Please, please, please my knees!

November 5, 2007 12:42 PM

Is there a low impact alternative to the Couch to 5k?

I've just started week 5 of the Couch to 5k plan (well... I'm repeating week 4 to be honest). But I'm having problems, my knees are feeling it badly. I broke down on the middle session of week 4 and was in some discomfort for the whole weekend. I've been to see my Doctor and she told me to take some anti-inflammatories if it got any worse. Now I'm not a quitter so I've jumped straight back on the horse so to speak, and it feels ok at the moment. But I'm thinking that I could probably do with an equivalent plan that's not as hard on my poor old knees (OK OK! I'm only 31!!). And not have to resort to pharmaceutical measures. So is there an equivalent plan? Say for the elliptical machine, bike or rowing machine? Or do you have any other ideas into how I can increase my cardiovascular fitness gradually whilst working towards a goal?

Some stats: I'm a 31 year old male, recently joined the gym after working 2 years on a night shift where I put on 14Kg (30lbs). Starting weight = 108kgs (240lbs) Current weight= 97kg (214lbs). I'm looking more to getting cardiovascular fitness rather than weight loss.

Hope you can give me some tips!

posted by gergtreble to Sports, Hobbies, & Recreation (25 answers total)

it's ok to walk. Take some time off and maybe, if you have access to a pool, do some water therapy as directed by a trainer.
posted by parmanparman at 12:58 PM on November 5, 2007

This circuit training routine will get you conditioned as well as running 5K will. (And if you happen to be interested, it's better for developing anaerobic endurance, as well.) It's much easier on your knees and lower back. It's also only twenty minutes, albeit fairly intense.

The thing you may need to be careful about is the squats. You need to do them slowly and correctly. Make sure you don't bend forward over your knees. That puts undue pressure on them.


Oh, actually, there is definitely something you can do on the elliptical that would be equivalent to running 5K. Most elliptical machines have meter indication how many calories you've burned on it. You could look up how many calories a typical 5K run burns and just do that on the elliptical.
posted by ignignokt at 1:15 PM on November 5, 2007

Can you swim? I joined a master's swim team a while back, and it was great. It was a little intimidating, because a lot of the other people were former competitive swimmers or current triathletes, and I'm not. But it was fun and low-impact, and my swimming definitely improved. Then I got lazy and quit, but that's another story.
posted by craichead at 1:41 PM on November 5, 2007

Cycling is probably the best low-impact alternative to running. The first milestones in endurance cycling are 100 Km (65 miles/metric century) and 100 miles. More interesting scenery than the gym or the running trail.
posted by meowzilla at 1:43 PM on November 5, 2007

So is the goal to run a 5K? If so, the advice is as follows.

1. Go to a running store and get a gait analysis. They'll watch you run and recommend the right shoes for you.

2. Take some time off running, but realize that nothing prepares you for running except running. Add walk breaks, and add mileage a little more slowly.

3. Rest days are critical in any plan. Your body needs time to recover.

If the goal is cardio fitness, I like bikes.
posted by advicepig at 1:48 PM on November 5, 2007

Swimming is MUCH easier on the joints than either cycling or running, and is excellent cardio.

Plus, if you get in trouble, jessamyn can rescue you!
posted by misha at 1:48 PM on November 5, 2007 [1 favorite]

Swimming's probably the best equivalent you can do while still being gentle to your knees.

Lots of exercise machines overestimate the number of calories burned, so I would take ignignokt's advice on the elliptical with a grain of salt, but the elliptical is quite good for cardiovascular fitness and a good choice if you don't want to get wet - check out this recent post.
posted by Metroid Baby at 1:52 PM on November 5, 2007

Response by poster: Thanks for the replies so far. Unfortunately my gym doesn't have a pool. Although i am trying to swim at least once a week. I like the way that the couch to 5k starts off slow and gets harder. What would you think would be the equivalent of say 5 mins running on a bike? If I can figure out distance/time equivalents I can probably set up my own bike (or eliptical) based regime.
posted by gergtreble at 2:04 PM on November 5, 2007

Hot yoga (aka Bikram's) has done more to improve my knees than physiotherapy, anti-inflammatories or swimming. (I tried all three first.) The relevant positions of the yoga sequence go against ignignokt's advice on squats, but, hey, they worked on me. YMMV.

I now combine running with once/week yoga, and my knee problems have not returned.
posted by mediaddict at 2:10 PM on November 5, 2007

OK, look, if your knees are killing you taking a break is not "being a quitter", it is "preserving your joints". There is a difference between wimping out due to muscle soreness and wimping out due to real my-body-is-trying-to-tell-me-to-stop pain.

Get on the elliptical. That will do some good cardio work, and while it won't prepare you for running you will get cardiovascular training in. If you really want a workout try the Interval Training progression at the bottom of the page. But do watch your knees! If they start hurting do the interval training on a different machine!
posted by Anonymous at 2:23 PM on November 5, 2007

I injured my knee in week 2 of Couch to 5k! Look through this AskMe search and you can find several threads about aerobic exercises that don't involve knees. I like working out with a medicine ball.
posted by kamikazegopher at 3:28 PM on November 5, 2007

I started at 220lbs running and have worked my way down to 190lbs over about 6 months. The first 3 months I alternated with an ellyptical or cycling a day or two a week and then 2-3 days running. It helped give my knees a chance to heal but kept up the cardio AND allowed me to keep up my running muscles.
posted by Octoparrot at 4:23 PM on November 5, 2007

I highly recommend adding some lower body weight training to your regimen while you're recovering. The best thing I ever did for my knees was weighted squats. Here's the best online article I know on squatting (be sure to read parts 2-4 as well), and look here for specific details on patellofemoral syndrome, should that match your symptoms. (Yes, this is a site aimed at women but most of the information applies equally well to men).
posted by ch1x0r at 5:00 PM on November 5, 2007

No one's mentioned rowing yet. If you live in a city with water, chances are that there's a rowing club. Rowing burns more calories than just about any other everyday cardio exercise, and it works your whole body. I'm not sure what rowing culture is like in the UK, but most clubs in the states welcome non-competitive rowers.

It's not as idyllic, but you can get a good workout on a rowing machine, too, and most gyms have a few. The leading manufacturer, Concept 2, has an online community and ongoing competitions to keep rowers motivated.

I've been rowing at the gym for about a year, and rowing out of doors for about two months, and I think that it's actually *helped* my knees.
posted by freshwater_pr0n at 5:10 PM on November 5, 2007

A couple years ago, I tried running for a while. Within a few days, I found that my knees were just killing me. My ankles weren't so hot either.

The first thing I did was get off the treadmill and onto the road. This helped, but over time (a couple weeks) my knee problems began to return.

The next thing I did was put some Dr. Scholl's gel inserts into my shoes. Again, this helped, and in fact my knees stopped hurting entirely, but my ankles still felt it after a while.

The final thing I did was invest in some real running shoes, not just whatever sneakers I had at the time. I moved the gel inserts over to them, and after that I had no trouble with my knees or ankles.

To be fair, though, I only kept it up a couple more months before I decided that I really hated running and started swimming instead.
posted by solotoro at 7:34 PM on November 5, 2007

There is certainly no shame in choosing to stop running because you need to preserve your knees. If you choose to keep running, icing your knees for 15 minutes after each run can do wonders for reducing inflammation. During sensitive times and heavy training times it can be the difference between staying on the road and not.
posted by OmieWise at 7:51 PM on November 5, 2007

Yes, running shouldn't be that hard on the knees.

You can use the 5k programme pretty easily by just focusing on the durations. If you have a way of measuring your heartrate (electronically, by hand or by just sensing your exertion level) that would be ideal. You can find out what your anaerobic threshold is by doing a conconi test. Then pick an exertion level that's not too far below your anaerobic threshold and start training using the durations from the 5k programme on either rowing machine, bike or in the swimming pool.
posted by jouke at 8:25 PM on November 5, 2007 [1 favorite]

The first several weeks of the couch-to-5k program are in the walk-jog-walk stage. The alternating levels of intensity help increase your cardiovascular fitness while you're still not fit enough to actually jog for large chunks of time. You can mimic this effect on a bike or elliptical machine by adjusting the resistance at 30-second or 90-second (or whatever they are recommending for that day) intervals - you should be alternating hard bursts with easier bits to recover. Pay attention to your heart rate and how hard you're breathing, and you should be able to find good approximations of "jogging" and "walking" intensity. This won't do anything to help your knees, but it will help improve your fitness without continuing to hurt them. I have no idea how much extra weight you're carrying, but perhaps the running will be easier on your joints once you've dropped a few pounds with the lower impact exercise.
posted by vytae at 8:27 PM on November 5, 2007

Lots of good tips here and I just wanted to add, there's no shame in taking Ibuprofen to help with knee pain. It helps reduce inflammation so that your joints can heal. You want to be somewhat moderate in how much you take and it can upset your stomach but I always take mine with a little food and that plus taking it easy for a day or so, stretching and varying my exercise usually gets me past my knee pain. Good running shoes are a must and I've found that doing wall-sits is a great exercise to get my knees in alignment. However, those were recommended to me by a physical therapist I saw for knee pain so it might not work for your knee pain. I was also overweight at the time so, of course, dropping pounds is the best thing you can do.
posted by amanda at 9:04 PM on November 5, 2007

With the bike you could always get a heart rate monitor and use this to scale up your riding. Use the C25k model of different times, but monitor your heart rate so in the "walk" sessions your heart rate stays at say, 130, and then in your "run" sessions let your heart rate get up to 160 or so.


Polar have good HR monitors and helpful programs you can use as well, not that I'm spruiking for them.
http://www.polarusa.com/consumer/cycling/getstarted.asp

Of course, this is a bit hard outside on a bike as weather/road conditions will dictate your workout intensity to a degree, but you could always start on a stationery bike, do the 9 weeks, and then hit the road for real.

Good luck.

Oh and I'd recommend getting some proper advice on strengthening your knees from a physio - the right exercises can do wonders, even if you're not running. You don't want weak knees, especially as you get older.
posted by jasperella at 4:09 AM on November 6, 2007 [1 favorite]

i started the couch-to-5k about 6 months ago, did about 4 weeks and had bad pains in my shins. i stopped for about a month, then started again, and I'm now on week 8 with no pain.

not sure if that's of any use, but it's my experience.
posted by ascullion at 4:36 AM on November 6, 2007

erm.. make that "started the couch-to-5k about 4 months ago"
posted by ascullion at 4:37 AM on November 6, 2007

You can do the C25K on the elliptical...just go at walking speed to walk, faster to "jog". That's how I do it when my knees get cranky as the weather changes. I've been through the whole program, but my usual "jog" is to do one of the week 5 or 6 routines. If I've got a 5K on my calendar, I ramp up with the last three weeks of the program just before. But mostly I just do it to keep interested.

By the way, this guy's podcasts were really helpful for me, so I didn't have to keep track so much.
posted by foxydot at 2:40 PM on November 6, 2007

Also, I'd second the advice about getting your gait checked. USually people with knee issues have alignment problems. I had to learn to point my toes straight forward when I run...takes concentration and makes a light jog a very head-clearing experience (can't think about work, money, etc.) when concentrating on putting the feet down straight!)
posted by foxydot at 2:42 PM on November 6, 2007 [1 favorite]

I've had similar experiences with running. I ran a little bit years ago, but after putting on about 30 pounds in the past 4 years, it's taken its toll on my body when I try and run.

Now, I run 1-3 days a week depending on how I'm feeling, and if I start to feel sore or have problems in my knees or shins, I take some time off. However, I do a lot of work on the cycle machine, which I've found to give me excellent heart conditioning if done right. (I aim for at least 3 days of cardio a week, 5 is my goal with the majority of the time on the bike, as I'm also a mountain biker)

I do the Hills > Interval program on my machine (which alternates between one minute of difficult resistance followed by one minute of light resistance). This allows me to do HIIT (or High Intensity Interval Training).

I've found that by doing hard bursts of 60 seconds, followed by light spinning for 60 seconds, my running has actually improved significantly without needing to run that often. Just running once a week has allowed me to lose weight, build my heart conditioning, and successfully run a 5k without that much training *actually* running.

Throw in some core exercises after every workout, and it's showing a marked improvement in my overall health.

For me the key is to run, but keep the frequency low while my body gets stronger and adapts to the demands slowly.

Also, stretch stretch stretch stretch. Before and after. REALLY WELL. And sit in the hot tub when you can if your gym has one.
posted by adrock31 at 3:20 PM on November 7, 2007