London Running PT

Knee pain when running – Injury prevention tip of the day 

Those of you who have followed my recent posts, will know that I have successfully been accepted to next years London Marathon, Wahoo! So in true physio-style, I have started my training nice and early and plan to share any tips, or interesting points, that come up during my training. Basically, anything I think will help you guys out, I’m going to share

So here’s today’s injury prevention tip: My training had been progressing nicely, with no hiccups, for the past 2 weeks, when out of of the blue, I went out for a slow, aerobic run and immediately noticed some pain under my right kneecap. It was nothing too serious, so I thought I’d just monitor it as the run went on. As the distance progressed I felt the pain growing in severity, creeping from a 1-2/10 to 4-5/10. So firstly, I did what most of us do at this stage, which is curse my body for being a bag of S*@T and get pretty annoyed with the situation in front of me. I was really looking forward to the run and wanted to finish the workout I had in mind.

I definitely had the urge to push on through and ignore it, but I had to take my competitive/athlete head off and put on my more reasoned and sensible physio head. I knew it would be a very bad idea to just run through the pain. The likelihood would be that I’d make it through the run, but pay for it the next day and potentially not be able to run for 3-4 weeks. Not a good idea. So I began going through my running re-education “tool box” to see if I could alter my technique, with the goal of shifting some load from my knee…so I start with an increase in cadence…30secs go by…no change in pain…Ok, let’s try a slight increase in step width….no, that’s making it slightly worse…OK, concentrate on posture – up, nice and tall and landing close to my centre of mass…hold on, wait, this might be worki…no, actually I can still feel it exactly the same as before… F@#K! 

So running technique cues are simply not working at the moment. I’m already out and running, so I can’t change my trainers. What else can I do?…light bulb moment…I’ll change the workout. So instead of finishing my steady, aerobic run, I’ll turn today’s session into a speed session. If you’re doing pure speed work, the good news is you can do this all year round and it’s not too taxing on your body. The other good news is, from an injury prevention point of view, it will recruit different muscle fibres, in different ways, and I will use different ranges of motion to that of my slower-paced, aerobic run = different load on the knee. So my workout became 8-10 sec fast run/sprints with full recovery in between and I repeated 8 times. I didn’t have any knee pain whatsoever and I still got in a decent, beneficial workout, without pushing myself into injury (I have had 2 further long-ish, aerobic runs since, with no problems – no idea why my knee was so sensitive on this particular run, but it seems to be OK now)

From an injury prevention point of view, the take home points from this story are:

  1. Do not run through pain. As much as you want to finish your workout, don’t do it! Save the war and gritted teeth for competition.
  2. Use strategies to try to shift the load from the painful area e.g. change shoes (Generally, think maximalist = more stress on knee and shin, minimalist = more stress on foot and ankle), play around with some running technique cues, or in this case: change the speed you run and therefore alter your session.

If you want some more in depth information on runners knee, and how to treat it check out my other articles:

What is runners knee? (HERE) and How to treat runners knee (HERE)

November 11, 2015

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