kinds of injuries.

Good luck.
posted by OmieWise at 1:46 PM on April 15, 2005

Hindu Squats have worked for me.
posted by the cuban at 1:48 PM on April 15, 2005

I second the advice to take it easy with a run/walk program while you build up strenth.

The problem I've had a few times is that I build up cardiovascular capacity much faster than my joints can handle, and those long runs feel so good, and then I end up overdoing it... It's counterintutive, but it ends up taking more discipline to do less, at first.
posted by insideout at 2:28 PM on April 15, 2005

I injured my knee while running. Here is the rehab program my physical therapist gave me:

1. Squats, on a weight machine. It is much easier to control the amount of weight on the machine and do smoother squats.
   
2. Calf extensions (on a machine)
   
3. Balance on one leg and hold the other leg out to the front for 20 seconds, to the side for 20 seconds, and behind you for 20 seconds. Repeat with other leg.
   
4. Thera-band around my ankle, and move that leg 20 times in all cardinal directions. Repeat with other leg.
   
5. Avoid any kind of exercise where you apply pressure to your leg rather than to the soles of your feet. This means no leg flexions or extensions.
   

My experience is identical to andrew cooke's, sadly. I am in excellent cardiovascular shape, but my body is not really used to running, so I push it too hard without even exerting myself too much.
posted by grouse at 3:11 PM on April 15, 2005

Coolrunning.com has a Couch to 5k training program that I've seen recommended all the time for beginning or returning runners. They also have a lot of other resources for runners including a forum that has a lot of useful advice. It's basically what Miko advises but it gives more detail on how to build up speed.
posted by hindmost at 4:21 PM on April 15, 2005

w/r/t building up speed: noted, but also note that good trainers recommend training for Technique, Volume/Endurance. and then Speed...in that order. Technique first so as not to injure yourself; volume second so as to be able to run longer distances for better cardiovascular health, and speed last because for most of us as fitness runners, it just isn't very important. It will increase as you get more fit, but you can be in great shape with a fairly slow running speed.

Only as you get competitive does it matter. Look at it this way -- say you set a goal of running a 5K. How much does it matter if you've trained for speed and can run a 6-minute mile, but never tried to run three of them in a row?

During the entire first year or so of running after a long break, the concentration should be on good technique and then slowly adding volume, a minute or two at a time. Save the speedwork for a time when you have a solid aerobic base and you are running in such a way as to not exacerbate the injury. Don't worry if you're slow at first -- just work your way from walk/run to full run slowly, keeping workouts short (maybe 20 minutes), and only when you can run the 20 minutes without going into a walk would you begin adding minutes to gradually lengthen the workout. Keep to the rule of never increasing your duration or intensity more than 10% in one jump, and every fourth week, scale workouts back to a lower level for rest, recovery, and muscle rebuilding.
posted by Miko at 6:33 PM on April 15, 2005

I am not a runner but do have bad knees & have had surgery on them. I found The Knee Crisis Handbook very helpful. Lots of information about stretching & strengthening exercises.
posted by MLIS at 12:17 PM on April 16, 2005

I'd recommend starting any program on a treadmill as opposed to outside, if possible. What this does is teaches you how to self-regulate in terms of pace and exertion. I've found that lots of treadmill running at the gym this winter (I'm in New York, so running outside in February is something I've largely lost the taste for) has made it a lot easier for me to control my pace while running outside. This makes for a much better experience and more productive runs.
posted by AJaffe at 11:34 AM on April 17, 2005