Mitigating Runner's Knee
After my 2nd full marathon, I started experiencing runner’s knee for the first time. It took me a few years, including a few visits to physical therapy, to actually figure out what I should be doing differently. I’ve relayed this information to a few people individually in the past, so just typing it up as a blog post for easier reference.
Quick note: I found that no single thing individually was a panacea - I always needed to be doing at least a couple of these things simultaneously.
There were 3 main things I did:
- Warming up
- Changes to my form
- Going to the gym/strength training
- I watched this Ryan Hall video about how to warm up and started incorporating some dynamic stretches. From the video, I basically just started doing 10 leg swings on each leg to the side, and then straight. There are other videos out there that are a bit more robust, including that Ryan Hill video, so I’m likely only doing a very minimal set of exercises to warm up and could be doing more.
Changes to form:
- I would watch stuff about overstriding and think “that’s not me”, until one day I realized that it really was me! The thing that made me realize it was thinking about cadence, rather than thinking about where my foot was landing. I was running at probably about 150 steps per minute, and most advice on the Internet recommends being in the 160-180 range. I went to Cleveland Track at night with my phone and played a Spotify playlist I found called “160 bpm” - Complicated by Avril Lavigne was on the list, so now I just sing Complicated in my head and match my steps to the beat.
- Faster cadence means I take shorter steps. From what I’ve read/watched, this is really what matters (as opposed to emphasizing landing on the balls of your feet, which is generally a signal being used to determine that you’re not overstriding)
- Suzi told me a long time ago that I swing my arms wide when I run. I realized recently that swinging my arms on multiple planes means that I have to rely on my lower body to stabilize my upper (due to the arm swing). So now I try to focus on swinging my arms only along 1 plane and feeling the movement in my chest muscles.
Going to the gym/strength training:
- I foam roll a lot more. Thanks Chieh for the foam roller! I watched a video where someone says they spend 10 minutes rolling each side of each leg (that’s 40 minutes a day!).
- I pushed a bit too hard earlier this summer and got a pinched nerve. A sports medicine doctor was telling me that I needed to get back into the weightroom just like once or twice a week to squat and basically balance out my muscles. They said the weight itself doesn’t even really matter, what matters is the motion of it to balance everything out.
Other things I do:
- I do, still, wear this underneath-the-knee brace.
- I buy multiple pairs of shoes at a time and alternate between them. As of late 2021, I found that I can reliably run in the 2020 Brooks Adrenaline GTS model, and a quick foray into the 2021 model resulted in a big flare up in my Achilles and not being able to run for almost a week. So I’ve just been buying a bunch of old 2020 Adrenaline GTS shoes, which are still available around the Internet.
- My slow runs should be much slower. Most of my runs are not quite tempo runs, not slow runs, and not long runs. And usually you want to be focused on something like that when you’re running (if you’re training, you generally don’t want to be out running without actually having a purpose behind that run). To make this a little more concrete, my “really fast pace” is like 7 minutes. And I tended to do most of my runs at like 7:40. But truly anaerobic, conversational, and “I feel fine for tomorrow” is honestly more like 8:40, and so that’s probably how fast I should have been going during my slow runs.
- Suzi got me a higher end Garmin watch recently, which has a smart “training assistant” built in. It’s been recommending me to do my slow runs at 9-9:10 pace. While I don’t know if I really believe that’s where my fitness is (ie, I think I’m way faster than that), it probably has a bit more truth than I’d like to admit.
Hope it helps! I still don’t have any races I’m prepping for and generally haven’t been running consistently enough to see much improvement. But I’m at least maintaining, and running is still pretty therapeutic for me.