Runner's knee while training for first half-marathon
November 29, 2014 8:56 AM   Subscribe

I've been training for my first half-marathon in two weeks following the Hal Higdon Novice 2 program. My knee has been acting up more and more during the long runs. What to do now?

Some more details. Happy to provide more if helpful.

On my long runs the last 3 weeks or so I've had a lot of difficulty finishing the run because of pains in my left knee. About halfway through the run 3 weeks ago and 2 weeks ago I've had to walk for a while and then when I started running again it was with some great pain. Last week I took some big hills on the long run and as I came downhill around mile 8 (of a projected 11) I had to stop because of the pain. I took it easy this week -- iced and elevated the knee Monday and Tuesday, and did the elliptical Thursday. I did a short 2 mile run yesterday (Friday), at the end of which I felt some knee pain, and again after 2 miles today at a reduced pace I felt some slight knee pain. Not sure what to do now.

Some specific questions:

Can I still do the half-marathon in 2 weeks? What should my training look like?
How should I be trying to help the knee? Stretches? Exercises?
What's the best place to look online for answers to these kinds of questions?

I have to admit I haven't been very consistent with the training, which is probably part of the problem. I've rarely gotten all 3 mid-week runs in -- more like one 3mile run and one longer run (4 or 5 miles). If I'm honest I've also only gone cross-training probably half the suggested time. I also have been repeating weeks since I began the training far too soon. Could that be part of the problem?

It seems like the runs have been generally feeling worse since I did a 10k about a month ago, where I ran much faster than I normally do (even at pace runs for training). Could that also be the culprit?

I'm a 27 year old male if relevant.
posted by crazy with stars to Health & Fitness (8 answers total) 2 users marked this as a favorite
Go to a physiotherapist, follow their advice. This could be any one of a number of things and the only way to find out is to ask someone who knows. I developed dodgy knees while training for a marathon, about a month before the event. Some physio treatment (massage, taping, and doing the daily exercises she gave me) got me through the race, but on her advice, I didn't do any training in that last month, and just coasted by on what fitness I already had.

Incidental question: How are your running shoes? Did you get them from a specialist running store after having them analyse your gait? How long have you had them? How far have you run in them? Shoes that don't suit your gait or that are worn out and have lost support can cause all manner of aches and pains, so sometimes getting new ones makes the pain go away (though this is best done well in advance of a race so you can break them in - two weeks might be a bit tight for time).
posted by penguin pie at 9:06 AM on November 29, 2014 [2 favorites]

I agree with penguin pie re getting professional advice. Funnily enough I just read an article that the importance of "the correct running shoes" is way overblown. YMMV of course, there is so much conflicting information out there (and I personally did get running shoes adapted to my needs).

I'll tell you what has helped me with every single one of my niggles so far though:
- I have a sports therapist. She tortures (i.e. massages / stretches) me and tells me what to work on.
- I do strength work, stretch and foam roll, based on the advice of my sports therapist and personal trainer.

This won't help you with your race in two weeks of course. I don't feel qualified to answer that question.
posted by ClarissaWAM at 9:13 AM on November 29, 2014

Are you 100% sure it's runner's knee and not ITBS? Totally different problems.
posted by roomthreeseventeen at 9:22 AM on November 29, 2014

Try a "patellar strap" to see if it significantly relieves the symptoms. If so it is probably chondromalacia. This is extremely common in runners. A strap often provides very prompt relief. It it works then you know it probably is chondromalcia, which is usually self limiting in men but tends to be more chronic for women. Has to do with the positioning of the knee cap over the knee joints. Not to dissuade you from seeking professional advice but this can be a quick and easy test (and perhaps fix).
posted by rmhsinc at 10:14 AM on November 29, 2014 [2 favorites]

What you're describing sounds somewhat like ITBS but that's hard to say for sure. It's more possibly ITBS if you feel the pain on the outside of your knee. You need to note where exactly on your knee the pain exists and the mileage where it starts to act up. My ITBS acts up reliably between mile 1.5 and 2.5; incidentally, I just ran a 10K on Thursday and changing my gait when I noticed it kicking in (by running more forward on my toes rather than heel first) allowed me to finish the race without issue.

That's just my anecdote. You definitely need to get it checked out by someone professionally if you want the correct diagnoses and stretches to prevent it in the future.
posted by glaucon at 10:44 AM on November 29, 2014

You need to cut down on training, or stop completely

And you need to cut down, or stop for long enough, so that training doesn't hurt anymore.

You're doing too much. That's what your body is telling you. It's not "normal" for people training for a half marathon to have so much pain while training to make them stop training.

Don't "run through the pain."

If after training less or not at all you still hurt, then you should see a professional. But not before then.
posted by BadgerDoctor at 5:19 PM on November 29, 2014

I have had various iterations of tendonitis in my decade as a runner — both runner's knee (patellar tendonitis) and IT band syndrome are basically versions of the same thing — an inflamed tendon — in different parts of your body. In all cases of tendonitis, the treatment is rest and anti-inflammatory. The trouble with inflammation is that, until it heals, it'll usually calm down after a day or two until you start running again, and then it'll flare back up about a mile or so in. So you'll think you are okay to run because it won't hurt — until it does. Training inconsistently can definitely be a cause.

How many miles are you up to in your training? If you are up to about 9-10 miles then you can probably take two weeks off and then run the full 13 on race day. If you are only up to about 6-7, especially if you've been running inconsistently, I'd give the race a pass.

For both of my cases of tendonitis I was able to get treatment via my GP (so, no specialist). The treatment was NSAID and rest (more rest than you think you need, because as I said before, it won't hurt until it does — which is why I recommend not running until race day if you can.) After my two bouts with tendonitis I am much, much better at recognizing the onset and treating it before it becomes a problem. This usually requires a few days of rest, not the full two weeks. A friend who is actually a running coach told me keep an Rx of slow-release high-dosage NSAID on hand all the time, and I just take that when I feel like I might be aggravating my knees or IT band.

One more tip — if it's ITBS, rolling with a foam roller or "The Stick" will help. It'll hurt like a motherfucker but it will help. (The Stick hurts less than the foam roller.)
posted by Brittanie at 6:35 PM on November 29, 2014

I've had some knee issues while training for a half marathon, so I wore an ace bandage around the knee all the time so that it didn't have to get tired from normal every day walking. This really helped the knee when I did have to run, because it wasn't as tired by then.

Just like you, I also never ran as much as the training program recommended - only a 3 mile, a 3-5 mile, and a long run every week, I never cross trained, and I was able to run 3 half marathons with this kind of training program, so don't worry about the training. As Brittanie said, if you're able to run 9-10 miles, then you should be OK to run the half marathon without any additional training for the next 2 weeks. It'll be hard, but could be do-able, if your knee is rested. Just make sure you have enough gatorade/gu/body glide or whatever your long run needs are.

But keep in mind that everyone is different and your knee sounds like it's a bit worse than mine ever worse, and you should listen to your body, etc etc.

Good luck!!
posted by at 8:53 PM on November 29, 2014

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