Running for Fatties

August 21, 2005 8:56 PM

ExerciseFilter: I am old (36). I am fat (5'8" 190#). I am out of shape (no real physical activity for a couple years). I have a bad knee (ACL replacement and some cartilage replacement two year ago). I want to run a half-marathon on Halloween. What can I do to prepare? Specifically, what can I do to minimize the risk of reinjuring my knee?

I found a training guide and have adapted it to my purposes. I ran two miles Tuesday, Wedenseday, and Friday. I biked yesterday. Tuesday and Wednesday sucked — hard — but I can already sense improvement. I did a three mile run today, and was able to run a full mile-and-a-half before resting (whereas I did more walking than running the first day).

The primary problem? My knee is killing me. It hurt a little after the first three runs, but after today's run it's especially bad. I hate to imagine what it will feel like tomorrow. I believe this is because I had several short downhill stretches. (Downhill is a bitch when you have ACL problems.)

I'm doing moderate stretching before running and after. (I believe post-exercise stretching is the most important factor in preventing injuries.) Is RICE appropriate?

Help me stay healthy and still meet my goal of running a half-marathon!

posted by jdroth to health & fitness (25 comments total)

Don't ask the internet. Meet with a doctor, preferably someone with sports medicine experience, and let them tell you what you can do to prevent re-injuring yourself.
posted by bobot at 8:58 PM on August 21, 2005

Check out the book Chi Running. I just bought it and have been practicing the running technique it promotes. It's supposed to be gentle on the knees.

The basic concept is you center your body over your feet, lean forward at the ankles when running, with knees barely moving and heel kicking up behind you as if you were pedalling a bicycle with the back of your heels, sort of like how the Road Runner zips down the road.

Early days for me yet, but it definitely seems to put less strain & shock on my knees, and less overall effort to cover the same distance compared to the way I used to run.
posted by mono blanco at 9:03 PM on August 21, 2005 [1 favorite has favorites]

I don't want to derail, but why running? Cycling or X-country skiing offer similar challenges with much less impact.
posted by docgonzo at 9:04 PM on August 21, 2005

Don't ask the internet. Meet with a doctor.

I acknowledge that this is great advice, and something that I've already considered. I'm hoping, though, that other mefites have some practical experience with this problem and/or advice that obviates the need for a doctor's visit.

Why running?

A couple of overweight friends are also prepping for this half marathon. We're all in the same boat, except that I have a previous knee injury. It's a camaraderie thing. With a built-in support system (e-mailed daily updates), it's easy to keep at it.

I spent a couple years doing a lot of biking, and I'll be doing a lot of biking as cross-training as I prep for this half-marathon. In the long run, biking is probably going to be my aerobic exercise of choice. The important thing for me right now, though, is that I'm actually doing some exercise. I'm something of a sloth, and anything that gets me outside is good.
posted by jdroth at 9:11 PM on August 21, 2005

J.D., try looking through here too. Since I presume it's the Portland Marathon, they can give you the best advice for the race in particular. My two cents are good shoes, try Portland Running Company, and a good NSAID.
posted by ..ooOOoo....ooOOoo.. at 9:32 PM on August 21, 2005

Please see a doctor anyway, as soon as you can. If you destroy your knee, I don't think you can just wait for it to heal and then start biking. You could really make it seriously difficult for yourself to exercise at all in the future. Not even a doctor would give you advice over the internet about something like this, I think (though I could be wrong).

I'm just getting over a sprained ankle, and had to try to get some exercise while staying off the ankle. It wasn't easy. Or pretty. I pretty much gave up.

If you're avoiding a doctor because you worry he/she will prevent you from following through with your plan:

Probably a doctor won't tell you not to do the half-marathon. If somehow your knee is bad enough to warrant not running right now, then it's better to find out now than one week before the event. In the meantime, you could maybe find some other way to keep solidarity with your friends (setting up healthy lunches? Biking alongside one of them in practice runs?).
posted by amtho at 9:44 PM on August 21, 2005

Here's the problem.

You (and your buddies) are coming off inactivity and trying what worked when you were younger - when your body rebounds faster.

Do the half marathon....Six months from now.

What's happened is you're gone from sedentary to weight bearing exercise...and now that your knee is irrirtated, it won't get better until you let it heal. In 8 weeks? And train for a half marathon (13 miles?) Forget it.

And call your doctor monday. it's only going to get worse as you continue.
posted by filmgeek at 9:53 PM on August 21, 2005

No offense. But this may be a little too much for you to handle. Especially with the short period of time you have to prepare. You are probably no going to be in running shape in less than three months. Especially with the bad knee.
posted by Mroz at 9:55 PM on August 21, 2005

No offense. But this may be a little too much for you to handle.

No offense taken. I'm well aware of my physical state. And I'll give my doctor a call. But I'd still like to hear stories from other people who've undergone similar experiences.

Trust me: I have no desire to reinjure this knee. That's one experience I didn't enjoy...
posted by jdroth at 10:00 PM on August 21, 2005

I agree that seeing a doctor is great advice, but I do hope others will contribute as I am interested in this thread as well. I am not in the same boat as the OP, but I also want to start running. However, I can't go very far at all, presently. I've never been a distance runner (I used to sprint in high school, with decent success), and years of inactivity since high school have taken their toll.

I just started back at the gym last week, and am feeling better already after using the elliptical trainer, but my ultimate goal is to get into running, as it is something that is cheap and won't require me driving to the gym where I often spend as much time waiting for equipment as I do using it.

The guides that jdroth linked to were useful but I am not even at the beginner level yet (I am quite a bit overweight, hence my determination to get back into an exercise routine).

So, now that jdroth has accepted that he is going to have to see his doctor, I hope more people can contribute their advice. Thanks!
posted by synecdoche at 10:13 PM on August 21, 2005

To echo what others have said, a half marathon by Halloween is too ambitious. That's only ten weeks away. A 10K run would be much more attainable with minimal risk of injury.

Realize that the primary limitation for beginning runners isn't so much their cardiovascular fitness but the inability of their legs to withstand the brutal pounding. And the problem is that you don't really feel pain until you've already injured and keep reinjuring yourself. You might put yourself out of commission for a couple years like I did -- is it really worth the risk?

This question gets posed repeatedly on Ask MeFi, and every time I can't overstate how good Walk-to-Run programmes are. They seem agonizingly tedious at first, but if you follow them patiently and diligently you will reap the injury-free rewards for many years to come. My more even-tempered friends did, I wish I had been more patient.

BTW, you are not old. A lot of people in endurance sports peak in their mid-thirties or later, including at the elite level. Think Mark Allen and Dave Scott (Ironman), Lance Armstrong (no introduction necessary), and Sir Ranulph Fiennes (superhuman in every regard.)

Just take it easy and stick with it -- the results will come eventually, and enjoy all the other benefits in the meantime.
posted by randomstriker at 10:32 PM on August 21, 2005

JD, don't do it. You'll hurt yourself. Run next year's half instead. Even the first two paragraphs of the training guide you're using agree with me. Think about how horrendous it would be to completely lose the ability to train on the knee at all. You can still train with your buddies, just not at the same intensity/volume and not with this year's half marathon in mind.

If you're going to do it anyway, start now with RICE for the knee and do it after every training session. Try including some light weight training for your legs (discontinue if it makes things worse) and be sure to warm up before and stretch after every time you train. Like everyone says, talk to your doctor about all of this.

Most importantly, discriminate between pain you can push through (like, say, physio after knee surgery) and pain that's warning you that you're doing damage. It sure sounds to me like you're doing damage.
posted by sennoma at 10:42 PM on August 21, 2005

I think you should probably put off the half marathon for now and find something like a 5K.


Knee problems can be increased by running in bad shoes, or biking on the wrong size bike. Did you get fitted for your particular running style?

For synecdoche:

For books, I would recommend No Need for Speed or Run Right Now.

Cool Running is great for any running question you might have.
posted by drezdn at 10:45 PM on August 21, 2005

THIS Halloween!? You can't. Not without risking permanent damage to your body.

It's incredible that you've been able to get up to the three mile mark so quickly. My advice would be to lower your daily range to half that, spread your 26-odd mile goal out to another 8 months, and walk the marathon this Halloween instead.
posted by Civil_Disobedient at 10:52 PM on August 21, 2005

I fourth or fifth or tenth everyone else's suggestions. Even if you were in shape, if you were having problems with the knee injury no sane athletic doctor would encourage you to ramp up your training. Try water running, the elliptical, cycling, and slow rehab. Add in the extra weight, years of inactivity, and that you want to get to half-marathon shape in about eight weeks, and it's nuts nuts nuts.

10K at most. Half-marathon in six months. It's hard, but really, don't kill your knee. I got shin splints and decided to train through the pain, and I ended up with stress fractures that put me out of the running (literally) for over half a year. Knees are monumentally more dangerous to deal with. If you train slower and recognize your limitations you're not being a pussy--you'll be a stronger runner in the end and you'll be maintaining your ability to walk in twenty years.
posted by schroedinger at 11:30 PM on August 21, 2005

To elaborate on specifically why it's a bad idea, you have to understand that running is an incredibly complex action. It is much more than just putting one foot in front of another.

There are literally dozens of different, specialized bones between your toes and your waist. The joints are incredibly complex and flexible in order to accommodate all the different motions that we're capable of. When you run, you are subjecting your limbs to massive stresses, and everything must be a) strong enough, and b) in perfect alignment for injury not to occur.

The strength comes from gradual adaptation. The tendons, the bones, the cartilage, the muscle and the ligaments must all bulk up in size and density. It isn't a process that can be sped up at will. Proper alignment comes from practicing good technique over and over and over again. Yes, there huge gap between good technique and bad technique in running, despite it being ostensibly so simple.

Furthermore, you need to be strong over your entire run in order to maintain good form. When you get tired, you get sloppy, and then you plant your foot incorrectly and tear something. It's not like biking or swimming where you can just take it easy. In the races I've volunteered at or watched, the vast majority of injuries occur in the last couple miles when runners get careless, hit a wall of fatigue, or get over-zealous about sprinting it to the line.

I guarantee if you stick with your plan, you will get hurt.
posted by randomstriker at 12:06 AM on August 22, 2005

The program I used to start myself into running is this one at Coolrunning.com. I have bad knees too, and when I started, I was around your initial stats - 5'5", 185 lbs. Besides fucking up your knee, you also really need to teach your body how to properly fuel itself for a sport as intensive as running - by teaching it how to breathe and use the oxygen and fuel and how it can get to your muscles and what not. You are NOT doing your body any favors by rushing too much activity to it - consider your knee acting up a wake-up call and your body saying, "I am not ready!" By easing into a shorter running program slowly, you gain endurance, which also helps with confidence, so that one day you CAN tackle longer endurance events like a half marathon.

Seriously. Take it easy. Aim for a 5K.
posted by cajo at 4:22 AM on August 22, 2005

I had an ACL repair and cartilidge work when I was about 34, and then again at 42 (the other knee). Consulting with a doctor is fair advice but you really need a physiotherapist or sports scientist and you might find them more easily at your local gym. I can't praise the YMCA too highly (in the UK anyway) but whatever, you're going to need to get fit and that means a gym that works for you.

Because I'll never really trust my knees again (and we both need to worry about arthritis later on) I have personally avoided running. My guess is that this is the advice any Physiotherapist would give you too, cycling is much lower impact and more effective in building the muscles up around the knee so that they have the strength that even your repaired ligaments lack.

You obviously have your own reasons for wanting to run but do remember how miserable it is to have the knee collapse, so join a gym, find someone on the staff who knows what they are talking about and do what they say.
posted by grahamwell at 5:19 AM on August 22, 2005

If you are dead-set on running, try getting a good knee brace. I also have knee problems when I run (already saw a doctor!) and when it gets bad, I use my knee brace and the pain pretty much disappears. And I'm not talking your thin sheet of a brace, but rather nice and thick a metal bar going down each side. This helps to a) keep the knee warm. Somehow that's supposed to help & b) more importantly, keeps my knee very stabilized. You might just be like me whose knee gets excruciating painful sometimes, but it's not degenerative and the pain indicative of my injury isn't going to cause any further structural damage (or so the doctor says).

However, realistically for someone in fine joint health, a normal person needs a full year of dedication to prepare for a full marathon to be in top shape. For a half-marathon, it still requires a good 4-5 months at the least- time which you seem to be lacking.
posted by jmd82 at 7:41 AM on August 22, 2005

Consider ROWING a half-marathon instead. Indoor rowing machines offer the best and safest exercise you can do that still tests your physical endurance and works out every major muscle in your body. It's especially excellent for bad knees.....it's THE rehab exercise of choice for athletes because there's absolutely no strain on the knee...

My 60-year-old mom with a bum knee has been rowing once or twice day since Janary and has lost 55 pounds so far. She invested in a good quality Concept 2 rower ($800 at http://concept2.com, "Model D"), but there are earlier models--B or C that you can find used for less. I found a Model B used for $125. Concept 2 offers videos that'll get you started.

Or at the very least, you might consider alternating rowing workouts with running....

Good luck.
posted by rexruff at 8:42 AM on August 22, 2005

I agree with the those cautioning restraint. What is it about couch potatoes, suddenly with dreams of marthon? More like that, discussed previously.
posted by Rash at 10:09 AM on August 22, 2005

use the Galloway method: run 4 minutes, walk 1. repeat until 21.1 miles have elapsed.

now- the training. do not increase your total weekly mileage by more than 10% a week! otherwise you **WILL** get injured

alternate fast training (10 x 400m on a track - all run at the same pace, with 400m recoveries) with long slow distance.

take days off. for example -
Monday-rest
Tuesday- gentle run
Wednesday-track
Thursday-rest
Friday-tempo
Saturday-rest
Sunday-long slow distance

If you run 3 miles each time that you train, you've trained to run 3 miles! At that pace! Vary your mileage, vary your pace, and keep your eyes on your goal.

October 31 is only two months and a week away.

Your program today: rest. Go to the library, get the Galloway Marathon training book and read carefully. You can do this, but be diligent about training.

And yes, RICE is good for sore knees.

Good luck
posted by seawallrunner at 10:32 AM on August 22, 2005

In addition to track work outs, I would also highly recommend some hill work outs. They work by finding a nice hill- I usually go shorter and steep or longer and shallower. Proceed by busting balls up the hill, and then slowly slowly jog back down (do not stop to walk- this goes for the track workouts, too. Even of you're forced to job at the same clip as a walk or slower, keep your body in a jogging motion!). For a beginner, I'd repeat this about 6 teams, and gradually increase as you can. Hill workouts are your best friend to make runs in a hilly area without dying.
posted by jmd82 at 10:39 AM on August 22, 2005

I'm 39 and an avid athlete. While I occasionally run to supplement other workouts, I won't even consider running on asphalt or concrete. Only on grass, soft dirt, or sand.

Working out should be about improving your long-term health and like diets should be sustainable. I know several people in their fifties who run 10+ miles per day, but my body simply isn't capable of doing that on a sustainable basis due to the injuries I've accumulated.

Hiking and walking are great exercise and are easier to find partners for.
posted by Manjusri at 11:13 AM on August 22, 2005

It really not fun news to hear, but take it from me, someone who not only ran 10k races every weekend for over 4 months straight, but also ran a marathon and two half marathons in the same time frame: it's not worth it to injure yourself. Take things slow.

Addiction is probably not a strong enough word to describe what running was, for me. The hardest part wasn't running, but NOT running; being able to say "It's ok to STOP today." I couldn't do it, and because of that stubborn stick-to-it never-quit attitude I ended up injuring my knee and was unable to hobble even a mile. For over a year.

Your body will thank you for taking things slow, and you'll thank yourself.

I went from running half marathons in under 1 hour 20 minutes to having trouble walking to class.

I can finally run again, and I really hope there's no permanent damage, but this time around, I'm sticking to the gameplan of what someone said above: don't increase your mileage by more than 10% a week. That is sage advice, and tough to adhere to, but a must, for any serious runner.

Running is a great sport for setting personal goals, and everyone who has ever hit the pavement has dreamed of completing a marathon, or a half. But part of running is setting realistic goals that won't kill you. So set some more realistic goals, and pat yourself on the back for work well done when you reach them. Before you know it, it will be October 2006 and you'll be crossing the finish line in that half marathon--at which time you can start shooting for the full marathon in 2007.

Good luck!
posted by dead_ at 2:25 PM on August 22, 2005