by Cassie Bjork in Training Tips, image by Duncan

Running with (and preventing) injured knees

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The last words my orthopedic surgeon said to me were: “Whatever you do, don’t become a runner.” Here I am, ten years and two knee surgeries later, and I’m proud to say I’m a marathon finisher—currently in training for my second and signed up for my third. Some people say it’s foolish, but to me, it’s a part of my life and something they may never understand. Being a runner is more than just a hobby or part of an active lifestyle—it becomes part of your identity. My journey as a runner has challenged me to grow in ways I never thought I could.

That being said, taking care of my body, especially my knees, is imperative. Over time, I’ve had many people ask me how I run with “bad knees.” I’m hoping this will answer that question along with providing tips to help you safely train with injuries or injury-prone knees.

The runs

  • Invest in a quality pair of running shoes. As a runner, your very first priority should be a great pair of running shoes. Be sure they are specifically designed for running, and try to go to a specialty running store, as they have trained staff that will help you find the perfect pair. Everyone’s foot type and gait is different. This is your main piece of “equipment,” so don’t take it lightly.
  • Don’t forget to warm up. Instead of taking off at full speed, easing into your run will help your knees adjust to the activity. I don’t recommend static stretching before running (it can set you up for injury,) but I do recommend doing a few quick stretches—and holding each stretch for 10-15 seconds. Loosening up these muscles before you run helps prevent overcompensating for a tight muscle by putting extra strain on the knees. I try to always stretch the quads, hamstrings, calves and hip flexors before I begin.
  • Choose soft surfaces. When possible, run on anything other than pavement or concrete because these hard surfaces place extra stress and shock on your knee joint. In addition, mixing trails into a race-training regimen can help you become a stronger, more well-rounded runner. I follow sidewalks and pavement trails, but instead of running on them, I run beside them, on the grass or trail. I also enjoy running through off-season golf courses and wooded trails. The more you can run on softer surfaces, the better it is for your knees. This isn’t always possible, (especially in Minnesota where the plowed sidewalks are usually safer than the icy trails,) but my advice is to utilize softer surfaces and the other strategies when possible.

The recovery

Ice: You can use commercially available cold packs or simply put a wet towel in the freezer before you run. I don’t normally take (or promote) over-the-counter drugs, but popping an aspirin or ibuprofen afterwards may be beneficial for any swelling. Be sure to take this with food and only take after a run—never before. If you have other areas that are hurting, I strongly recommend ice baths (see below) because they’re easier than attempting to cover your body with ice packs.

Ice baths: They’re beneficial for every aching joint and muscle in the body—not just the knees! This was a brand new concept for me when I was training for my first marathon. I remember the first time a nurse at work told me about this form of therapy, and I honestly thought she was crazy. After doing my own research and experimenting after an 18-mile run, I personally discovered how beneficial ice baths truly are. The ice bath works by constricting blood vessels which decrease inflammation, swelling and tissue breakdown all over the body. Ice baths are a great way to ease all your muscles and joints in one sitting. For an ice bath, fill up your bath tub with cold water and ice, throw on a sweatshirt and some pants if you’d like, grab a cup of hot tea and sit in the cold bliss for 15-20 minutes. It sounds crazy but I think you’ll be impressed with the results.

Glucosamine: If you are open to taking supplements, research has positively reflected the outcomes associated with taking glucosamine to improve joint health. Glucosamine is a natural compound found in cartilage, and since I’ve had cartilage removed from my right knee, I cover my bases and try to remember to pop one or two of these each day. It is an expensive supplement, but if you are someone who wants to take every preventative measure to keep your knees healthy, this is one that I recommend.

Eat a variety of nutritious foods. I’m sure you were waiting for the dietitian in me to touch on this topic, but this is the truth: good nutrition can promote healing in your body. A diet rich in fruits, vegetables and healthy fats is believed to reduce joint pain and inflammation. Consume healthy fats from avocadoes, nuts, seeds, fish, olive and coconut oil. The omega-3 fatty acids found in fish oils from cod, tuna, salmon, sardines and supplements have anti-inflammatory properties.

Identify fatigue and listen to your body. Your body’s instincts should take priority over your training plan. Like any injury that hurts, take time to rest and don’t push it. If you do, it will impair your training and performance in the long run (no pun intended.) If your knees hurt, cut back on your mileage and add some variety to your training. Swimming and biking are great cardiovascular activities that don’t cause as much pounding/wear-and-tear on your knees. Sometimes I have stretches where my knee pain persists which requires me to take some time off from running. It may just be a day or two, but there have been times when I’ve had to take a few weeks off as well. I know it’s the last thing you’ll want to do, but if you want to continue your career as a runner, it’s necessary.

The takeaway

If you take nothing else away from my advice, remember this: Listen to your body. If something is hurting and you are in pain, it is trying to tell you something. Err on the safe side by resting. The best athletes in the world will tell you the same thing because it’s exactly how they got to the level they are at. Periods of rest after intense exercise are essential to high level performance in any sport. Continuous training can actually weaken even the strongest athletes. If you don’t incorporate rest into your athletic routine, you will inevitably get burnt out and put yourself at a higher risk of injury. And when you do include rest, your energy level will rise and in your performance, you’ll hit a sweet spot and never turn back.




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