Ran a 5K today

Had a casual conversation with a sports doctor at the running store, and he's fairly convinced that my patellofemoral dysfunction (runner's knee) is in fact back. Apparently just taking 20 years off from running won't make the underlying condition go away. He's also of the opinion that mid-foot running may help, but isn't likely to cure the situation by itself.

So now I either need to: 1) find a sports medicine place to develop a rehab plan to correct the dysfunction or 2) buy a good bike.

That, or I can just rest and ice for another week, ignore the advice and get back to running albeit in a bit more leisurely manner. I'm sure ignoring it will make it go away, right?

After walking down a steep hill I had pain below my kneecap that lasted several days. I've had 2 surgeries on that knee (and actually have a torn meniscus in the knee now, but that's not relevant to this) related to kneecap tracking, so I got a knee strap.
IMAGE(http://www.kk.org/cooltools/knee-strap-sm.jpg)
It goes around under the kneecap and puts pressure on the tendon and supposedly keeps the kneecap in alignment. Whatever it does, I've not had pain since wearing it and moving from walking to running. Well worth the $14 I think it was.

cheeba wrote:

IMAGE(http://www.kk.org/cooltools/knee-strap-sm.jpg)

I couldn't help but hear Ben Stein when I looked at that pic.

"Mueller?...Mueller?......Mueller?..."

Are those things these "Jumper's Knee Straps"? I'll definitely give them a shot, it's worth a try right?

Thanks for the tip.

I think you should:

a. Run a little more like an old man. 10% rule applies, unfortunately.
b. Avoid putting pressure or strain on any part of your knee when running. When you run, your entire leg should be relaxed and flowing - like you're ghosting along on nothing more than gravity. The predominant feeling I get when I'm the zone is that I'm floating along on limber legs that aren't doing anything more than pulling up my feet behind me as they get left behind. You might want to try out barefoot running technique.

Teneman wrote:

Are those things these "Jumper's Knee Straps"? I'll definitely give them a shot, it's worth a try right?

Thanks for the tip.

Yep, though don't get pink ;). I think I got mine at Walgreen's or CVS or one of those places. It's basically just a velcro neoprene strap with some surgical tubing in the front to put pressure on the tendon.

Got to thinking about my knees after my run today as I was looking at my shoes. They're about a year-and-a-half old, and are really showing a lot of wear on the outside edges of the heels. I'm a man who takes his overpronation very seriously:

IMAGE(http://i646.photobucket.com/albums/uu188/boeckmanm/P1010255.jpg)

Hope you can make something out of that image...I couldn't seem to get rid of the shadows under the heels.

Does anyone think that uneven heel surface could be hurting my knees? Seems like I'd feel it in my ankles before my knees, but then again, the knee pain started at around the time the shoes started get worn.

IMAGE(http://img38.imageshack.us/img38/2812/tumblrli9nkmhvae1qfg08d.jpg)

Mytch: Normally I change my running shoes every five hundred miles but certainly by the time they get that worn. It works out to be at least once a year or so. The shoes are still perfectly wearable, so I cycle my runners to my daily wear and just buy new running shoes. It might not help with your knees but it might. So pure IMHO guess: swap shoes. More generally, I'd go to a running store, try on new ones, run a few laps of the parking lot, and see if it feels different/better enough to warrant purchasing new ones.

Mytch wrote:

Does anyone think that uneven heel surface could be hurting my knees? Seems like I'd feel it in my ankles before my knees, but then again, the knee pain started at around the time the shoes started get worn.

You really shouldn't be landing on that part of the heel, but yeah it's way past time to replace them. The padding loses bounce over time. I'm even more aggressive about changing shoes than Miashara - I would recommend every 200-400 miles or 4-5 months, or if the shoes started showing much wear at all. My old shoes don't go to the graveyard, though. I still use them for hill sprints up a sandy hill or for walking.

Edit - And awesome pic, Montalban! I'm kinda fretting how slowly I'm going to be running my first 5k on Monday, but that kinda thing helps :).

Mytch wrote:

Does anyone think that uneven heel surface could be hurting my knees? Seems like I'd feel it in my ankles before my knees, but then again, the knee pain started at around the time the shoes started get worn.

It's not the uneven wear on your heels, it's the fact that they are worn at all. Obviously I can't tell what the heel looked like in the first place, but if the wear is as bad as your image suggests then you are clearly running with a pure heel strike. This transmits 100% of the force straight up your leg into your knees. You really need to try to change your form so that you are striking on the mid-foot (pros will tell you a forefoot strike is essential, but I think you'll find it's impossible to go straight from being a heel-striker to a forefoot strike). With a proper stride your ankle and your calf muscles will work to absorb a large amount of the impact and spare your poor battered knees.

Even if you're only running once a week, 1.5 years is too long to keep a pair of running shoes in service. I get 3 months out of the average pair, and when I get lazy and try to push it to 4 I end up with sore feet as the padding and structure of the upper start to loosen up as they break down from the wear. It's not about how worn the sole is!

Gotcha, thanks for the advice, everyone.

I am working toward a midfoot strike--easing my way into barefoot/minimalist running, in fact, but it's going very, very slow and in order to keep running anywhere close to the distances I want, I'm still doing a lot of traditional running.

You replace your shoes every 3-4 months?!?? At around $100 a pop (at least for the shoes I like), that's just not feasible for me. I did buy my Vibrams at about the one year mark with the intent of switching over to them fully by this time, but as I said, that's going a lot slower than planned.

I may go ahead and replace my traditional shoes soon, with the hopes that by the time the new ones break down, I'll be doing most of my running barefoot/minimalist.

Mytch wrote:

You replace your shoes every 3-4 months?!??

It's about mileage, not the time. The average lifespan of a pair of running shoes is generally considered to be 300-400 miles. If you're a really small/light runner then sometimes you can push it a bit further. The Mizunos I wear run me about $110+tax, but on the plus side my shoe shop gives you one free pair for every five you buy.

Mytch wrote:

I am working toward a midfoot strike--easing my way into barefoot/minimalist running, in fact, but it's going very, very slow and in order to keep running anywhere close to the distances I want, I'm still doing a lot of traditional running.

I have flat feet, well my right foot in particular is pretty flat anyways, and VFF's aren't really suitable for flat feet. I use Asics GT2160's.
IMAGE(http://images.citysports.com/f/726/28361/4h/www.citysports.com/assets/product_images/194233_md.jpg)
The point is, I'm mostly a mid-foot striker. By far the fastest part of my shoes that show wear is at the balls of the feet. So it's not so much about shoe where you're striking. I've heard a lot of people recommend a shorter but faster stride to strike mid-foot. A long stride forces you to come down on your heel. Personally I use a short stride just because I'm slow as molasses, but hey, it works. I've had 3 knee surgeries in the past from various sports injuries and I've had a torn meniscus for many years, and other than a case of runner/jumper's knee which was solved by the knee strap, I've had hardly any knee pain at all.

I did the who runner's knee thing. Two years on the bike strengthening my quads fixed it.

Elycion wrote:

Obviously I can't tell what the heel looked like in the first place, but if the wear is as bad as your image suggests then you are clearly running with a pure heel strike. This transmits 100% of the force straight up your leg into your knees. You really need to try to change your form so that you are striking on the mid-foot (pros will tell you a forefoot strike is essential, but I think you'll find it's impossible to go straight from being a heel-striker to a forefoot strike). With a proper stride your ankle and your calf muscles will work to absorb a large amount of the impact and spare your poor battered knees.

By the way, there is exactly zero medical research on this. As of yet, no one has even performed a study on whether or not heelstriking in padded running shoes is good or bad. Zero, zip, nadda. Nor has a single study compared injury rates between shod and unshod/mostly unshod runners in any way that engenders the slightest bit of scientific confidence.

What there is is research on how barefoot/minimalist shoe wearing runners strike. There data runs heavy on the mid-foot strike as you might expect, with the significant period of adaption you mention. There is also a NEJM survey on how marathoners were striking at the mid-point of a race. There are also a couple other things, and some interesting biophysics on the frequency of the stress waves that propagate through the foot and shin bones/muscle. Harvard had one I quoted earlier in the thread.

Now the military has done a series of studies on running pain. Here's one on knee bracers if you're interested, here's another on stress fractures and flat feet. None of that addresses heel/mid-foot striking off course. There's another one I can't find the cite for that implied most knee pain was caused by weak stabilizing muscles in the knee. (Here's an ABC link, but I can't find the cite and ABC Medical news is not reliable.) The implications of it are that a good method for reducing knee pain is stretching, and especially stretching the side muscles of the lower leg and shin. From a purely anecdotal batch of evidence, it's worked for me.

Getting back to the point, a lot of common wisdom is that heel-striking=bad and midfoot-striking=good. It may very well be. But no one knows yet, and no one's serious attacked the matter from a research perspective.

Miashara wrote:

By the way, there is exactly zero medical research on this. As of yet, no one has even performed a study on whether or not heelstriking in padded running shoes is good or bad. Zero, zip, nadda.

Oh come on now, hyperbole may be fun but it's hardly useful. There have been many studies on the biomechanics of the human running gait, in fact here's a LINK to one of the most commonly cited resources. If you want to be accurate you'd simply state that there is no study that has conclusively determined that heel striking increases the frequency of injury. Even while the Harvard Skeletal Biology Lab study points out that the link between heel striking and injury is unproven, they have no qualms about pointing out:

Harvard Biomechanics of Foot Strikes Resource wrote:

Therefore, quite simply, a runner can avoid experiencing the large impact force by forefoot striking properly.

In the end, this isn't really an issue where exhaustive medical research should be needed to come to a common-sense conclusion that using more joints and muscles to absorb an impact will result in lower stress levels than concentrating all the force into the knee does.

That's the Harvard study I quoted earlier. Skip ahead two pages, to http://www.barefootrunning.fas.harva...

and go to the bottom of the page. Heading: "Is There Anything Wrong With Heel Striking in Running Shoes?"

We emphasize though, that no study has shown that heel striking contributes more to injury than forefoot striking.

It's in bold.

edit: This is what I referencing when I said there have been a fair number of studies saying barefoot gaits that rely on the midfoot or toe strike have less injuries. They don't say anything about wearing shoes.

Edit 2: I'm sorry. I quoted this in a different thread. My apologies. This is the Harvard thing I mention in the above post, but I did not link it.

Once again I reiterate that common sense is the issue here. When you're dealing with a heel striking runner who complains of knee pain I don't see it as particularly helpful to point out that science hasn't conclusively proved a relationship between his foot strike and his knee pain. Scientific study has shown that a heel strike transmits a greater reaction force into the leg as opposed to a midfoot or forefoot strike.

The difference is easy enough for anyone to test out for themselves, you don't even need to go running to do it. Find yourself a step, stepstool, or similar platform from which you can drop 8-12". Now drop down landing flat-footed with your heel hitting first and your knees absorbing all the impact, do this 10-15 times to get a good feel for how it affects your knees. Then go and repeat the experiment landing on forefoot and allowing the arch and ankle to help the knees absorb the impact. See for yourself which method is easier on your body.

My personal opinion based upon my own experiences in these issues is that you may very well be able to run injury free in well-padded running shoes with a heel-strike gait, but your odds of avoiding injury are much better with a midfoot or forefoot strike. This is even without factoring in people who wear the same shoes for 18 months or more until the padding is no longer providing adequate cushioning against the impact forces.

No, I never said a thing about common sense. Nor did I say heel striking is or is not liable to cause injuries. I said there is exactly zero medical research on this. There is medical research that says anterior knee pain can be prevented or reduced by proper stretching. There is more that says knee bracers have a limited effect. But my initital conclusion: "Getting back to the point, a lot of common wisdom is that heel-striking=bad and midfoot-striking=good. It may very well be. But no one knows yet, and no one's serious attacked the matter from a research perspective." is unchanged.

The statement "heel striking leads to more knee injuries" may be correct. There's just no research that supports it.

The heat and humidity is making my runs quite a bit more challenging the last two days. Last week, I did two 2 mile runs at my usual 6am time before work without too much trouble. My runs on Friday and this morning were done at mid-morning since I had the days off. Wow, so much harder. Friday's was a mile run, 1/4 mile walk, mile run, today's was a straight 2.25 mile run. Both days I was utterly out of gas by the end. Today I even had to walk about a half a block at around the two mile mark just to be able to finish, though that did give me the boost I needed to get through it.

However, I just checked my Runkeeper averages, and apparently today I was averaging an 8:30 pace, which is definitely faster than I usually go. Apparently my body just be dumb. I'm supposed to be moving up to 2.5 miles per day for this week's workouts, but I might need to cut that down until I get used to the humidity.

Tried running again today after taking the better part of the week off to rest the knees. Tried out Cheeba's knee straps, or something really similar at least. They definitely seemed to help. Knees are still a little bit sore, but considering they were filled with shooting pain needles of pain after my test run on Tuesday, I'll take "a bit sore" as a victory.

Thanks for the tip Cheeba!

Today was the Camp Patriot Fun Run. Going in I wasn't even sure if I could finish without walking some since I hadn't run a lot since Memorial Day. I figured if I did run it all I'd end up finishing with a 10:30ish pace, with hopes of being closer to 10:00.

Turns out adrenalin is a hell of a thing, I finished in 27:49 with a average pace of 9:17. That's faster than I've ever run a 5K before, go me!

All the proceeds from the run went to Camp Patriot, which takes disabled veterans on outdoor adventures (hunting, fishing, mountain climbing, stuff like that) and there were a handful of military guys doing the run in military boots with heavily loaded packs. I dunno how much weight was in there, but I saw one guy trying to lift it and he was struggling. Impressive!

Now I get to set my sights on the Warrior Dash in a couple of weeks. Really looking forward to it.

fleabagmatt wrote:

Today was the Camp Patriot Fun Run. Going in I wasn't even sure if I could finish without walking some since I hadn't run a lot since Memorial Day. I figured if I did run it all I'd end up finishing with a 10:30ish pace, with hopes of being closer to 10:00.

Turns out adrenalin is a hell of a thing, I finished in 27:49 with a average pace of 9:17. That's faster than I've ever run a 5K before, go me!

Gratz fleabagmatt, well done!

fleabagmatt wrote:

... and there were a handful of military guys doing the run in military boots with heavily loaded packs. I dunno how much weight was in there, but I saw one guy trying to lift it and he was struggling.

We used to run in full uniform with a 55-60 pound ruck, boots a rifle and LBE straps holding amongst other things two full canteens. Really adds a bit of zing to your standard 12 mile jaunt! I'm fairly certain I couldn't walk 12 yards in that gear today, let alone run 12 miles in it.

Nice, Fleabag! My race is at 7pm, so I'll post my results pretty late tonight after the fireworks (I had no idea, but it appears they're having a firework celebration tonight just for me running a 5k! who knew?)

Great job, Fleabag! Sounds like a great cause and a fun day!

And...y'see, cheeba? See what I mean about the adrenaline? You'll do fine. Go out there, have fun, and enjoy the race and the fireworks!

Teneman wrote:

We used to run in full uniform with a 55-60 pound ruck, boots a rifle and LBE straps holding amongst other things two full canteens. Really adds a bit of zing to your standard 12 mile jaunt! I'm fairly certain I couldn't walk 12 yards in that gear today, let alone run 12 miles in it.

My God, does that make me feel like a fat old man.
Stuggling with the heat now to make 7k before I feel so crappy I can't run anymore.

Is there a plateau around 8k? Seems like I breezed through 2,3,4,5, even 6k. After that, I've hit a wall.

35:39.6. I'm no speed demon, but at 255 lbs and my first race, I'm not disappointed.

What an amazing experience. Having people cheer you on as you approach the finish line is spectacular.

Ghostship wrote:

Is there a plateau around 8k? Seems like I breezed through 2,3,4,5, even 6k. After that, I've hit a wall.

From our personal experience (early 30s, not particularly athletic builds), my wife and I swear that there's some invisible barrier between 4 miles and 5 that when you push through it, suddenly you're able to run even 9, 10, or 11 miles with only boredom and injury holding you back. Something seems to click in the body where it finally says, "Ok, fine, I get it. We're going to be running for a while. I guess I'll stop yelling at you to stop every tenth of a mile."

cheeba wrote:

35:39.6. I'm no speed demon, but at 255 lbs and my first race, I'm not disappointed.

What an amazing experience. Having people cheer you on as you approach the finish line is spectacular.

Congratulations! You're right not to be disappointed...nothing wrong with that at all!

Montalban wrote:
Ghostship wrote:

Is there a plateau around 8k? Seems like I breezed through 2,3,4,5, even 6k. After that, I've hit a wall.

From our personal experience (early 30s, not particularly athletic builds), my wife and I swear that there's some invisible barrier between 4 miles and 5 that when you push through it, suddenly you're able to run even 9, 10, or 11 miles with only boredom and injury holding you back. Something seems to click in the body where it finally says, "Ok, fine, I get it. We're going to be running for a while. I guess I'll stop yelling at you to stop every tenth of a mile."

My completely unscientific research fully supports that theory. Since I've started running again after my injury, time constraints have been keeping me back to around four miles a day...and by the time I get to that point, I'm wondering how in the HECK I ever got up to a half marathon! I did, though, and thinking back, breaking five miles or so was the point that I really started taking off.