I have considered myself a runner since 7th grade when I first joined the track team. At 30 years old I like to think all these years of running have made me fairly tuned into my body. That being said it seems that there’s always something new to learn.
Winter 2012 I started to develop some knee pain while running. I recall a run that resulted in me having to actually stop completely and walk the final 2 blocks home because the pain would shoot through my knee with every step. That was usually a sign it was time to replace my running shoes. Unfortunately getting new sneakers didn’t alleviate the problem so off to the family doctor I went. I was lucky in that my doctor was also a runner and referred me to a physical therapist who was a runner as well. I can’t speak for all runners, but I think most of us feel a lot more trusting of someone who actually does what we do as he or she is less likely to tell us to just stop running.
The physical therapist went through his normal protocol in analyzing my running style as well as my feet. He stated that I was wearing too much of a motion controlled shoe and that because my arches were normal I should be in a more neutral shoe. I found that quite interesting as I had been wearing Brooks Adrenaline shoes for a few years without any issues. Rather than put me through sessions physical therapy if it wasn’t needed, he recommended that I change my shoes first and see if that helped. Luckily Scranton Running Company took back my recently purchased pair without issue to exchange them for Brooks Glycerin instead.
That seemed to do the trick. I was able to train for and run my first half marathon Sept. 2013 without knee pain. I was glad to have such a simple fix. Or so I thought.
Over the years the knee pain started again. It never was bad enough to stop my runs, but it also made them a lot less enjoyable. I knew there was no injury as sometimes my right knee would hurt and sometimes the left. Sometimes it was along the outside of my knee, sometimes the inside and sometimes the kneecap. Sometimes I could run 5 miles pain free while other times 2 miles would have them locking up. It was a frustrating mystery that left me feeling as if I’d never be able to train for a half marathon again. I tried telling myself there was no point in seeing a doctor unless I got to the point where I couldn’t run since there was no consistency in the pain. I tried to be content with the fact that I was physically able to run at all and accept the fact that maybe just age and wear and tear on my body was causing it.
This winter I reached a breaking point. Nearly every run, particularly if the weather was less than 50 degrees, was resulting in knee pain. I was afraid to run fast and I was afraid to run more than 3-4 miles. It wasn’t enough just to be able to run, I wanted to train again.
I finally caved and went to the family doctor who referred me to sports medicine. When I scheduled the appointment I was told the doctor was a runner and that all his patients said nothing but good things about him.
I was partially concerned that I could have the start of osteoarthritis, but the xrays of my knees taken at my visit showed nothing of that nature. I was diagnosed with squinted patellas (meaning my kneecaps turn inwards) which is fairly common among women given our hip structure as well as a slight leg length discrepancy, again something fairly common among most people. Neither of these sound like anything major but when you start putting your legs through mile after mile they can make an impact. The doctor recommended 2 sessions of physical therapy, one to include a thorough gait analysis, and said to follow up if I didn’t find improvement in my running.
I was extremely impressed by the physical therapy sessions. The first one the physical therapist identified my hip flexibility as a likely source of my knee pain. Having ran hurdles for years in track and done numerous hip flexibility drills I found this very surprising. He said often when we have sit down jobs it leads to losing mobility in our hips. He gave me various strengthening drills as well as foam rolling techniques to use to help improve this.
My second session was my gait analysis. This consisted of running on a treadmill while a different physical therapist filmed from behind and alongside of me. While my form and stride were very good, she pointed out that I was a hamstring dominant runner meaning I wasn’t engaging my quads or glutes as much as I should be. By relying on my hamstrings to do the majority of the work this was putting more stress on my knees. She also pointed out that my hips were dropping more than they should be, again a sign of limited mobility in them. She went over warmup drills and cooldown stretches to begin including before and after my runs.
My physical therapy sessions were right before the start of my first season coaching track for Dallastown. As any coach will tell you it seems counterintuitive but you’re usually not as in shape during the season as you are the rest of the year. This was certainly true for me as while I found time to workout, I was usually getting in just 1 run per week so it was quite challenging to figure out if my newfound strategies were helping much.
Once the season ended I began running more frequently and I’m happy to say that 90% of the knee pain is gone and I’m building up my mileage to hopefully run my 2nd half marathon this fall. As long as I do a thorough warmup with my mobility drills and foam roll regularly I only get a twinge of knee pain here or there. I have also tried to add more hills to my runs as it forces me to engage my glutes more and build strength. The days I’m not running I do DailyBurn workouts and I give props to the trainers on there for incorporating a lot of mobility and stability moves that I believe complement the exercises the physical therapists gave me. I had a follow up visit with sports medicine last week and the doctor was very happy with my progress. He said that I had even decreased the slight leg length discrepancy from the hip exercises I had been completing.
I would have never guessed the pain I felt in my knees wasn’t from anything in my knees at all but rather in my hips. Proof once again of just how connected our body really is and how much more there is to learn about it.