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TooTall
10-05-2007, 16:45
As I was clearing out some old files the other day I stumbled upon an old profile that I had been given at AIT. I had been sneaking out of the Barracks on weekends to run up Madkin(?) mountain at Redstone Arsenal, which was off limits to IET students because it was so far out from everything else. Myself and a couple of the EOD students liked the run because we had found a way to go straight up the telephone cut that leads to the observatory up there. To cut to the chase, after a few weeks of this my knee started acting up. Runs were getting to be a problem for me. I didn't think that it was that bad until my drill sergeant asked me if I was going to get my knee looked at. This took me out of the pack for a week. In retrospect, there was a lot I wasn't doing to prevent injuries. I probably could have been stretching, and it would have helped if I hadn't been running on the same shoes I had had since basic (the drill sergeant actually made a cadence about my shoes). Having done a search and found nothing, I think it would be a good idea to start a list of dos and don'ts to avoid injury while running. I still have a good number of questions myself even after the lecture the doc gave me, and with the medical guys here I figured there would probably be some insight and experience that I and other beginners could profit from. So, here goes.

TooTall
10-05-2007, 16:53
My first few are the obvious, FAQs.

1. Stretch your WHOLE BODY before running. Not just knees, ankles, hams and calfs, but everything that you can stretch in the time available.

2. Stretch your whole body after running. You did it once to warm up, now do it again while the muscles are hot.

3. Along with your foot routine you learned at basic, stretching should also have been part of your basic daily ritual. If you are like me, it wasn't until you hurt yourself.

4. Make sure your shoes are in good condition and fit properly. (I'll leave someone who knows more to spell this one out)

And a few questions to get it rolling: Does anyone know if physical therapy exercises work as preventatives? The doc said that the ligaments around my knee were a bit weak, increasing the risk of injury. Does anyone know if running on the balls of your feet can cause injury? I definitely run faster and easier if I don't go heel-toe. (I do switch for going downhill)

Geo
10-05-2007, 19:33
So, your advice is to stretch and buy good shoes?:rolleyes::munchin

GratefulCitizen
10-05-2007, 21:31
Be careful when it comes to stretching.

There is stretching to "loosen up" before excercise, and then there is stretching to increase range of motion.

You should never stretch to increase range of motion prior to excercise.
That is a warm-down activity.

Also, make sure that your muscle and joint temperature is up (warm up) prior to your "loosen up" stretching.

Careless stretching is a great way to cause injury.

Pete S
10-06-2007, 05:09
Depending on how much you are running, shoes need to be replaced every 4 to 6 months.

VAV1500
10-06-2007, 09:44
The rule of thumb I use is appx 500 miles before you start phasing a pair of sneakers out of use. Keeping track of this is helpful.

As far as running itself goes, one of the best things I can personally reccomend is to seek out the softer surface whenever possible. Not only will running on soft grass cause you to exert (an albeit minimally) greater amount of force to push off, hence strengthening more muscles in the feet and legs, the long term ramifications of not slamming your feet on concrete, stone, or whatever you are running on will pay dividends later on. Espescially if you are putting in serious mileage.

If you're going to be going on a long one, I would advise eating something small beforehand, if you have that option. It is amazing how much of a difference that nutra-grain bar makes when you're coming up to the 2/3 point of a run greater than 12 miles. The difference, to me at least, is not suffering massive energy loss and slowing down to the point where you cannot go for more than 200 yards at a time without having to stop and dry heave.

I'll echo something mentioned in "Get Selected" as well. At the very least, all runs should begin at that "conversational pace". I have spoiled a lot of potentially good sessions of excercise because I was feeling strong at the beginning and decided to run 20-30 seconds faster for the the first several miles than the pace I am able to reasonably maintain for the prescribed distance. Once you get into rhythym, you can speed up if you want to, but unless you are racing, there is no point in charging out of the gate.

I'll crawl back in my hole soon, but I feel it is also important to mention running form, particularly that of the lower portion of the body. If anybody has seen the movie "Without Limits" you know that you can't bring your knees up when you are sticking your butt out. Even if you're jogging around the block with your wife as shes trying to get back in shape, you should always be thinking, hips forward, knees up. This will minimize the rear action of your legs, in other words not kicking back too far and concentrating on actually putting your feet in front of you.

Just a few thoughts from 10+ years of running, if you do all the small things right, you will be that much less likely to get injured and that much more likely to gain positive benefits from running.


EDIT: (for Too Tall)

Stronger muscles are more resistant to injury, obviously, so working on the knee ligaments is probably a good idea. As for trying to deliberately alter your footstrike, I can't say I'm a podiatrist, but I can say from personal experience that it is probably not a good idea and will cause you more trouble than it will prevent. Do you know how your foot hits the ground when you are running? Do you pronate or supinate or are you neutral? How high are your arches? Although it is easily written off as BS, the many different kinds of running shoes for different kinds of feet are in fact quite helpful. The questions I posed before, when answered, can be used to determine which shoe is best for you. I would also mention that perhaps more important than what part of your foot is striking the ground is the position your foot is in immediately prior to striking the ground, as dictated by the flexion(sp?) of your ankle and the point of your toe. Also--keep in mind that some people just have weird feet, you may be one of them. If it is natural for you to run on the balls of your feet (i.e. you do not have to think about what you are doing) there may be more benefits than hazards to be had by performing as such. Generally, however, forcing yourself to put more pressure on one part of your foot is not wise, it isolates a specific area and puts the full stress of your weight on it.

ccrn
10-07-2007, 00:42
Thought Id throw in a couple of things too...

Sometimes "runners knee" can be from an imbalance between overly strong hamstrings compared to weaker quads. This can be changed in the wieght room with a good quad routine. There is one movement that specifically addressess the qaud that influences how the patella moves over the knee during ROM.

Running downhill can also cause knee pain.

I definitely concur with the converstaional pace running, or aerobic running. The majority of your running should be at this rate with a tempo run and strides every week when enough base has been built. You can save the serious speed work and hills for the month before your taper (JMHO).

Also, avoid the "terrible too's," too much too soon-

Scimitar
10-07-2007, 02:11
I am far from a medical professional of any sorts but this particular injury happens to be some what of a hobby of mine (common fencing injury - all that lunging).

So if I may add my bit?

As you rightly suggested 'Runners Knee' can be caused by a weakening of the inside knee muscle causing the outside knee muscle to be too strong. This causes the outside of the knee to tilt downwards. Which as you said can be remedied by specific quad strengthening.

However another possibility always needs to be looked at and is often overlooked by Ortho specialists, and better diagnosed by a good chiropractor or sports physio.

Itís not a weak inside knee, but a too strong outside knee.

Runners knee can also be caused by too much bad technique running (Fencing Lunging) with not enough stretching causing the ITB to wind up as tight as steel wire.
Basically pulling the knee over to the outside.

Common Symptom:
Distal part of ITB sticking out and lateral part of calf is flat instead of rounded.

Remedy:
A lot of painful deep muscle massage and stretching of the whole ITB.

My understanding is that leaving this untreated for any length of time can cause the weakening of the inside knee muscle, hence the common misdiagnosis.

Bit of an evil cycle isn't it.

Hope this helps someone.

Moral:
Bad knee
=
Orthopaedic and Xrays
+
GOOD Chiro or physio as well

Scimitar

ccrn
10-07-2007, 11:43
To clarify
I may practice within the medical community but I am far from an expert when it comes to running. Everything I know about running I learned the hard way ie over training and making mistakes.

When I first joined this website I couldnt run 200m without stopping, now I can run over 12 miles and go take on the day but it came at a price.

I highly recommend a physical therapist over any other and Ive been to chiropracters, sports physiologist, and physical therapist. Nothing against chiro as my wife is a chiropracter as well as a couple brothers in law but they simply arent the experts in this very specific area.

When it comes to PT it might be a good idea to find the Docs who work on your local professional sports teams and see who they recommend.

Daniels Running Formula by Dr Jack Daniels (no joking), and Road Racing for Serious Runners by Dr Pete Pfitzinger (my favorite) should be required reading-
HTH

VAV1500
10-07-2007, 11:57
the Daniels book is considered to be a bible to many people, maybe I'm included in them, it depends when you ask me. However, I offer the caveat that Daniels is specifically oriented towards producing high performance in running competition, rather than approaching running as an ancillary excercise designed to increase cardiovascular fitness, which is the primary purpose for many members of this board, so I would imagine.

On a personal note, I had a rough one this morning. Went out for 12+ with two friends who are currently in much better shape than me. Failed to heed my own advice and ended up running the first three miles very fast. I managed to hang on, cut my losses and reigned it in, and gradually worked my way back up to speed to finish pretty strong. I've been working at getting back in racing form, but its tough planning around rucking, maintenence workouts, school, and generally high volumes of nonrunning PT.

Scimitar
10-07-2007, 17:21
Thanks for the advice ccrn,

Hope you didnít feel I was correcting you just adding to your already good advice.

Yes on the Chiro thing, a good physio is general the best as they are muscle and bone orientated.

Regards


Scimitar

ccrn
10-07-2007, 19:25
...cardiovascular fitness, which is the primary purpose for many members of this board, so I would imagine.


I think I see your point but keep in mind, running events in the Army arent that much different than a road race considering the consequences be it a simple APFT or much harder event. Performing badly (or just not that good) can make or break you.

Plus quite a few even in straight leg Infantry units, let alone Special Forces or Ranger Regiment, run road races, duathlons, and triathlons.

I think I feel some of your pain (I guess). If you think your busy now wait 'till you get older (and less responsive to training) and you work 48 hours a week, have three children, and have to lift weights 6 days a week, run 20-30 miles a week, ruck, and swim thousands of meters a week to stay competitive!

The Reaper
10-07-2007, 19:32
I think I see your point but keep in mind, running events in the Army arent that much different than a road race considering the consequences be it a simple APFT or much harder event. Performing badly (or just not that good) can make or break you.

I disagree.

In almost every case, military events are about finishing as a team. The rabbit does no one any good but himself. Twelve 7:00 guys are faster than eleven 5:00 studs and one 8:00 guy.

I will take the guy who is good at everything, especially rucking, over the guy who is the fastest runner almost every time. The only time his skills are valuable is during the APFT, or as a gopher.

Just my .02 based on 25 years of military service.

TR

ccrn
10-07-2007, 19:45
I disagree.

In almost every case, military events are about finishing as a team. The rabbit does no one any good but himself. Twelve 7:00 guys are faster than eleven 5:00 studs and one 8:00 guy.

I will take the guy who is good at everything, especially rucking, over the guy who is the fastest runner almost every time. The only time his skills are valuable is during the APFT, or as a gopher.

Just my .02 based on 25 years of military service.

TR

Lima Charlie, Sir-

Geo
10-07-2007, 20:38
http://www.foxnews.com/story/0,2933,299956,00.html

Scimitar
10-08-2007, 18:49
The 5 most common running injuries.

http://www.time-to-run.com/injuries/thebig5/itb.htm

kachingchingpow
10-08-2007, 19:40
ITBS sux. At one time running was something that I truely enjoyed. One of those sports that kinda found me, I didn't find it. I get plenty of cardio in other ways now, but I do miss running for miles on end.

I blame it on sitting at a friggin desk all day. There's a very specific stretch that helps, but it never has made much of a difference for me.

grumpz
01-02-2008, 11:37
You should always do a nice warm up before you go running. If you don't your chance of injury increases greatly.

You should always stretch before and after as well. Always. You should even stretch everyday if you have the time. Back in high school I had a running coach who was 42 years old, but could still jump 26 feet. That is good enough for the olympic team. He said the reason he could jump so far at his age is because he had stretched everyday since he was 19.

Usually when you run long distances, run heel to toe. Running on the balls of your feet puts more pressure on your knees and is harder on them. Usually you should only run on the balls of your feet when you are sprinting. Unless your running a marathon, run heel to toe.

You should always run on the softest surfaces possible. This can help lessen the impact to your knees and will prevent injuries and wear and tear to your joints and ligaments.

If you get tendonitis, take flax seed oil. That helped me clear up the tendonitis quickly when I got it. For joints and ligaments, take glucosamine chondroitin. That helps repair them and make them strong.

I have had several top running coaches and have ran at TOSH. So I'm not just talking out of my ass :D

grumpz
01-02-2008, 11:42
double post, apologies

The Reaper
01-02-2008, 11:44
you should always do a nice warm up before you go running. if you dont your chance if injury increases greatly.

you should always stretch before and after as well. always. you should even stretch everyday if you have the time. back in high school i had a running coach who was 42 years old, but could still jump 26 feet. that is good enough for the olympic team. he said the reason he could jump so far still is because he has stretched everyday since he was 19.

usually when you run long distances, run heel to toe. running on the balls of your feet puts more pressure on your knees and is harder on them. usually you should only run on the balls of your feet when you are sprinting. unless your running a marathon, run heel to toe.

of course run on softer surfaces as well. that can help lessen the impact and will prevent injuries and wear and tear to your joints and ligaments.

if you get tendonitis, take flax seed oil. that helped me clear up the tendonitis quickly when i got it. for joints and ligaments, take glucosamine chondroitin. that helps repair them and make them strong.

i have had several top running coaches and have ran at TOSH. so im not talking out of my ass :D

Shift key broken, or just don't care?

TR

Mr. Wizard
01-22-2008, 16:44
POSE Method running is all the rage in the CrossFit community for distance running. There is numerous articles on the internet for reference.

http://www.sportsinjurybulletin.com/archive/pose-running-technique.html

I have been practicing this method and it is incredibly hard to maintain the correct form when you are so used to heel-toe strike method. I have found that it is incredibly useful for maintaining a specific pace for longer distances though and has helped incredibly on my posture in general.

If you really want to learn more about it I would recommend just checking out www.CrossFit.com and lurk around on the forums. The monthly newsletters have an incredible amount of information in them as well, CF has completely changed my outlook and overall level of fitness. :lifter

hoot72
01-23-2008, 20:54
POSE Method running is all the rage in the CrossFit community for distance running. There is numerous articles on the internet for reference.

http://www.sportsinjurybulletin.com/archive/pose-running-technique.html

I have been practicing this method and it is incredibly hard to maintain the correct form when you are so used to heel-toe strike method. I have found that it is incredibly useful for maintaining a specific pace for longer distances though and has helped incredibly on my posture in general.

If you really want to learn more about it I would recommend just checking out www.CrossFit.com and lurk around on the forums. The monthly newsletters have an incredible amount of information in them as well, CF has completely changed my outlook and overall level of fitness. :lifter


This sounds interesting. I think its worth giving it a go in comparison though I wonder how easy or difficult it is really to change one's mindset at my age to a new system of running.....

Ryval
01-27-2008, 00:13
I really appriciate everyone's info here. I'm currantly coming off of a 9 month battle with runner's knee, in both knees so this was very interesting to read and, I might add, right on track with what my pediatrist has told me to do.

Just to add a little, there are exercises to strengthen the knees. For instance, ballancing on an inflatable disk (don't know how else to describe it) one leg at a time, for about 20 to 30 secs a leg. Slow, one legged hip sled (light weight) focusing on you knee NOT going side to side. Taking a resistance band, putting it around your ankles and doing slow, deliberate side steps. Those are some of the exercises that have helped.

Also, stretching your kneecaps helps too. Pushing them up, down, left and right. Each direction for a 20ish sec count. It feels kinda weird (to me at least) but you get used to it.

Take it for what it's worth. Thanks for the great thread.

sleepyhead4
01-27-2008, 01:21
You should always do a nice warm up before you go running. If you don't your chance of injury increases greatly.

You should always stretch before and after as well. Always. You should even stretch everyday if you have the time. Back in high school I had a running coach who was 42 years old, but could still jump 26 feet. That is good enough for the olympic team. He said the reason he could jump so far at his age is because he had stretched everyday since he was 19.

Usually when you run long distances, run heel to toe. Running on the balls of your feet puts more pressure on your knees and is harder on them. Usually you should only run on the balls of your feet when you are sprinting. Unless your running a marathon, run heel to toe.

You should always run on the softest surfaces possible. This can help lessen the impact to your knees and will prevent injuries and wear and tear to your joints and ligaments.

If you get tendonitis, take flax seed oil. That helped me clear up the tendonitis quickly when I got it. For joints and ligaments, take glucosamine chondroitin. That helps repair them and make them strong.

I have had several top running coaches and have ran at TOSH. So I'm not just talking out of my ass :D

Recent research and experiences of athletes show that heel to toe running method is not only inefficient but bad on the knees. Also, running on your toes is difficult and can tire your calves out before the other muscles in your legs. Even POSE method isn't the end-all-be-all method. With that said, mid-foot running method seems to be the lesser of two evils. Which ever method you choose, proper fitness (overall body fitness) will help prevent most injuries. (I know, kind of an obvious statement).

sofmed
02-06-2008, 15:31
Hi, Gents.

This is a great thread. Thought I'd add my 2 cent's worth here.

I've been running for nearly 27 years now. Have performed on Jr. Triath's and Marathons, as well as numerous 10K's, etc. My average run during a typical week is between 4 and 7 miles at a 7:30 to 7:00 pace once I've moved beyond the initial "warmup" mile to mile & 1/2.

All that being said, I've also undergone 2 arthroscopic reconstructive hip surgeries, so when it comes to rehab-ing and pushing to get back into running shape I have some experience on my side. Try not being allowed to run for nearly two years (cumulative)! It sucks.

And if you want a good laugh, ask Surgicalcric about my running. :D See what he says about trying to keep up with my long-legged self.

I've been running heel/toe long distance for so long, and I've tried the other methods and they just didn't take. I can say that I've had a minor change in my footfall/breathing pattern from one breath in every three strides/one breath out the next three strides, to one breath every two strides, etc, but that was after the surgeries. And the longer I run, the faster I get, as well as my stride growing longer. That's where SC's problem comes in...short, little legs. LOL

Proper fit of running shoe and the proper running shoe, period, are key to the longevity of running, espcially long distance. Athelete's Foot in Fayetteville ran a program for our 18x's that gave them a bigger discount and a full foot eval on the computer via the step pad method. Solved a lot of guys' problems just getting them into the proper shoe. Kept them from inundating me at sick call with foot, knee, back and ITBS issues.

I do appreciate all of the information shared here. I guess everyone has their trends that they keep to, as I have mine, and being an 'old dog' it is difficult to 'learn new tricks' to some degree. I look forward to more shared intel on the running game. Hope some of this is helpful. Thanks.

Mick

hunteran
02-06-2008, 18:49
Recent research and experiences of athletes show that heel to toe running method is not only inefficient but bad on the knees. Also, running on your toes is difficult and can tire your calves out before the other muscles in your legs. Even POSE method isn't the end-all-be-all method. With that said, mid-foot running method seems to be the lesser of two evils. Which ever method you choose, proper fitness (overall body fitness) will help prevent most injuries. (I know, kind of an obvious statement).

Midfoot/forefoot is the way to go. After a couple of months of intense running you should sorta find your perfect "groove". Out of all the people on my cross country team, the only guy who goes heel-to-toe is a freshman, everyone else is a mid-fore-foot striker.

Surgicalcric
02-06-2008, 19:49
And if you want a good laugh, ask Surgicalcric about my running. :D See what he says about trying to keep up with my long-legged self...

...That's where SC's problem comes in...short, little legs...

Short yes, little hardly...

I am not the one here who looks like they are riding a chicken when they are wearing shorts. :lifter

Besides, running breeds cowardice.

Crip

sofmed
02-06-2008, 21:47
Short yes, little hardly...

I am not the one here who looks like they are riding a chicken when they are wearing shorts. :lifter

Besides, running breeds cowardice.

Crip

Can I help it that an ectomorphic metabolism keeps me thin, and running miles upon miles just for the sheer fun of it?

Love ya, Brother. And I'm running TO the battle, not from it. By the time you get there we'll have a difac, PX and massage parlor set up and open for business. :D

Stay well!

See you when you're back.

Mick

Marvin Blank
02-28-2008, 21:52
Ohhh!!! Ohhh!!! I know, I know!!!

Training for a marathon, but doing it full bore right after two months of Surgery and Leave (and because you were lazy, no running)!!! 25 miles a week, with old shoes, because you didn't want to spend the money QUITE yet to get new ones!!! Getting a weird pain in your leg, and ignoring it, because you are a hard (dumb) ass!!!!! Finding out the Myrtle Beach marathon is a week away, and even though you have the leg pain and have only trained for a month and a half (and never runone before), deciding to run it!!! Running through the pain because "PUSSIES QUIT!!!" Finding out a week later you have a grade two stress fracture and have to spend a month in purgatory as a broke dick, waiting a class instead of going to Sage next Sunday!!!! Going two and a half years with two sick call visits (Poison Ivy in the field), and NOW, at the END, hurting yourself because you are a cocky barrel chested freedom fighter wannabe.
......Or at least, I would ASSUME that's a running no-no....not that I know, or anything (Hand slapping forehead) :rolleyes:

stuW
12-26-2009, 15:08
Does anyone have a suggestion for good resources for ITBS?

I have read everything I can find online about it and am not really satisfied.

I am somewhat bow-legged, and I have rehabilitated the knee. It feels good now - 9 months later - and I don't get pain when I run, squat, etc. I do crossfit and have not had pain, though I do still get a small click/pop if I put my hand and apply some pressure on the IT-band concurrent with bending the knee about 25 degrees - no pain, but I don't get the click on the other leg. The click has reduced since strengthening and reduction in pain.

I roll the band, stretch the band, and have previously ice-cupped the knee when it was painful. I'm getting ready to begin running seriously on it (more than a mile per day) and I want to make sure I'm covering all my bases. I'm about to go out and buy a new running shoe. Any suggestions for me and other unfortunate sufferers of ITBS?

Thanks,

Stuart

Scimitar
12-26-2009, 16:36
Unfortunately I can speak from experience here.

There are two schools of thought...

The more generally accepted one is...
ITB is caused by weak abductors, specifically weak Glute Med. We get this from our sedentary lifestyle, sitting on our ass all day.
There is a specific ITB strengthening exercise; I can get the link if you want it. Other exercises are clam lifts and medial and posterior abduction lifts all to strengthen the abductors.

Other causes can be over pronantion of the foot, it does pay to see a sports podiatrist preferably one that works hand-in-hand closely with other sports specialists.

The reason is you have to always watch for specialist syndrome, where every single problem he sees is because of the foot also they all want to sell you orthotics. Go to one recommended by your sports specialist.

My opinon is issues tend to start at the top of the chain (i.e. hips) causing issues further down the chain. But I'm no Dr.

Regarding training back-up, this is the process I'm currently in. Take it easy, no more then 10% increase per week if you can help it. You'll be recovering from Atrophy Syndrome, stay in touch with a GOOD sports physio, preferably getting him to monitor you every 2 weeks or so. YOu may also find that your gait is a mess, be prepared to rebuild it.

Lastly there is always the possibility that you have permenatly damaged the Bursa between the knee and the distal ITB, and this is where surgery comes in.

Word to the wise, I probably wasted 24 months getting jerked around by Med Pros who weren't willing to say "Hey go see this guy he's a specialist" and instead continually gave incorrect disgnosis and then incorrect prescriptions. This was my first time every really working with Doctors on an issue apart from flu and infections, so I didn't really learn go stright to the ultra-special, specialist and skip all the guys who think they know.

I don't know if your seeing a Dr right now, but alwasy see a Sports Dr, not a surgeon straight away (they tend to just want to cut stuff out) who works closely with Physios. ITB has to be a Dr, Physio solution if you ask me.

HTH any questions.

Sean