I am currently training for my first half-marathon (which is still a ways away), and am working on upping my mileage. Today I ran 6 miles (my longest run to date), but my right knee started to ache around mile 5. And maybe "ache" is the wrong word.....it was maybe more of a tightness that seemed to be a PRE-ache. I run on a lot of concrete, so I'm aware that the poundage on my knees is at a maximum on concrete. I also know that my knees are adjusting to this new running lifestyle. My question is, what do people do to help with aches and pains from wear and tear? I'm pretty sure my shoes are fine.....should I wear a knee brace? Compression garments? Do something else?
Couch to 5k Training Program - Started 11/29/2010, Completed 2/11/2011
Cupid's Chase 5k - Chattanooga, TN - 2/12/2011
Scenic City 5k - Chattanooga, TN - 2/26/2011
Get Your Rear in Gear 5k - Chattanooga, TN - 3/12/2011
Gateway Bank 5k - Rossville, GA - 3/19/2011
Run for Education 8k - Signal Mountain, TN - 4/23/2011
King of the Mountain 4-miler - Lookout Mountain, TN - 5/7/2011
Run for Relief 5k - Chattanooga, TN - 5/28/2011
Chattanooga Chase 8k - Chattanooga, TN - 5/30/2011
Riverbend Run 10k - Chattanooga, TN - 6/18/2011
Missionary Ridge Road Race - Chattanooga, TN - 8/6/2011
Chattanooga Mud Run 5k - Chattanooga, TN - 8/13/2011
Registered for the Women's Half Marathon in Nashville - 9/24/2011
Registered for the Disney Wine & Dine Half Marathon in Orlando - 10/1/2011
First, regarding concrete, you are better off on a flat concrete surface, than on the slanted side of a road. Concrete is indeed hard, but black top is not much softer. The road surfaces, often slanted for better drainage, can create new injuries quickly. Better still for recovery, would be to run on the kind of soft, well maintained grass one might find on a golf course. Just expect to get chased off if that's what you do!
Some will recommend a treadmill, but that depends on the quality of construction. If you do train indoors, turn the incline off. It is likely to hurt more than help. All this is if you continue to run, but I think it's time for a break to rest and analyze what's wrong. You will lose some fitness, but stand to lose much more by running through an injury. There is always pool running and ellipticals for safer rehab with minimum impact.
I remember wearing a knee brace in the early years of my running, and an ankle brace as well - even through races (not recommended). I've worn tape and arch supports, too. These devices certainly will boost your confidence, but remember they are props that won't replace healing what's hurt. The hurt comes, unfortunately from overuse - what we call "too much, too soon." Your body hasn't yet adapted to the rigors of your training, and your patience needs to match that rate of adaptation.
Of knee braces, I have read they may help to stabilize a knee that is structurally loose, but the long-term effect of running with them can include problems associated with restricted circulation. While this can have a numbing effect, maximum circulation will do more for your injuries over time. If your knee is unstable, it is more helpful to strengthen the muscles that act on the knee, getting your support from inside the body rather than from without. I am a fan of compression shorts and tops for better cooling, aerodynamics, and less chafing. Running/competing with therapeutic compression gear, though a current fad, has short term gains at the risk of long-term losses. If you feel the need for this stuff, there are other strategies that wil benefit you more.
Again, circulation is key; it's what heals you. We often hear about icing and stretching, but both are halves of a better whole. Ice alone is for acute injuries, while alternating cold and heat does more to stimulate circulation in working muscles. Stretching can invigorate healthy muscle tissue, but a muscle that is tight or in spasm can be easily damaged further by stretching. Massage, including self-massage, followed by light stretching, is a more professional solution that delivers better (and safer) results.
Once you are on the mend and loosened up, it's time to strengthen your quads, calves, hips, and core muscles. Strong, healthy quads and calves absorb more shock and smooth your stride. The quads alone guide your kneecap and stabilize your knee so wear and tear within is less likely. Increase your mileage only when these are strong enough to protect your entire run. Running tired on wooden quads will lead to damaged knees. You can relax the quads by kneading them between thumbs, palms, and forefingers. Straighten the leg into a relaxed position first.
Likewise, tired calf muscles, some of which cross the back of the knee from lower to upper leg, can produce pain within the knee. Ditto when they are overworked and too tight. Always target your therapy in both directions - to strengthen and relax. One without the other is asking for trouble.You can gradually relax many of your calf muscles by sliding them down the opposite knee when seated, even at work. Let people stare.. you're an athlete!
The hips and core muscles are what provide the stability to your stride, and reduce lateral and twisting stress on your knees. Once again, you can't overdo it. Too much stiffness in your core (back, abdominals) and hips will result in back pain and muscular compensation below. Tight back muscles, and upper glute muscles around the hip, are easily loosened by laying them on a tennis ball before bed. Abdominals are best approached by hand.
Some knee pains result from the area known as the Ilio-Tibial Band (ITB) on the lateral quad. While some pain can be traced to the Band, the quad is highly vulnerable to running. Many athletes have learned to do regular maintenance on this area with a foam roller to insure that knots of tight tissue to not develop in these structures. If that's what you have time for, it's better than nothing, but I've found ways of using my hands and available soft furniture to accomplish the same circulatory benefits, almost anywhere, any time.
All of this strength and speed sits on the all-important platform of your feet. While shoes are for most, an important part of the picture, the type of foot you have must be matched not only by the shoe you wear, but for many, by modifications to your shoes to account for extreme variations in foot structure that are not addressed by the shoe manufacturers. Many orthotics have you running on your arches - not the best thing for an athlete. A solid knee requires a smooth, efficient, and natural footstrike. This is a complicated issue that warrants further discussion if you need it.
I trained for my first Half mostly on concrete, and I recall how painful it was. As I got faster and more vigilant, I found ways to mix my surfaces with better results. In my opinion, the best places to train for racing are parks that are closed to thru-traffic. This most closely approximates the average racing environment of full road use, flatter surfaces, and less concrete.
However, not so fast - try some of the suggestions above to take care of the tension on your knee, and when it feels better, you can work on a moderate course of strengthening exercises. Then (within a few weeks), back-track your training somewhat until you are strong enough to up your mileage. Meanwhile you have productive ways to spend your down time. Be patient with your body, or you might spend six months down like I did!
This certainly won't be as comprehensive, but I want to second the recommendations regarding stretching. I never do well with stretching BEFORE a run though. I usually walk quite a bit before any run (even a long race) and then concentrate a lot of time on stretching AFTER the run. It's so tempting to cut the stretching short. I bnring food to the gym if I am training on a treadmill that day or to the park or just go back to my house and eat/drink and STRETCH for at least 30 minutes.
The tightness you describe is exactly what I got at mile 23 of my first marathon. After a week or two of trying really short runs with continued pain (more pain on days when I did not run) -- I took three weeks off but when I resumed running the nagging ache/tightness continued until someone recommended some specific stretches for ITB -- or is it IBT -- it's the tendon that essentially runs from your hip, crosses the knee and to the shin. The foam roller is the most marvelous invention EVER. My stretching certainly helped and I used heat at night if I felt any pain at all (rice bags heated in the microwave- these mould to the body quite nicely and the heat lasts and lasts) -- but once I started working with the foam roller, I could actually feel where the knots were in my legs.
Best of everything as you work through this issue!!
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