While there’s an ongoing debate around whether running is good or bad for our knees, runner’s knee makes up almost 50% of running overuse injuries, and the pain — radiating from behind and around the kneecap — can come in a wide range of feeling, make running less fun or completely impossible.
There are thousands of articles out there about preventing runner’s knee from occurring, but try to find some actual guidelines for making a comeback once you have it, and suddenly, the advice gets a lot less helpful. There are some faux ‘easy cures’ like knee braces, but ultimately, it’s a slow, irritating process. To slowly make your way back from a nagging injury like this that has a super high rate of recurrence is difficult — but necessary. Here are a few tips to get you back on the trails:
If you’re feeling pain in the same spot around your knee on more than one run, it’s time to take a few days off entirely — or at the least, dial the intensity way down for your next few runs. Most recreational runners can avoid a major issue simply by taking this time off, so don’t continue to run until the discomfort becomes unbearable. Ultimately, the cliche is true: The best offense is a good defense.
“The key to dealing with injuries is patience,” says Under Armour runner Jordan Tropf. “It’s important to accept that you are hurt and adjust your schedule accordingly for a proper recovery. One of the traps I found myself falling into early in my running experience was rushing back from injuries, as to not lose fitness, but this ended up just prolonging my recovery. This often set me even farther back than if I would have just rehabbed patiently in the first place. Now, just accepting that fact, not trying to train through it and performing useful cross-training gets me through these injuries and flare ups.”
Seriously. “Mentally, injuries are tough,” says Tropf. “Especially when it occurs close enough to a race to drastically impact your race. It’s easy to feel sorry for yourself, reminding yourself of all those hours of training that are now for nothing.” But freaking out about your injury isn’t going to help cure it — stay calm and start prioritizing getting healthy versus getting back to training.
It will be frustrating to go without exercise, so don’t! Just because you can’t run doesn’t mean your training has to stall entirely. Supplement with what you can do, which could include deep-water running, cycling or swimming to keep your aerobic conditioning. Often, physical therapists even recommend cycling to get through runner’s knee problems, and while it may feel different or not be your first choice of activity, you’ll come back to running without losing your fitness entirely.
ADD REHAB EXERCISES
This is a great time to visit a physical therapist to learn how to properly rehab your knee in the most efficient way possible, but even if you’re not willing or able to make a PT appointment, you can stretch at home. Yoga is a great start, and foam rolling both legs — not just around your one knee — can help loosen tightened muscles.
FIND THE POSITIVE
“Injuries are very humbling for me. They remind me of how lucky I am when I’m not hurt,” says Tropf. Maybe this injury is exactly what you needed, to remind you why you love to run. “This is a big perk in the middle of intense training blocks, when your body is tired and you’re sacrificing sleep for training. It’s important that we all remember this and not take a healthy running season for granted. And, injuries get me hungry for the next one. Nothing like a good ol’ set back to get me focused and hungry for the next race,” Tropf adds. There’s always a silver lining!
START RUNNING AGAIN
When you start running, don’t just jump back into your old mileage. The best way to get back to running is actually with a walk/run, easing back in. At first, the minute walking/minute running might feel frustrating since your aerobic capacity is still solid, but these on/off intervals help avoid setbacks. Gradually, increase the run intervals. When you can do intervals longer than a few minutes without any pain or discomfort, you can shift to short runs with no walking (20–30 minutes at first). Give your body time to re-adapt to running, and trust you won’t lose your running fitness as you make your comeback.
WARM UP AND COOL DOWN FOR LONGER
You might have been the runner who stepped out the door and hit the ground running in your past life, but during and after runner’s knee, you’re going to want to spend a lot more time walking and foam rolling to warm up and cool down. It’s not sexy, but it’s necessary.
DON’T MAKE ANY DRASTIC CHANGES
It might be tempting to think about making major changes to your running — you blame your shoes, your stride, your gait or your speed for your injury. But this isn’t the time for dramatic changes, like swapping to a hugely different pair of shoes. Don’t go from 10mm drop to barefoot in an attempt to ‘cure’ your knee pain.
If you feel any pain when you run, slow to a walk and ease up. When you’re first getting back on the road, a little discomfort post-run is OK, but make sure it’s not painful to walk — if you’re limping back to the office after a short lunch run, you’re doing too much too soon.
UNDERSTAND THERE IS NO REAL CURE
The biggest bummer about runner’s knee is once you have it, you’re much more prone to having it happen again. So just because you’ve gone a couple of weeks or months pain-free, don’t stop your rehab exercises. Continue adding in those stretches and clamshells.
CONTROL THE CONTROLLABLE
“Try to make every setback an opportunity. Don’t dwell on what could have been. Instead, focus on what could be,” says Tropf. Focus on what you can make progress on during your recovery: get more (high-quality) sleep, hone in your nutrition and eating strategies, hydrate enough and practice good stretching and foam rolling. Use your time away from running to make gains in the other small pockets of your life that, when put together, can make your training a lot smoother once you get back out there.