Novice runner (k)needs help!
June 6, 2013 5:32 PM   Subscribe

After not ever running before in my life (without being chased), I've started Couch to 5K. Week 2 is where the trouble began......

I am significantly overweight (5'2" and 220ish). My husband and I are doing Couch to 5K to get in better shape. Everything is going well except for one thing. My right knee is killing me.

I'm running extremely slowly (4.5mph is my fastest right now), so I'm not overdoing it. I'm doing two rest days in between runs. I ice when I remember/can. I take naproxen. It doesn't hurt the whole time I'm running, but it's always sort of there in a subtle way. It's worst when I'm going uphill or turning or otherwise putting more weight/tension on it than I normally would. It even sometimes hurts later that same day (like right now) when I go up and down steps especially. I run on concrete, usually...I know it's not ideal, but I'm still exploring different trails and options to get away from the concrete.

Other important info: I have bursitis in my right hip and a very tight IT band on the right as well. I've tried those stretchy brace things, but embarrassingly, they don't fit larger-circumferenced legs like mine. I have awesome shoes already, so they're not the issue.

Questions: what can I do besides ice/naproxen? Should I be taking things even slower? Should I have my gait/form looked at? Should I (gasp) give up before I screw myself permanently? All or none of the above?
posted by altopower to Health & Fitness (26 answers total) 10 users marked this as a favorite
I woulld see a sports doc asap. or physiotherapist. they can help with preventative stuff as well as how to handle the pain.
Definitely don't give up! Maybe take it back a notch and replace the running with walking until your muscles and knees and whatnot have adjusted. In no time you'll be back at the running! Rest is super key and paying attention to how your body feels - slow it down if it's starting to hurt.
posted by katie521 at 5:35 PM on June 6, 2013 [1 favorite]

Response by poster: I should add one more detail about the pain itself...what seems super apparent is that the knee is very unstable and weak. Even when I'm just walking lately, it seems to be a lot weaker than it used to be.
posted by altopower at 5:39 PM on June 6, 2013

I would quit running for a while, and see a doctor if you can. You really, really don't want to mess something up long-term or even permanently. I tried to ignore and/or deal with running pain on my own and it turned out I had a stress fracture in my femur and I couldn't even go for a walk for three months while it healed. That sucked.

If you can walk without pain, try doing that for 30-45 minutes a day instead, at least until you're pain-free.
posted by something something at 5:45 PM on June 6, 2013 [1 favorite]

what seems super apparent is that the knee is very unstable and weak. Even when I'm just walking lately, it seems to be a lot weaker than it used to be.

Second seeing a sports doctor or a physiotherapist for PT and exercises. Have you tried the foam rollers on your IT band? Any stretches? If you have weak muscles, running may exacerbate those issues. I would say that kind of sounds like patellofemoral syndrome but honestly, knees are incredibly complicated and prone to a lot of issues. Don't give up, but maybe try a day of biking or swimming a week, if your doctor okays it? They're lower impact, and they can help build up weaker muscle groups that running doesn't help with.
posted by jetlagaddict at 5:52 PM on June 6, 2013 [1 favorite]

Yeah, I'm not a medical professional, but I am a runner, and for me that would qualify as a "quit running until you find out what's wrong" type of problem.
posted by outfielder at 6:17 PM on June 6, 2013 [3 favorites]

I'd see a doctor just to be safe. Before you go, I'd try to identify very specifically what pain your experiencing so the doc can help. The details you gave are helpful. Also, what about trying speed walking? I don't know too much about it but it might reduce the impact and stress on your joints for now. This isn't a big deal, just take it easy, see a doctor and take it from there. And props for starting to run! It gets easier and more fun, promise.
posted by kat518 at 6:18 PM on June 6, 2013

I'm a new runner too and did the Couch-to-5k thing last year. I also have crap knees.

You don't mention your age - but I was about 40 when I started, so I was very cautious about the knee stuff. Ice, ibuprofen, and quad strengthening exercises helped me (the quad muscles help support the knee joint). It was never bad enough where I went to see a doctor --but I had pretty much figured years ago it was some kind of non-injury-related cartilage problem. Which can be chronic and managed.

Your case sounds more painful than mine - so I would definitely go see a doctor. I would bet you have a similar thing going on though. With the pain you're describing and the weight issues -- be careful and get some medical advice. Good physical therapy can work wonders. Hang in there!
posted by pantarei70 at 6:27 PM on June 6, 2013

Concrete is prolly the worst surface you can run on. Asphalt is much preferable. Trails are actually harder at first; you'll fatigue the smaller stabilizing muscles pretty quick, and you'll really wipe yourself out. So run in the road. After sports doc/ physio/ plenty of walking.
posted by disconnect at 7:00 PM on June 6, 2013

Seconding all the people saying you should get your knee looked at and possibly get some physiotherapy.

FWIW - I am also significantly overweight (your height but about 20lb heavier) and I have had temporary problems with my knees in the past. I recently started doing a Couch to 5K type regime, but on an elliptical/cross trainer machine at the gym, and I haven't had any issues with my knees whatsoever (let's hope I haven't jinxed myself). It depends what you're trying to get out of it - I wanted to use the structure of the C25K to build up my stamina and get to a point where I can exercise for longer, with a view to increasing my fitness and the amount of exercise I am able to do for weight loss etc. From that perspective, it is working, slowly. I know that no amount of "running" on an elliptical machine will make me a road runner, and it won't allow me go running with my friends, which would otherwise be nice. If I could just run around the block it would be cheaper than a gym membership too. However I just didn't feel that running on a hard surface was going to be sustainable for me in my current weight range. YMMV, but if the doctor and the physio can't fix it, make sure you consider lower joint-impact exercise before you give up!

Wishing you every success in reaching your goals, whatever they may be.
posted by Cheese Monster at 7:19 PM on June 6, 2013

I've had hip bursitis and IT band issues. Physical therapy cleared that up right quick. I highly recommend it.
posted by desjardins at 7:28 PM on June 6, 2013

Doctor for sure, and PT. My IT band issues stemmed from a balance problem which I got fixed with a lot of physical therapy and a good foam roller.

Also, do check to make sure you are in the right shoes, when you start running again.

Good luck!
posted by roomthreeseventeen at 7:36 PM on June 6, 2013

Response by poster: I messaged my PT tonight to see what he thinks...I saw him for a while to deal with my bursitis and IT band. Those have improved significantly, which is why I'm even more motivated to take advantage of increased activity.

To answer some questions, I'm 35 and haven't used a foam roller but have been interested in starting. I'd really like to keep doing the running if at all possible...I never thought I'd enjoy it, but I really am. I do plan on adding in some biking once my bike is finished with its tune up. Walking is hard for me in different ways...I have a really difficult time keeping a decent pace, and I really hit hard on my heels if I'm not conscious of it every step of the way.

So, we'll see what the PT says the very least he might have some strengthening exercises for me to do. I appreciate everyone's answers! Running is still very foreign to me, so this is a case where the hive mind is extremely helpful.
posted by altopower at 7:47 PM on June 6, 2013

Yeah, unless you've done it already, having your running shoe situation checked out is a good plan. I'm a noob runner and have had a bit of knee pain; I took myself and my shoes to a running store and the person there could immediately see that my foot, just the one on the side of the bad knee, was overpronating. She found a shoe that fixes it with arch support. Like magic! (She told me I can perhaps return to my old, less squishy shoes as my quads get stronger.) This is in addition to rest and ice and ibuprofen and stretching as described upthread. I've found leg raises especially helpful.
posted by clavicle at 8:08 PM on June 6, 2013

2nding that concrete is terrible and asphalt is better. Dirt is even better of course. The hardness of the running surface makes an incredible difference - so, I'm not sure what mileage couch to 5K has you running but you can always go shorter and work up to whatever they recommend. Or, mix walking and running.
posted by fieldtrip at 8:17 PM on June 6, 2013

Agreed with seeing a PT. But FWIW, for someone who has never run before, I would not call 4.5mph "extremely slow". The first few days I did C25k (after starting from nothing and being an overweight woman), I averaged an 18mm. Anything faster and my knees started bothering me. After a year of running, I am just now getting to the point where I am consistently doing 13mm without pain. When you do start running again, I would suggest slowing way down. Also, I found that C25k ended up not working for me because I couldn't run long stretches without my knee hurting. I use a combination of the Galloway run/walk method, taping my knee with KT tape any time I'm going longer than 2 or so miles, and ice when I can, and it's usually not too bad.
posted by kro at 9:05 PM on June 6, 2013 [2 favorites]

I would say in fact you ARE overdoing it. That's the message from your knee. It's not the speed, it's the weight and pounding.
posted by Dansaman at 9:33 PM on June 6, 2013

I did Couch to 5k last spring/summer and am/was not really overweight and still noticed some joint weirdness sometimes. (5'9"ish and about 165 at the time; I'm a little lighter now.) I'd second/nth the recommendations to get your shoes and joints checked out, as well as reconsider your running surface. I started enjoying running a lot more when I started running on the trails in a nearby park -- plus, I was usually in the shade, which was another bonus. (I also noticed that being somewhere less exposed than the multiuse path near my house made me feel less anxious about running and people judging me, which may or may not be something you also deal with.)
posted by naturalog at 10:05 PM on June 6, 2013

Also, paying attention to your strides (both length and how you step) made a huge difference in the way I ran. It's still something that I have to pay attention to (I've taken a few breaks from running for various, mostly health-related reasons) sometimes, and the adjustment period included some really, really hard runs.
posted by naturalog at 10:07 PM on June 6, 2013

I'd advise taking it slower. I agree that your body is telling you that you are actually overdoing it. In fact, 4.5mph is not extremely slow for a new runner. That's a 13:20 mile pace. You could dial it back to a 15:00 pace (4mph) or even slower and still see plenty of benefit in terms of building stamina. Going back through my logs from when I started running (in my 40s as an obese, just-quit smoker) I see that it was two months before I could run 5k consistently, day in and day out, and it was another three months after that before my average pace got down to 13:20.

Just don't run when it hurts, but if you can walk then walk. It's all about developing the habit at this point, so you'll stick with it even when there isn't an injury to give you an excuse to take a day off. Don't take the naproxen or any pain killers before you run. You'll do more damage if you run through pain that would stop you if you could feel it. Also ice immediately after every run whether you think you need it or not. The standard advice is Rest, Ice, Compression, Elevation. Stretch and strengthen the muscles around the knee.

Also maybe consider looking into a forefoot strike/minimalist running style if you haven't done that. There are plenty of skeptics, but in my experience switching to minimalist-style shoes and a forefoot strike was what enabled me to break out of the cycle of injuring my knee over and over again while I was running in all kinds of supportive and cushiony shoes to try to compensate for my flat feet and the extra weight I was carrying around.

My knees hated me when I started running too. I was significantly overweight and in terrible shape. I kept hurting my knees and having to wait and wait until they felt better and I could run again. Two steps forward, one step back for months on end. Once I was able to get into a regular running routine, there were still several weeks when stairs were just the worst thing ever. It just takes time for your body to get used to the pounding. It is possible that your knee just can't take the pounding of running, and you'll have to stick to lower impact exercise, but I think it's probably way too early to make that decision. Running is one of the best habits to have, and I wish you the best of patience and luck with your running.
posted by Balonious Assault at 11:34 PM on June 6, 2013

A few things:

1) Make sure you are stretching appropriately after running. Not that weird bouncy stuff you see people doing when you're out and about, but appropriate post-workout stretching. If you have a PT, they can make suggestions, or you can look online

2) Don't think of your knees in isolation, but as part of a larger chain of muscles/systems that work together in running. Make sure you're taking care of the chain, if one part's weak, you can get injuries in other parts. So work on your calves, quads, hamstrings and glutes when looking at strengthening exercises.

3) Especially if you consider Balonious' suggestion about forefoot strikes, you need to make sure your calves are up to it.

4) You might seek out a coach to help you make sure your form is good. Your PT might have some suggestions, or you might ask at a local running store. I know there are some places that do group runs with coaches. How you step can load your muscles better/worse, and it's hard to evaluate yourself, and why not have an expert give you the advice.

Take care!
posted by Gorgik at 5:54 AM on June 7, 2013

I tried C25K last year and just killed my knees (I think Week 3 was where I had to stop, and it was murder to go up/down stairs, sit on the toilet, etc. for a month). Once my knees felt better, I spent the half-hour I had been spending on a run climbing stairs instead. I think my knees were just not strong enough. I did just stairs for a month or two, and then went very slowly when I went back to C25K. I also had to change my gait -- I had been landing on my heels (heel strike) and I changed to a midfoot strike (landing on the ball of my foot felt too unnatural to me). I also run very slowly, probably more like 3mph.

That said, I think some people just don't have the knees for running. I don't think I do. I run the occasional 5K now, but don't run regularly anymore (I swim and walk instead) because I found that in order to prevent my knees from hurting, I just have to run too slowly to make it the best form of exercise. It's a real shame, because running is just so much more convenient than any other form of exercise, but it's just not for me. Walking is great though!
posted by rabbitrabbit at 7:45 AM on June 7, 2013

I had a similar experience with C25K - a few weeks in, pain in one knee. I took some time off and iced it up. When I got back into it, I started on trails/grass, and worked back to pavement once things felt right again. This seemed to help a lot. It's purely speculation, but I do wonder if the fact that roads are slightly pitched toward the curbs had something to do with it - that is, running on the same side of the road the entire time, with one leg slightly downhill from the other, was to blame.
posted by schoolgirl report at 10:08 AM on June 7, 2013

See if you can find a local track to run on. Often schools or parks have one you can use in the evening or on the weekend. It will put less pressure on your joints as you build them up for running. Great work getting into running! Keep at it and you'll see great results in your health and well being.
posted by cnc at 10:34 AM on June 7, 2013

Response by poster: I had my shoes fitted and my gait analyzed at a local running store, though I wouldn't be surprised if my actual gait/form (rather than just walking on a treadmill) was different. I love the shoes I have (Saucony somethings) and they feel great, but maybe I need orthotics or something. I'm working on a midfoot strike, but again, I don't know that I'm really getting that or not.

I'll (grudgingly) take some time off from running and do strictly walking till I get this figured out. I also found a dirt trail that I can run on to avoid the concrete when it comes time. Part of why I'm loving the running so much is the difference in my cardio health that I'm already seeing. Not being as out of breath, that kind of thing, is new and different for me. I don't know that I'd get that from walking as much.

The 4.5mph figure is my absolute fastest right now, definitely not my average. Average pace over the course of 1.25 miles (including running and walking) is about 3.6 or 3.7.
posted by altopower at 11:52 AM on June 7, 2013

With regards to the tight IT band, I must reiterate: foam roller, foam roller, foam roller!

I had bad bad IT band issues and my physio gave me a bunch of complicated IT band stretches, but nothing helped more than rolling it out on a foam roller. It will hurt like hell at the start, but when it gets easier, you'll know it's working.

As for the runner's knee, you will want to strengthen your quads. I bought some ankle weights and did a few sets in front of the TV every night... I don't know if this particular thing helped, but something did.

Good luck.
posted by piyushnz at 3:40 PM on June 7, 2013

I also had pain-in-one-knee doing C25K (despite running on the nice high school track), and gave it a rest for a few weeks. After talking with a running coach friend, I've just started it up again, and what I'm trying this time around is doing harder and more lengthy stretches afterwards, and also stretching on off days. Theoretically this should help prevent the leg muscles from tightening in such a way that they pull the knee out of alignment, and so far it seems to help a lot.
posted by swift at 5:38 PM on June 18, 2013

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