Are knee sleeves worth it? And other advice for returning to running.

January 24, 2018 6:54 AM

I'd like to get back into running. I stopped over a year ago due to a knee injury (was eventually diagnosed with a partial meniscus tear). I have been working on strengthening my knee for several months and feel like I'm ready to try running again, and am looking for advice about how to do that as safely as possible. So, are knee sleeves worth it? Any other runners who've successfully recovered from a knee injury? What worked for you?

Capsule history: First started running regularly 4 or 5 years ago via Couch to 5k. Injured my knee ~2 years ago, had physical therapy, returned to running, 6 months later injury flared up again. Couple failed attempts to simply rest and recover on my own and then go running again, still felt it. Eventually went to knee doctor and had an MRI, I have a partial meniscus tear that seems to have never fully healed. Surgeon suggested I try physical therapy/strengthening the knee --- basically knee ain't broken enough for surgery to definitely help, but definitely ain't quite right either. Doesn't hurt day to day and putting weight on it doesn't hurt, but sometimes stiff if I sit a lot, occasional weird twinges. So I've been focusing on strength training stuff for the past several months, made improvements, but miss running and would like to get back.

I'm going to a running store this weekend to get fitted for new kicks. My current plan is to redo a couch to 10K program, warming up extensively before each run, and icing after. Is there anything else that I should be doing/trying?

posted by Diablevert to Health & Fitness (9 answers total)

I have arthritis in both knees, but my PT recommended that I strengthen my quads and IT band to reduce some of the pressure and pain. I am sure your PT gave you lots of exercises to do, but the one that seemed to really give me results and (for me) is part of a good warm up are banded squat walks. I found a set of resistance bands on Amazon and work on building up that strength. Swimming also really helped with my running, as it allowed me to build strength up without putting too much pressure on my knees. I generally wear a knee sleeve on my right knee mostly to keep it warm and provide a little stability, but I am not the biggest fan of wearing them when I run because they tend to slip
posted by thefang at 7:05 AM on January 24, 2018

I've got no experience with knee sleeves, but I do have experience with running and knee injuries. I had an issue with one of my knees for close to a year. The MRI wasn't conclusive (it showed inflammation in the knee but no clear source or injury) but pain persisted, even while resting. Physical therapy didn't do anything for me. Eventually I quit for a few weeks until all discomfort was gone. When I started running again and the pain returned, I stopped for the day. Every day I could keep going a little longer without my knee hurting, but when it started to, I stopped running within minutes. Today I run about 10k every other day and I'm very happy that the pain is entirely gone.

So, long story, short: rest, rest, and more rest. Listen to your body first, and only then to the guidelines of your running program. Everything else is secondary. I hope you can stay pain-free!
posted by Desertshore at 7:56 AM on January 24, 2018

In addition to strength training for your knee have you been doing strength training for your hips/glutes? If/when your hips get tired your stride can degrade such that symptoms are felt elsewhere. From my path from beginninng to my current intermediate status, I've had ITBS, some calf strains a stress reaction and mild ankle tendinitis. I've progressed beyond all of them with 1) some work on the problem area, and restarting maintenance strength work on my hips and glutes. 2-4 months without strength work in retrospect has preceded all of my injuries except for one that was likely based on slight physical trauma.

Happily I've gotten up to 90-110km weeks, and I credit my body not breaking down with finally being good (3-7 days per week) about doing a "myrtl routine" (examples on youtube) will also adding in one legged bridges and some core work. If you haven't been working on your hips/glutes, given your previous knee problems I'd strongly recommend waiting at least 2 more months while doing some great hips/glute work. If delaying starting to run, generally working any forgotten part of your legs (calf, ham, quad) that might not have gotten good training when working on knee strength would be a great idea.

While starting to run, be sure your foot strike is happening under your body's center of mass (I.E. don't over stride). I advocate not caring about forefoot vs heel strike, so long as you're not over striding.

As a sanity check, your warm up routine does not involve any static stretches? Static stretches weaken the muscle for 1-2 hours after - weak muscles mess with your stride which leads to injury. Any time you do strength work and running, strength work should follow running; not precede it. Additional sanity check; given your injury history, anytime that you're increasing your mileage or for a week or two after (I.E. the entire couch 2 10k program) you're doing easy/light effort running. Formi/comfort/feeling strong while running is more important than speed.

When getting fit for running shoes remember studies have shown that stability shoes aren't actually associated with avoiding injury. I'm a pretty heavy pronator (pictures of me running look ridiculous/painful), but when I tried wearing the recommended stability shoe just to walk in it felt horrible and un-natural. I've been running for almost 4 years now in neutral shoes without issue, despite the two running stores in my area saying I need stability shoes to correct my over pronation. A running shoe should be immediately comfortable. Do not buy shoes that "need to be broken in." Tons of info and cites at http://fellrnr.com/wiki/The_Science_of_Running_Shoes .
posted by nobeagle at 8:11 AM on January 24, 2018

Re hips etc. --- I've been doing compound lifts and core work, not just knee rehab stuff. I've been using a dynamic warmup before lifting sessions. I'm going use that and a few more body weight exercises before my runs.
posted by Diablevert at 8:57 AM on January 24, 2018

I was in a similar spot, though with a lesser knee injury, last year. Doing PT exercises and strength training are a huge part of the battle, and it sounds like you're doing really well with those.

For the running part, starting over with Couch to 5K/10K is great; I started a few weeks into C25K when I re-trained myself to run again, but if you haven't been running for a while start at the very beginning. Follow the advice to run as slowly as you can; I found a treadmill helpful for pacing and timing myself. If you progress several weeks and your knee gets acty-uppy, fall back a few weeks and repeat from there. There will be a stretch of several weeks where this is super boring and you can't believe you're jogging for five measly minutes, you feel like you're ready to tackle your old runs, etc. - but stay with the schedule.

I do like knee sleeves for warmth/compression; I don't think they solve or prevent anything on their own, but they're a good part of the mix. In addition to running, I will wear one for just walking around if my knee's been cranky. I also wear street shoes with good arch support or orthotic inserts whenever I can.

I've also found that old joint pain acts up more in cold weather; I thought I'd completely healed my knee but when we went through that cold snap the pain and stiffness came back a little. So I've decided to scale back my running a little bit during the winter and focus on strength, and then ramp back up in the spring.
posted by Metroid Baby at 9:31 AM on January 24, 2018

I have torn meniscus and arthritis in both knees. Had surgery a couple times. I wear Mava Knee Braces. Very helpful, highly recommended. They are comfortable enough to wear all day. After an injury, any support takes stress off the knees and probably helps them heal faster.
posted by conrad53 at 10:15 AM on January 24, 2018

Nthing getting good shoes and changing them regularly - go to a store that will do a gait analysis for you before a fitting. And warming up is super important - don't just start running. The FIFA 11 is well studied and seems to prevent injury. Metroid Baby's advice on starting slow and going back and repeating is key.
posted by OneSmartMonkey at 11:01 AM on January 24, 2018

It's entirely possible it was just placebo effect, but after I started taking Glucosamine while rebuilding strength after a similar injury, I experienced a dramatic reduction in pain after exercising which helped with sticking with the process.
posted by Candleman at 12:35 PM on January 24, 2018

Like nobeagle, I was also having a bevy of ITBS, knee and ankle issues. Working the hips and glutes has been a big help for me. Since I've gotten more regimented about supplemental strength training in those areas, I've had my longest injury-free stretch in a while (*knocks on wood*). I've also gotten more disciplined about stretching and warming up, which seems to help too.

Another thing that has helped my knee health is converting from a heel strike to a fore/mid foot strike. Heel striking sends all the energy straight up your leg to your knee, but if you strike more on the forefoot, then your ankle absorbs a bit more of the impact. I've gotten around quite a few knee problems once I took this approach.

Finally, if there is a PT/running specialist in your area, give them a call. We have a place in our area where I went in for a 20 minute appointment (for a mere $35) and they analyzed my gait, talked about my injury history, gave me a list of exercises to do, and recommended some specific shoes. It was basically what a good running store will do, but with more of a clinical perspective.
posted by slogger at 12:08 PM on January 25, 2018