Tuesday, February 23, 2010

Runner's Knee Cured - part 3

In Part #1, I declared myself cured from 20+ years of "Runner's Knee".
In Part #2, I enumerated the my long and painfully stupid search for the cure.

Now, I will reveal what the ridiculously simple two word cure is. Drum roll please...

small steps

That's it. I take small steps when I run. In other words, I shortened my stride.

NOT the cause of the problem
Here is a short list of the "sports medicine experts" mis-diagnoses:
  • flat feet
  • tight hamstrings
  • improper tracking kneecaps
  • overpronation
  • bad "Q-angle"
  • weak quads
  • tightness of the "lateral retinaculum"
All complete bullshit.

The cause of the problem
The root cause was that I:

  • over-strided and landed on my heels when I ran
This is actually a very common mistake, particularly among recreational runners like me who never ran cross-country or track. In retrospect it seems so obvious, and why the "experts" didn't think of it is mind boggling.

Now, I am sure that some smart ass barefoot runner will tell me "if you had ditched your shoes and ran barefoot, you would have solved that problem."
And unfortunately he would be right. The damned cushioned shoes that I thought would alleviate the problem were actually allowing it and even encouraging it.
I wish I would have tried barefoot, a long time ago. Instead...

How I found the solution
By accident.

I had given up searching for a cure to my Runner's Knee, and resigned myself to a lifetime of pain, stretching and ice bags. That is until last month when I realized my Runner's Knee was gone.

I had to look back to figure out what changes I had made to understand the cure:


My accidental cure for Runner's Knee

ChangeYearCostResult
More Trail Running2005-$230,000Smaller steps
In 2005, I searched for, and bought a new house. The #1 criteria was that I had to be able to run out my front door and into Umstead park.
Since then, I do about half my miles on single track trails.
I had thought that trails were easier on my knees because of the softer surface. WRONG. It is because the roots and rocks forced me to take smaller steps. Trying to stay balanced on the uneven trail taught me to land with my foot directly beneath me instead of on my heel in front of me.
Biking2006-$(Embarrassed to admit)Smaller steps
I started biking in 2006 when I quit running for a year, and have since been using it to supplement my running.

I started to noticing that the more I biked, the more I could run. When running fast down a hill, my feet would spin in small circles instead of bounding down with long strides. The pedaling trained my legs to take smaller steps.

The PowerCranks might have had something to do with it (but my experience with PowerCranks requires it's own epic blog post, complete with tragedy, humiliation, and the triumph of human will).
No stretching 2009-$0Smaller steps
I used to stretch my hamstrings before, after, and sometimes in the middle of a run. Everyone told me that tight hamstrings were bad, and that I had to stretch.

But over the last few years I have stretched less and less, and my knees and hamstrings felt better and better. I now do zero stretching and can run more miles, at a faster pace, than I ever have before.

My hamstrings are very tight now, and I can barely touch my knees let alone my toes. The result is a much shorter, quicker stride... smaller steps.
Less shoe2009-$89Smaller steps
While my Red Shoes are far from minimalist, they are much less than what I had been wearing.
These are quite different than the orthotics and motion control shoes that the "experts" had prescribed. They are light weight and very flexible. There is no stiff "support" or "motion control" features, and I can easily fold them in half.

After I took out the cushioned insert, it feels like I am standing flat on the ground instead of on a wedge like all my other shoes. It feels much easier to move my feet fast, and they seem to encourage smaller steps.

My next pair of shoes will be even less, and maybe barefoot soon.


Well, that's my Runner's Knee story. The whole thing has left me disillusioned and even angry with the whole "Sports medicine" and running shoe establishment.

The fact that an orthopedic surgeon was ready to cut ligaments in my knee to solve my poor running form sounds like something straight out of the dark ages of medicine.
And the only thing hamstring stretching ever did was give me horrible hamstring pain.

In any case, I am now enjoying running a lot more than I ever have. I only wish I could go back 20 years, slap myself up the side of the head and say:

Small steps.





31 comments:

  1. Damn. I thought it was olive oil.

    Of course, you have no PROOF that smaller steps cured you. And as we all know, proof requires spending $$$. If it's free, surely it must be wrong.

    That's why you should send me $59.99 for a bottle of Miracle Olive Knee Serum. It's proven to work (because I'm charging you for it), and more importantly you can't prove it *doesn't* work. And it's great for sauteing onions.

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  2. Is it extra virgin? If it is extra virgin, I'll take 2.

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  3. Seriously, though, great post. While I would certainly recommend barefooting to anyone, I understand how wackado it seems. Being smooth (which is achieved in large part by taking shorter, quicker steps) is the only thing that matters. Well, that and food, water, shelter, etc.

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  4. Love it! I too have taken smaller steps, got rid of my orthotics and enjoyed running. Small steps feel weird at first, until you realize that you can run ALL day long using small steps. *woot* This post makes me happy, thanks!

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  5. I concur - small steps = success!

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  6. hey, my red shoe guess wasn't that far off afterall! not sure if the no stretching = small steps is necessary a good plan though!
    congrats on the new found painlessness!

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  7. Well, you certainly were persistent in your attempt to run without vicious knee pain. I too have discovered the wonders of tiny girly steps. Thankfully, I didn't spend nearly as much as you did to find the benefit. Cheers!

    (Arrived via BFJ)

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  8. I'm curious: do you know how long your short stride is and how much you shortened it? I ask cause I'm a barefooter and measured my shorter barefoot stride and was a little surprised to find out that my stride from on foot to the other is about 36 inches. I thought it would be less. This is while running about 9 min. miles.

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  9. Thats a great question, and I have no idea.
    I can take a wild-ass guess.
    I have counted my steps per minute at about an 8 min/mile.
    A couple years ago it was maybe 140, and now it is 180+.
    140 = 57"
    180 = 44"

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  10. My stride is about 3". My legs flutter like a hummingbird's wings. I get distracted by the color red.

    Actually, I quit measuring things a long time ago.

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  11. This is really interesting! Who is the doctor that correctly diagnosed that you didn't have a serious knee problem? That was helpful for someone to tell you that it was okay for you to run even if you had some pain. I'm so glad that you were able to keep running and get rid of the pain! I was an over-strider, too--As I've worked on my technique and decreased my stride length during the last 2 years, it's helped me to run faster.

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  12. ive just started having knee problems and have only been running for about 1 year. im 43 and medium build so not really carrying to much weight. ill try the small steps anyway and thanks for the free advice. glad your enjoying running again.

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  13. Very funny and informative... but a little unfair to the POSE method I think since it's all about both short strides and not landing on the heels.

    Having said that, I prefer my minimalist running shoes: I now use the FiveFingers KSO Treks and I love them! I got blisters so I had to also buy the weird tow socks :-)

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  14. Very funny and informative... but a little unfair to the POSE method I think since it's all about both short strides and not landing on the heels.

    Having said that, I prefer my minimalist running shoes: I now use the FiveFingers KSO Treks and I love them! I got blisters so I had to also buy the weird toe socks :-)

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  15. I noticed the same thing a couple of years go. Anytime I would lengthen my stride my knees would immediately begin to ache. Luckily I did not push it and just shortened my stride and found that it went away. It still happens if I don’t pay close attention to my strides going down-hill.

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  16. I've been running for about 6 months now, and just a few weeks ago started having knee trouble. I'm pretty sure it's due to me trying to lengthen my stride :(. How long did it take to stop hurting once you started taking shorter steps?

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  17. It took about a year for me to runners knee to go away, or at least get drowned out by all the other aches and pains. But like the last guy said, it can come back pretty easily.

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  18. Funny and informative post, loved the conclusion about all the knee problem diagnoses being '...complete bullshit'...

    I haven't tried as many methods/options as you did, but can add one more: rubbing capsaicin (hot pepper extract) on the affected knee area. It doesn't help much but no dog will bite you there.

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  19. Don't know who you are, but thank you so much! I stumbled upon this post in a desperate attempt to figure out what was wrong with my knee. I'd been to doctors, sports specialists, physios etc and no one could figure it out. The day after I read this, I went for a run and have been going ever since, pain free. THANK YOU!

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    Replies
    1. Honestly Rachael? God I hope this is true.
      I'm about 3/4 of the way through the list of specialists all giving me different diagnosis. I've got a couple of new shoes, been to physios, got some orthotics, doing so much pilates it's coming out of my ears, was going to get an MRI in a couple of weeks.
      I'm close to tears and can't imagine ever being able to run again! But I get so much enjoyment out of it I really really want to fix it.
      I'll give this a go for a bit and see how I go. At least it will be free!

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  20. Racheal,

    Thank you so much for writing. It makes me happy to hear that I the "small steps" advice was helpful.

    I am a pretty average runner, which makes me think a lot of people go though the same thing with runners knee. I should do a more coherent post...

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  21. This post made me sooooo happy! After a year of ortho/PT/rest bullshit, I left the doctor's office in tears. I got fat taking time off and now running is really gonna suck...ah well. I figure my MRI is benign so I might as well live with pain and keep on going. Screw it. BTW, you made me laugh and I needed that today. Now I can move on. Cheers!

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  22. Thanks for sharing your experience, i am 23 years old and have chondromalacia patella over a year. The docs doesn't help end they don't even care. I have been doing streching exercises but they ain't cure the shit. Well i will stick with you methot a fewmonth's cause i have to stand all day and will make my steps small as much as i can. I will update a few months later if it will help, if its help i a short time i will up anyways.
    Thanks a lot

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  23. Weird. I bought minimalist shoes and after 1 week I can't walk. The 'experts' told me I moved into these shoes too quickly and it usually takes about 6 months for experienced runners to transition into the minimalist running method. Hmmm... Also I have short legs to begin with (being under 5'2") but even still.. every time I try to run I get runner's knee. PS.. just bought the damn straps!

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    1. Barefoot running is working for me. it is going to take a long, long time to get back to where I was, but at least my knees don't hurt anymore.

      Good luck!

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    2. How much time did it take?
      Did you have chondromalacia patella?
      Maybe barefoot is stretches the muscles around the knee which can relieve the pain but not sure. If your pain is over you need to take an mri to make sure.
      Regards

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  24. I will try that... miss my running! After a year of being soft on my knees decided to do kick boxing this evening (I know - but I thought that after a year there was no chance my knees would still be a problem).

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  25. Hey Anthony, found your blog while browsing around for Runner's Knee.

    Like you, I'd like to run for as much as possible, even the marathon. However a little bit of pain at the front of my knees (3 out of 10 on the pain scale when I play basketball 3x weekly or run more than 3miles).

    I was laughing all the way down your part 2 article because I tried almost all those things except for the treadmill, POSE, magnets!

    I'm wondering on a scale of 1 to 10, how painful were your knees when you only ran 3miles, 3x weekly?

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  26. i just started running and have had the same thing starting to happen to my knee and through chi running and others i've started to try short step forefoot running but my knee is hurting still. How long did it take for the pain to go away? Ive taken 2 weeks off and recently starte and the pain is still there.

    thanks

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    Replies
    1. I needed to finally go to minimal, zero drop shoes. and running barefoot. It is a difficult transition that took a couple years for me. but it is worth it. my knees are now OK. they still hurt sometimes, but not anymore than anything else.

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