When I first started getting into running again a while back, I was a bit too enthusiastic and ran more distance than my body was prepared for. After my first race I ended up suffering from something that just about every runner has had to deal with, knee pain.
After the fact, I realized that the pain was the result of poor flexibility and bad running form which was facilitated by shoes that allowed me to heel strike.
I don’t have to worry about that kind of pain now because when I run I do so barefoot or in my Vibram Five Fingers (it’s hard to run in poor form without cushioned shoes, the pain will quickly force you run properly). But, that transition didn’t happen overnight and the process of rehabilitating my knees was a slow and deliberate process.
Today, I am happy to report that I run much farther distances than I was doing back then, and am doing it without any pain in my knees. So what did I do to heal my knees?
The first thing I did was schedule an appointment with a sports orthopedist. These are doctors that are specialized in treating injuries from activities like running, and are more likely to make an accurate diagnosis. An x-ray will also be useful for determining if there is any damage to the patella or the surrounding cartilage.
There are many different kinds of injuries that can involve the knee, but for me it was the very common patellofemoral pain syndrome. It is essentially a non-specific injury, often caused by poor knee tracking, and which is indicated by pain and inflammation of the patellar cartilage, and the front of the knee cap. Next, it was imperative that I stopped running until the cause of injury was determined and physical therapy was initiated to resolve it.
Through conversations with my training coach and my physical therapist, we surmised that my pain was the result of a combination of factors: excessively harsh heel striking, poor overall leg flexibility, and a far too aggressive training program. The therapist instructed me in several exercises and stretches that I needed to perform on a regular basis in order to get my legs into shape.
As it turns out, when the primary muscles of the leg (quads and hamstrings) are imbalanced they can have a tendency to pull the knee cap out of alignment within the femoral groove (the area the knee slides along when your legs bend). Poor leg flexibility exacerbates this problem because all of the main tendons of the leg connect at the knee joint.
Of course, my therapeutic exercise regimen included copious amounts of leg stretches, but it also incorporated an emphasis on proper squatting technique.
The way a person performs a squat can say a lot about the strength of their legs and the balance between the muscles of which they are composed. Practicing and perfecting the squat movement is essential for preventing injuries from every day activities, and maintaining the proper relationship between the leg muscles.
I was initially worried about doing that kind of exercise, but I found that if I went slow and concentrated on keeping the proper form, my knees were unexpectedly pain free. In fact, my knees felt better after the therapy sessions. So, reincorporating movement is an important part of the recovery process, but it is paramount that you do so within reason.
Other tips for recovery:
- Take glucosamine-chondroitin supplements. The jury is still out on these, but they may help. They contain the molecular building blocks for joint tissue and cartilage.
- Avoid sitting for long periods. The sitting position stretches the tendons over the patella, and increases pressure against the irritated cartilage without releasing it. This is usually referred to as the “movie sign” since sitting in a movie for several hours can leave you with hurting knees. I experienced this myself, in the theater, and on an airplane, and bus ride. It was a rough holiday.
- Ice the problem area several times a day, especially after workouts.
- Stop taking NSAIDs (“non-steroidal anti-inflammatory drugs” like ibuprofen) since they inhibit the healing process, and are known to reduce blood flow to cartilage. Pain-killers also prevent you from utilizing the “bio-feedback” from an injury. Pain is one of the ways that your body tells you that you’re doing something dangerous or injurious.
- Read the book Heal Your Knees by Robert Klapper, M.D. and Lynda Huey. It contained some great tips on self-diagnosing and recommendations for treatment.
In the end, once I started doing some light running (barefoot or with Vibram Five Fingers) my knees finally felt 100% again. Before that, the other stuff I had been doing had alleviated most of the pain, but there was still some minor nagging aches every now and then. It seems to me that there is something innately therapeutic about running barefoot.
With barefoot or minimalist running, your body gets a chance to move about and feel the ground like it was designed to do, and in turn it is able to tell you right away when you are doing something that will cause injury.
Of course, it is still possible to ignore those signals. The phrase “no pain, no gain” and the general attitude of runners to just suck it up and run through the discomfort probably leads to many unnecessary injuries. If we pay attention to our body, it will rarely lead us astray!