Running Through an 'Injury'?

Marathon Newbie wrote:

I've started to have what I have self diagnosed as 'runners knee' and I wanted to ask some of you that may have had similar experiences, at what point do you completely stop running? I've been doing the advil and ice thing and no running for 4days and ran an easy 4 miles this morning with just a little bit of tightness/pain, but it's still there.

Curious to know what some of you may suggest.

Stop advil. If you cannot run without pain killers/anti-inflammatories, don't run. They treat the symptom, not the cause, and as often as not allow you to make the problem worse. Frankly I think that if you NEED to even ice regularly to keep running, you have a problem that needs to be fixed sooner or later. Ice really does not need to be part of the regimen of a truly healthy runner. Note I'm not talking about ice baths so much as icing a specific body part.

I would stop running if the problem keeps getting worse, even mildly so.

You say you have self-diagnosed this. No offense but I would not put too much stock into this. Go find a doctor who treats runners. Not someone who is going to say, "Oh just stop running for a while," 5 minutes after seeing you. That might be what you have to do but get someone who knows that runners generally want to run. In any event, get a real diagnosis.

I had patellar tendinosis last year and (as with all of my tendon injuries) the only thing that really fixed it was a long period of no running. I probably would have been fine had I taken 2 or 3 weeks off right at the start, but instead I kept on running and even broke my own rule and took Ibuprofen to keep running. The result was that I made it so bad I was forced to take 4 months off.

I've run similar achilles injuries into the ground as well (though I never took ibubprofen with those).

Do you wear neutral shoes? I had symptoms of runners knee (the 'movie sign') and switched from Mizuno Wave Rider (neutral) to Mizuno Inspire (stability) and the issue disappeared. Not to scientific but good enough for me.

Noakes 'Lore of Running' suggests that changing shoes is often the solution.

Thanks but I'm somewhat hesitant to change trainers as I've been in the same brand/style for 8yrs without so much as a twinge of any pain.

I know rest is probably best, but after 4 days of completely zero activity the thing was no better or worse. I'm thinking of possibly just keeping everying super slow and off the road on flat trails for a few weeks and see what happens.

Marathon Newbie wrote:

Thanks but I'm somewhat hesitant to change trainers as I've been in the same brand/style for 8yrs without so much as a twinge of any pain.

I know rest is probably best, but after 4 days of completely zero activity the thing was no better or worse. I'm thinking of possibly just keeping everying super slow and off the road on flat trails for a few weeks and see what happens.

4 days is nothing for a tendon injury. When you are young they heal faster but seriously you have no idea. I had that attitude a few years ago with my achilles injury and ended up losing 2.5 YEARS of running to it. I would run for a couple of days, feel pain, watch it get worse, be forced to stop. Then take as much as a week off and try again. Over and over. Never could train consistently.

Finally I just took two months off. No matter what I did not run. Oddly, after 4 weeks it hurt even worse than it did when I started. But I knew my body was healing so I had faith. Finally, 2 weeks after it stopped hurting at all, I started running again and it was finally healed.

I'm not trying to alarm you or saying you need that much time off. But get it straight that 4 days is nothing. Sometimes a couple of weeks not saves you months later.

Anyway, get to a doctor so you won't end up wasting your time wondering what to do.

No reason to run in pain this early. The first thing that jumps out at me is bumping to 100 mpw from 50 in 6 weeks? Were you a high mileage guy when you set those PR's (which were very respectable times btw)?

If you can't handle the higher mileage (that most of the successful marathoners I know do)you may want to check the Hansons/Brooks plan where the mileage is in your current range and the focus is on more marathon pace running, instead of the classic "long runs must be over 20 miles" idea. I know several mid mileage people that have met their marathon goals by following the Hanson's schedules.

..before everyone goes ballistic about the mention of the Hanson's approach, try to keep in mind that running a 22+ "long run" may not be the best overall approach for a newer marathoner who is only getting 50 MPW.

I prefer the Pfitzinger long run and medium long run approach but I may not feel that way if I couldn't get 75+ MPW and/or be training on an injury.

Lastly, I'd say to find any aerobic thing you can do to cross train (elliptical, deep water swimming, etc..) to keep as much fitness as possible until you can run again without pain.

Good luck!

I agree with what Average Joe is saying. Tendons suck. At first you think it's just going to be a couple of days, then maybe a couple of weeks, then you say "well, maybe in three months." Then you realize it takes on the scale of YEARS and if you had just rested up early instead of trying to come back every 2-3 weeks it would have taken 2-3 months max.

You have to RICE that injury. Also go to PT and get checked for muscular imbalances. They'll give you a massage roller, stretches, and exercises to do, and if you're good about it, and good about coming back slowly (every other day, a mile or two at a time), you'll be back to running painfree.