Running No-Nos.
 

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.

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)

So, your advice is to stretch and buy good shoes?:rolleyes::munchin

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.

Depending on how much you are running, shoes need to be replaced every 4 to 6 months.

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.

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-

Look at the opposite as well
 

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.

It’s 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

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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

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.

thanks
 

Thanks for the advice ccrn,

Hope you didn’t 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


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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!

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-