How to Get Back to Running Pain-Free

Are you a runner having knee pain?

Every spring, as the weather warms up, who can resist the urge to get outside as much as possible? For runners, that means trading the treadmill and boring indoor workouts for fresh air and sunshine! With the added miles and varied terrain, this is often the time of year I see more injuries, both in the gym and clinic- knee pain is one of the most common complaints. 

At first it’s just annoying. But it lingers and intensifies. Then it starts affecting your gait.

As I runner myself, I know the 2 thought processes that tend to pop up:   

·        “Grrr… I can push through it, it’ll work itself out.” 

·         “Uh-oh… I should quit running for a while”.

I think the best approach may be a little of both, implemented carefully.

What I See (And What’s Often Misunderstood)

The bottom line: As you increase miles, your body needs time to adapt to the added stress. Knee pain is rarely a “knee joint problem.” More likely, it is a consequence of how your body is moving and responding to load. The truth is, running is a lot of impact on all of your joints.

Think of it this way, there are 13 muscles that cross the knee and contribute to stabilizing the joint. Most of those muscles also connect with the joint above (hip) or below (ankle), this is why you must always look beyond the site of pain. Weak hip stabilizers, limited ankle mobility and poor posture- can put a beating on your knees. Carrying a few extra pounds amplifies the pounding, combined with poor mechanics can really wreak havoc.

The common practice I see:

• ·        Ice it

• ·        Rest briefly

• ·        Get new equipment (shoes, inserts, knee brace, etc.)

• ·        Decrease in pain (or not) – go back to running

• ·        Same pain returns or a different pain emerges (back to step 1)

Why doesn’t this work? Because the root cause hasn’t been addressed.  I often see runners shuffling along in pain, with hi-tech $300 shoes, knee braces, KT tape, etc.– doing anything they can think of to continue doing the activity they love but really doing nothing to fix their problems.

What the process should look like (My approach)

Step 1: Calm things down, sports acupuncture is great for this. For knee injuries, I love using gua sha and cupping to release myofascial tissue, then local needling with electric stimulation around the knee. This usually relieves pain and inflammation within a few treatments. Keep in mind treatment frequency is crucial during this initial period, 2-3 acupuncture sessions a week may be necessary when dealing with stubborn pain.

Step 2: Movement screening to diagnose weak links, prescribe specific mobility and stability exercises, and form drills to improve running mechanics. Adding some squats, planks and stretches to your routine isn’t going to cut it. Strength training must be intentional and intelligent.

Step 3: Gradually return to running (maybe never stop completely). One of the biggest mistakes people make is adding too much too soon. Start with intervals- something like: 1min run/ 5 min walk. The key is to establish a safe level of discomfort, I use 4/10. If severity exceeds 4, walk it off until it’s below 4, try again… if you can no longer stay below 4- workout is over. This requires patience and discipline but I find that it is the best approach to return to running.

If this sounds like a lot of work, it is- changing movement patterns takes time and effort. In essence you are re-learning how to run. 

Shift the thought process away from “ I will run to train” to “ I will train to run efficiently” Elite runners still do form drills and work on mechanics AND they do not run everyday, no matter how nice it is outside.

The Takeaway

Knee pain doesn’t automatically mean you have to stop running. But it is a signal that something needs attention.

If you approach it the right way—calming the pain, improving movement, and building back gradually—you can often get back to running stronger and more resilient than before.

MaryBeth is a licensed acupuncturist, herbalist, ACSM Certified personal trainer, specializing in human biomechanics and corrective exercise. She has competed in 10 full marathons, 50+ half marathons and coached high school cross country/track and field for over 10yrs.