Starting to run again—good habits?
May 20, 2019 5:51 AM   Subscribe

Literally 20+ years ago, I got into a good routine of running five or more miles almost daily. I stopped running totally about 10 years ago. Other than walking 3-8 miles daily, I really haven’t exercised aerobically in maybe 7 years. I want to start running again (at age 44), and did my first run yesterday. It was ok—though with some knee pain. Can you help me get on the right foot and hopefully make this program stick?

Bought new shoes (and synthetic socks), strapped them on and did a mile at a comfortable 12 minute pace. Route was on sidewalks and some walking trails. Towards the bottom of the mile, my right knee—or just below) started hurting. I alternated walking and running for another mile or so. Sprinted to a finish because of rain—the knee was ok and didn’t hurt afterward (including today) though my quads are pleasantly sore.

I guess the biggest question is around the knee. It was just the first time out, so limited data, but I’d like to stay in front of that. What should I be doing to avoid doing damage?

More generally, what good habits can I be starting now—or bad habits can I try to avoid?

My goals are some weight loss/toning and stress release. Not really interested in working towards competitions or the social aspects of running.
posted by Admiral Haddock to Health & Fitness (23 answers total) 41 users marked this as a favorite
Doing hip abductor exercises (basically #3 here) accomplished what felt like a miracle cure for my knee pain.
posted by exogenous at 6:01 AM on May 20, 2019 [11 favorites]

Couch to 5K worked for me. Cheerful and non-judgmental.

Plus a sticker chart (seriously -- I have a sticker chart up in the kitchen, right next to my 3 year old's).

And working out a schedule that other people in my household also had to rely on, so if I didn't go I was messing up their schedules for the week as well as mine. This meant I had more motivation to go even when I was feeling lazy.
posted by EllaEm at 6:04 AM on May 20, 2019 [4 favorites]

Find yourself a good Couch to 5K programme - not sure where you are, but the NHS does a good podcast one in the UK (not sure if it's available elsewhere but look it out). Alternatively, this one from a previous comment of mine is a great way to build up. You don't really want to go from zero to running for a mile non-stop, better to alternate walking and running over a longer period of time and build up that way. You can start part way through the process if you think you're already beyond just 30s of running (eg. run 2 minutes, walk 3 minutes, for half an hour).

Bad habits to avoid - don't go back to running daily. Your body needs time to rest and repair between exercise sessions. There are people who have 'run streaks' lasting months or even years, but it's generally not recommended.
posted by penguin pie at 6:07 AM on May 20, 2019 [2 favorites]

Just to add - when you (re)learn to run, you're not just strengthening your muscles and cardio, you're also strengthening the ligaments, tendons, the padding in your knee joints etc. So you need to break them in gently and give them the chance to strengthen over time, not just run as far as your lungs/leg muscles will take you. Stop before you think you need to, include walk breaks, gradual build up, will all help your joints develop strength as well as everything else.
posted by penguin pie at 6:09 AM on May 20, 2019 [8 favorites]

One thing that's helped me re: knee / ligament pain is using illotibilial bands until you feel like your legs are back under you - if that's what's hurting your knee. Worth checking out.
posted by RajahKing at 6:18 AM on May 20, 2019 [1 favorite]

I hate to be a bummer, but as a person in your same position, I have unfortunately concluded that it's not realistic to rely on running as a way to get fit in your mid-40s, especially when you're starting out with knee pain right out of the gate. You have to cross-train, and focus on building muscle and flexibility, then add in low-impact cardio.

As for the knee pain, there's not a ton of research on this, but what I could find substantiated strengthening the quads, hip abductors, hip lateral rotators and extensors.

When I started working with a trainer, he specifically discouraged me from doing high-impact cardio (other than the shortest baby jog to get coffee) while I was building strength. He advises his clients who feel like they need to do cardio to walk on the treadmill set to the highest angle.

If you're still not persuaded, I will second Couch to 5K! But I would repeat weeks as needed, and not run through any knee pain.
posted by schwinggg! at 6:35 AM on May 20, 2019 [3 favorites]

What should I be doing to avoid doing damage?

You should be taking the passage of that 20+ years seriously enough not to expect your body to build and recover itself as quickly now as it did then. Back off your expectations about rates of progress to what's easily achievable rather than going in as hard as you used to, and give small injuries especially to cartilage and tendon as long as they need to heal up properly before pushing them again. Be more conservative about pain generally so that those injuries are all smaller to begin with. Make doubly sure to be kind to your Achilles tendons.
posted by flabdablet at 6:37 AM on May 20, 2019 [1 favorite]

++for cross-training.

Knees wear out so incorporate some aerobic activities that do not involve impact loading of your knees such as bicycling or swimming.

At age 62, after 40 years of running as my primary form of exercise I had to stop. I will need knee replacements within the next 5-7 years. Don't be like me.
posted by mygoditsbob at 6:52 AM on May 20, 2019 [1 favorite]

I just turned 41 and I can't really run anymore without knee pain. I can't enthusiastically do the martial arts I used to love either.

I have renewed my love of cycling which has been a great low impact exercise for me. You may want to consider some alternate activities besides running.
posted by gnutron at 7:04 AM on May 20, 2019

There are certainly cases in which running causes knee problems. It seems perfectly reasonable that adding in strength training and other types of cardio will reduce your injury risk for knees and other parts of your body. And knees can wear out, and some older people have to stop running because of knee problems. But overall, the evidence is that running is good for your knees.
posted by Mr.Know-it-some at 7:04 AM on May 20, 2019 [2 favorites]

As a 40-something who wishes she had never run, and only walked fast or done other activities, consider that running is very hard on the knees, and that the damage cannot be undone. Everyone I know who used to run has stopped due to knee problems. The people who continue running through their 40s and 50s and beyond are a very specific self-selecting population who somehow manage to not have joint problems (or they ignore them and then face greater damage.) Consider doing something kinder to your joints.
posted by thegreatfleecircus at 7:08 AM on May 20, 2019

It's a long shot, but if the pain was outside below the knee (1:30 on the right side or 10:30 on the left), you may be able to "reset" it.

I got this pain after no more than a quarter mile any time I tried to run until age 30. Eventually I was able to build up the muscles, tendons, and ligaments that the pain no longer presented itself.

To "reset" either run up a flight of stairs every time the pain starts(like I said, my pain occurred at 1/4 mile, so stadium stairs at the 1/4 mile high school track worked perfect) or do a set of pushups/plank for 10 seconds.

It may work for you; it may not. Basically, you've got to build up your legs over time, without overwhelming your system with pain.
posted by notsnot at 7:10 AM on May 20, 2019

Since you say you ran on sidewalks and some trails, I do find that concrete is harder on the knees and shins and try to keep my runs mostly on the trails.
posted by rodlymight at 7:19 AM on May 20, 2019 [1 favorite]

I am in a similar age range and have always relied on running for my exercise, but am getting into the chronic pain realm with my routine.

My trouble areas are different from yours, so I don't have any knee-specific recommendations. However, in my quest to alleviate my own pain issues and still keep running, I was recommended the book ChiRunning as a good guide to developing better body habits/form while running. Disclaimer is that I am still in the process of reading it so can't attest as to the effectiveness of the techniques!
posted by tentacle at 7:21 AM on May 20, 2019 [1 favorite]

The adage I’ve heard is “you get in shape to run, you don’t run to get in shape.” If you love running, by all means run, but it should be a part-of-this-complete-breakfast kind of exercise, accompanied with some strength training and cross training. Focus on exercises that build your hips, glutes, quads, core - any muscle group covered up by a pair of shorts. Gaining strength in these areas will reduce the stress on your ankles and knees.

I’ve had knee and ankle pain in the past, and it will reappear or get worse if I push myself too hard too fast. When you’re getting back into an exercise or recovering from an injury, there’s often a stage where your confidence (or impatience, sometimes) outpaces your physical body, and that’s when you risk making things worse. Start small, run slow (even if you can run fast) and increase the time/distance gradually - no more than 10% per week is what I’ve heard, but if you’re starting out or currently injured, slower than that. If you’re thinking “ugh this is too fucking slow” during a run, you’re doing it right.
posted by Metroid Baby at 7:45 AM on May 20, 2019

If you sit at a desk job like I do, follow the strengthening exercises that exogenous links to above. Three years ago, after being very sedentary with pregnancy and an infant after I used to run, I had pain just below my left knee. I went to PT a couple of times, and it really was needing to strengthen the connecting muscles. Your legs are springs, so you need to strengthen all of the bending points of the springs.

Additionally, for me, WALKING exacerbates my knee issues because I do heel strikes with my stride and that seems to send the impact directly to my knees. Learning how to run minimalist with a mid-to-fore foot strike instead (and learning on the grass along the sidewalk instead of the sidewalk itself) lets me run longer with no pain to my knees. I think this is because some of the impact is in the foot bending, some of the impact is in the ankle bending, some is in the knees, and some is in the hips. So the same force is spread out across multiple bending points.

A good way to strengthen the hips and lower abs and fix your stride a bit is to practice 100-ups. At our ages, the strength of all the binding muscles has deteriorated a bit, so we can't just go for a run like a 20-something. We gotta re-strengthen our bodies, first, mindfully.
posted by jillithd at 8:30 AM on May 20, 2019 [2 favorites]

I'm 37, but I tore my PCL when I was 20 and it is arthritic and requires constant management, so I've been running like an old person wrt knees for closing in on 20 years now.

I'd like to second that you have to take care of your hips (those exercises are great and you should do some of them before every workout), that "you get in shape to run, you don't run to get in shape" and that you have to focus on your leg muscle strength with weight training in order to be able to run a lot with minimal pain as you age-you should be lifting weights as often as you are running.

The last thing is that you have to expect some discomfort-if you wait until there isn't any pain, you'll rarely go running. My knee will sometimes take a mile to warm itself up and I just have to get through it; if I didn't, I'd never run. Learn the difference between pain that hurts and pain that indicates an injury.
posted by Kwine at 8:31 AM on May 20, 2019 [1 favorite]

I ran in my 20s, stopped, gained weight, lost some, then started running again at 46. I have a sensitive spot on my right leg, just below and to the outside of my knee, from a bike crash several years ago. I stopped again for nearly a year after a slip on the ice messed up my groin, but I've been back since April 2018. I'm evidence that despite all that it's possible to run without pain in your 50s.

By far the best advice I can give is to take it easy and do exercises to stabilize your core and hips. Jay Johnson's SAM (Strength And Mobility) routine is popular. Running puts a lot of stress on bones and connective tissue, so allow sufficient recovery time between runs. I'm currently running four days a week, after close to a year of three runs a week, and I make sure that on back-to-back days at least one run is at a very easy pace. I might end up adding a fifth day this fall, but if so, it will also be a short run at a very easy recovery pace.

Matt Fitzgerald's book 80/20 Running is worth a quick read, too. His basic point is that many runners do their easy runs too hard, which means that they unnecessarily risk injuries and can't do their hard workouts as hard as they should.
posted by brianogilvie at 9:12 AM on May 20, 2019 [4 favorites]

I'm a runner in my 40s and I find running helps my knee strength. I had ACL surgery 3+ years ago, and my knee feels less stable when I'm not running 3 times a week vs when I am. But I'll admit this is likely because when I'm actively running, I'm also doing other associated exercises:

- Stretch after any run. At least 10 minutes, ideally more, with my focus on hamstrings and hips. Your body may vary (for example, my partner has to stretch his calves a lot more than I do.)
- Foam roll after any run. At least 5 minutes, 10-15 after a longer run, with focus on quads, glutes, IT band.
- Do runner stability/other strengthening exercises at least twice a week. I use the Nike Training App which has a few different bodyweight routines I can do at home, or the PT exercises I was assigned after my knee surgery. Lots of hip and core strength.

I was never a runner as a young 'un, but nevertheless I had to get used to the idea that my non-running time doing stretching, foam rolling, and other strengthening exercises was nearly a 1:1 match for my time actually running. I also agree with the above comment about learning what pain you can run through and what you can't.
posted by misskaz at 9:13 AM on May 20, 2019 [4 favorites]

I started running at age 36, and for the years prior to that, I'd periodically have sore knees requiring me to wear a brace/wrap to alleviate the pain for a few weeks, and even once ever 2-3 years would just have the knee randomly give out while walking (followed only with surprisingly minor pain). Since starting running, I had some IT band pain saw a physio and got exercises that alleaviated the pain. Occasionally a knee will get a bit grumbling during the 3k-5k point of a run. Beyond that my knees are suddenly great.

I'll N'th that the habit to add is additional body/strength work. I like the SAM routine mentioned up above (modified form the myrtle routine that's otherwise been mentioned on ask), but anything to work your glutes/hips will do wonders to preventing/limiting injury. Not mentioned yet (on preview I do see a stability mention), but one legged balance work can help fine tune control of the musculature.

While my knees have been great, I've had some time off due to lower leg overuse injuries. When these have occurred, I've always realized it's been 6+ weeks since I last did some strength work beyond running.

The other thing, is congrats you're a master's runner. Maybe in the past when in shape you could do 3-4 hard workouts. Now, plan for 1-2/week. Note, by workouts I'm not including aerobic running. I'm assuming since you mentioned previously being a runner that you know you shouldn't run as fast as you can all the time.
posted by nobeagle at 10:19 AM on May 20, 2019

The adage I’ve heard is “you get in shape to run, you don’t run to get in shape.”

This + all suggestions above to cross train.

I prepared myself for running, after a long hiatus, by spending the first six months focusing on just strength training (with extra focus on core strength), yoga (with extra focus on hip flexors / IT band and all the muscles in my feet and ankles), and low impact cardio like cycling. When I did start running again, it felt much less jarring and I had the baseline flexibility and strength to handle the new routine.
posted by nightrecordings at 4:15 PM on May 20, 2019 [1 favorite]

I completed Couch25k when I was 58, didn't maintain a jogging habit, and five years later when I tried again I really hurt myself. And spent weeks hobbling up and down stairs, so am watching this Ask with interest. I have found that returning to a routine of stretches and squats has reduced my knee pain, and am hoping to go light jogging again eventually. I was surprised that squats have helped so much.
posted by glasseyes at 1:17 AM on May 21, 2019

I'm a 43-year old runner who has to watch out for iliotibial (IT) band pain. I agree with the other suggestions that some kind of strength training, even just using your own body weight, is very helpful. I actually invested in a squat rack and free weights and found that doing squats, and trying to actually gain strength in the squat, significantly reduced the incidences of IT band flareups. One reason for that is that most people, including myself, have a pretty weak posterior chain of muscles, due to all of our sitting. As I have strengthened my butt, I can run from those muscles (and my calves) more than I used to, which takes load off of my quads and hips.

This leads me to a few suggestions I haven't seen here. I am not a doctor, or a trainer, but here are things I try that are totally personal to me, but hey, maybe they'll help. Also, I should mention that, in addition to being 43, I am 5'9" and 160 pounds.

Focus on biofeedback. I think people just assume they can run. I have found that it has taken me quite awhile to get "good" at running, which only means that I can enjoy it and that I don't get injured from it. I try to pay attention to how I am feeling all throughout the run and adjust based on that. I have never tried to power through obvious pain. There's absolutely no training benefit to that. It's hard to know, of course, what's pain because a tendon is being abused, versus discomfort because muscles are weak. I think in general, I would stop immediately at any pain that has any kind of sharpness or urgency to it. Muscle pain from lactic acid buildup is usually slow to build and duller, and I suppose I do run through that. My one exception to running through sharp pain is that I occasionally get side stitches if I haven't focused enough on breathing. At the beginning, I mostly focus on going slow-ish and getting my breath cycle really strong. From the middle to the end, I focus on going as fast as I comfortably can, which leads me to...

Run as fast as you comfortably can for shorter durations. I find that lengthening (and loosening) my stride and directing my energy more horizontally helps a lot with knee and hip tightness. I will admit that I've had many people tell me that I have the body (long torso) and form (longish stride and mostly midfoot strike, little vertical movement) of a distance runner, so maybe I'm just lucky. I have been running for years off and on, and I find that a good comfortable run is about 25 minutes at 9:30 pace. It certainly gets my heart rate up to meet the general exercise recommendations. I'd like to eventually do a sub eight minute pace, like I could in my early 30s, but I don't ever plan on running a marathon.

Do active warmup stretching. I've added this in the last few years, because IT band pain takes me away from running for 6 weeks or more, and I hate that. I do air squats and one-legged deep knee bends, focusing on getting a mild burning sensation in my butt. I want my butt to feel activated, as if I were about to lift weights, before I start to run. I actually don't stretch after I run, as I think it's better for me to get my muscles really warmed up beforehand. I've read that stretching after intense exercise is actually risky as your muscles are weakened and could be strained by stretching. I do a long cool down walk after running and then try to remain standing once I'm back home for at least the next 30 minutes. I'm really a believer that it's not the running that's the problem, it's all the sitting in front of a computer that hurts my hips and knees (I am a designer as my day job).

Think about how you sleep. This may seem weird, but in relation to the sitting thing, I have found that as a habitual side sleeper, I am stretching out my hips in weird ways while I sleep. I'm not always great at remembering this, but I try to alternate in periods where I fall asleep on my back and periods where I sleep with a very slim pillow between my knees if I am going to sleep on my side. I also try to straighten out my legs and align my body comfortably straight before sleeping. The pillow between the knees thing is mildly aggravating, but it's a strength training trick for dealing with tight and sore hip muscles.

Good luck! Running is awesome!
posted by Slothrop at 5:20 AM on May 21, 2019 [2 favorites]

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