Advice needed from experienced runners/phys. therapists

[Mama Anna]

Should I wimp out and do the 3K or keep working toward the half-marathon?

 

Background: I'm a novice runner and have yet to run a race. For the last couple summers I was running a couple miles 2 to 3 times a week. I liked the energy it gave me. Then an acquaintance mentioned training for a half-marathon this spring and I jumped on it. It gave me a goal that encouraged me to run through the winter. (So I could continue to enjoy the extra energy, etc.) In general, my body takes running well, so I figured it should be manageable. My knees hurt at the beginning (tendonitis), but I asked for advice and took it, making sure I was running on a flat track and icing my knees after each run as well as at other times, and strengthening my hamstrings with exercises.

 

I've been following a 16-week 3 run/week training plan because that's what fits my schedule. For cross-training I've been generally walking a mile on my off mornings and doing a video workout that I can complete in about 15 minutes 3x/week. (It's meant to take longer, but I only have the amount of time that breakfast is in the oven so I move through things pretty fast.)

 

So now, 3.5 weeks out from the half, my knees are hurting again. It began a couple of weeks ago when I came back from a short run (I'd tried to do some speed drills) barely able to walk up a big hill. I could run okay on the flat, though. The next long run, which should have been 8 miles, I did on dh's bike - riding for almost 2 hours (until my knee was hurting whenever I had to pedal uphill). Things were better. Last Saturday my knees felt pretty good and I was eager to go for my 9 mile run, plotting it to take in as few steep hills as possible. But it was warm out and I started heading for heat exhaustion, I think. Between the nausea (water didn't help), the graying vision, and my lower GI having unrelated difficulties I managed under 6 miles, some of which I walked. That was a bummer.

 

So today I was supposed to run 4 miles - generally not a problem. I took an ibuprofen and started out delicately because my knee has been pretty sore lately. (I almost wasn't able to do my push-ups yesterday because my knees hurt so bad being that straight.) Going down the first hill, which isn't big, my knee was sore all the way. It stayed sore on the flat. I turned around and walked home. What am I supposed to do about my theoretical 10 mile run on Saturday?

 

I can't afford to get a severe injury. We don't have medical insurance and I can't do that to my family. The only reason I set my sights on this half was to give me an excuse to run through the weather. That worked. Should I just switch down to the 5K that's also offered?

 

On the other hand, I will have trained for more than 16 weeks. (It took me about a month to carefully work up to a good pre-training platform.) For a 5K?!?!? It seems like a waste! Not to mention the money I've spent on running clothes, a hydration pack, etc.

 

Can I do it? How? Is this a normal point for a rookie to get discouraged? I need advice! The solutions I've thought of are:

 

1. Gatorade for the heat problems. If it's only for a few weeks, I think our budget can handle it.

2. One of those tennis-elbow type bands for my left knee, which is the worst. Maybe I could run this afternoon with it?

3. I could always try biking again this Saturday, if that would help.

4. A heavier exercise band for my hamstring exercises to step them up.

5. Maybe not ramping all the way up to 12 miles in my long runs? (The schedule I'm following goes all the way up to 12 miles by the week before the race.)

 

Thank you for reading this book! Could any of you with experience weigh in with your opinions?

 

TIA!!

 

Mama Anna

[Momof3littles]

Did you self diagnose with tendonitis? Have you seen anyone for a complete eval?

 

Do you have any problems going up and down stairs at home or anything like that when you aren't running? Do you have problems if you go from sitting for a while to standing at home?

 

Is your pain primarily in your hamstrings?

[nono]

First, :grouphug:. Training not going along when it looks so great on paper can be frustrating!

 

I'm not going to hazard to tell you what to do. I will suggest that running a 3K is not wimping out. Running any distance with diligence and putting it all out there race day is excellent. Longer distance isn't "better." :)

[beaners]

I would try IT band stretches for the knee problem and see if that helps. You absolutely don't need to run 12 miles to finish a half-marathon. If backing off a little bit now keeps you from being injured, do it. Is it a 3K (about 2 miles) or a 5K (about 3 miles)? Either way, I know people who train all year to run a 5K, and they're pretty fast. ;) I wouldn't call it a waste.

[Trish]

I wouldn't train to run a half marathon if you're suffering knee pain. (Do you want functioning knees in your middle to older ages?) I think your running regimen is GREAT, and I concur with the extra energy etc that it gives you. Nothing wrong with training for a 3K or 5K.

 

If you push yourself too hard in the knee department, you'll end up with no running regimen at all, which I think would be a shame.

[Mama Anna]

First of all, thank you all for your quick replies!

 

 

Did you self diagnose with tendonitis? Have you seen anyone for a complete eval?

 

Do you have any problems going up and down stairs at home or anything like that when you aren't running? Do you have problems if you go from sitting for a while to standing at home?

 

Is your pain primarily in your hamstrings?

 

Yes, the tendonitis is self-diagnosed. We have no medical insurance and therefore no doctor. I've read up on knee pain on marathonrookie.com and it seems to fit the tendonitis description better than the IT-band issues, thought it could be a combo. We have a specialty running store in the area and I've been in several times to ask those guys for advice, too.

 

Going downstairs is uncomfortable. I've learned to stand up gently. I don't have any pain in my hamstrings, only in my knees. Primarily the pain/discomfort is in the area directly below my knee-cap. I was told to strengthen my hamstrings in order to keep my quads from pulling the joints out of balance, which is why I mentioned those exercises.

 

I would try IT band stretches for the knee problem and see if that helps. You absolutely don't need to run 12 miles to finish a half-marathon. If backing off a little bit now keeps you from being injured, do it. Is it a 3K (about 2 miles) or a 5K (about 3 miles)? Either way, I know people who train all year to run a 5K, and they're pretty fast. ;) I wouldn't call it a waste.

 

Sorry about the mis-type - it's a 5K.

 

How far would I need to be able to go beforehand on a long run in order to finish the half without real fear of injury?

 

Dh told me this morning that he'd be willing to try and help have time to train again for next year's half if I can't do it this year. It's not like this would be my last chance unless I hurt myself badly enough . . . I really do appreciate those of you who are telling me that a 5K isn't wimping! :)

 

One more question: If I just rest for awhile, biking to keep up some semblance of conditioning, how can I tell my knees are ready to try some more? I wish there were a sensor somewhere that would show red for "Injuy" and green for "Good to Go!"

 

Mama Anna

[Momof3littles]

First of all, thank you all for your quick replies!

 

 

 

 

Yes, the tendonitis is self-diagnosed. We have no medical insurance and therefore no doctor. I've read up on knee pain on marathonrookie.com and it seems to fit the tendonitis description better than the IT-band issues, thought it could be a combo. We have a specialty running store in the area and I've been in several times to ask those guys for advice, too.

 

Going downstairs is uncomfortable. I've learned to stand up gently. I don't have any pain in my hamstrings, only in my knees. Primarily the pain/discomfort is in the area directly below my knee-cap. I was told to strengthen my hamstrings in order to keep my quads from pulling the joints out of balance, which is why I mentioned those exercises.

 

 

 

Sorry about the mis-type - it's a 5K.

 

How far would I need to be able to go beforehand on a long run in order to finish the half without real fear of injury?

 

Dh told me this morning that he'd be willing to try and help have time to train again for next year's half if I can't do it this year. It's not like this would be my last chance unless I hurt myself badly enough . . . I really do appreciate those of you who are telling me that a 5K isn't wimping! :)

 

One more question: If I just rest for awhile, biking to keep up some semblance of conditioning, how can I tell my knees are ready to try some more? I wish there were a sensor somewhere that would show red for "Injuy" and green for "Good to Go!"

 

Mama Anna

 

I think you need a proper diagnosis, TBH. What you are describing could also go along with something like a patellar tracking issue for example, which is very common in women. In that case you'd want to strengthen your VMO, which is part of your quadriceps. Obviously without a comprehensive evaluation, it is impossible to say over the web, but I'm tossing out other ideas that you may need to consider.

 

http://www.webmd.com/pain-management/knee-pain/tc/patellar-tracking-disorder-topic-overview

 

I really think a proper diagnosis is essential if you want to get back to running. I don't think self-diagnosis is reliable for most people and I don't think I'd put a lot of stock in what someone says at a running store :grouphug: I would just hate to see you wasting time by operating from an assumption that may not be accurate.

 

Can you swing a PT eval and a few sessions? They may be able to see you for just a few visits and then set you up with a home program if cost is a major issue.

 

eta: another short blip about patellofemoral joint pain:

http://www.runnersworld.com/article/0,7120,s6-241-285--7773-0,00.html (again, not saying this is your diagnosis but it would be something that a good evaluation would rule in and out, vs. assuming you have tendonitis).

Edited March 22, 2012 by Momof3littles

[nono]

I don't understand the no insurance = no doctor. Won't doctors see you without an insurance card in your area? That stinks!!! We've had times of no medical insurance. Some docs wanted certain coverage, but many were willing to see a "cash" patient.

 

If you are saying you have no $$ set aside to pay for an evaluation, then I would seriously think about what will happen if you try for the half marathon and find out you were running on a developing injury. You could come out of the experience with a serious injury that doesn't necessarily just heal without medical intervention. An irritation (which sounds like the stage your are at currently) may well heal on its own. Maybe that's something to consider.

 

I'm not trying to discourage you, as you are already a runner. I would simply suggest that you not push your body past the point of pain if you don't have any way to get care if things would get worse.

[Jennifer in MI]

How does it feel when you walk on flat ground? I would try walking the half marathon only IF it doesn't hurt when you walk. I would definitely not try running it at this point. Too much risk, IMHO.

 

My story - I had run two half marathons and was training for my first full when I got severe knee pain. It kept getting worse and worse and I was very discouraged. I went to my doc who diagnosed IT band issues and sent me to a PT. What he found was that the muscles that were to hold my patella in place were not even and that was causing all the issues. So, we worked on stregthening those muscles and he taped my knee so I could continue to train.

 

I decided to walk the marathon. Walking did not hurt. It was such a hard decision to make, but I didn't want to cause permanent injury. ANd, I had worked SO hard (I got to my 18 mile run) and I didn't ever want to do it again. This was my one shot! I did it and my knee was fine. It has been ever since and I've run two more half marathons since.

 

If there's any way you can get an evaluation done, I'd do it. If not, if walking doesn't hurt, I'd walk it!:grouphug:

[AK_Mom4]

you probably know this, but you need to check your shoes. If you have been regularly logging miles, you may have broken down the support. DD18 (who has had 2 knee surgeries) runs great with a $30 insole to keep her from pronating. If you have been training for a while and have built up those upper leg/lower back muscles unevenly (it happens to all of us sometimes), you may need a more supportive insole to keep the leg aligned and avoid the knee pain.

 

I know you don't have medical insurance, but it might be worth a single visit to a physical therapist to talk about exercises and ways to keep those knees working. Those PT folks ar amazing!

[Cera]

If there is any way you can get in to a PT it would be well worth it. I had tendonitis issues over the summer and the only solution was to stop running completely until the pain was gone. Once there was no tenderness at all I was able to get in to a PT who watched me run on a treadmill and suggested some strengthening exercises plus changes in body mechanics to prevent a recurrence of the injury. I have now been running without pain for 4 months.

 

I wouldn't try to do the half with knee pain. Honestly, I wouldn't even try to do a 5k with knee pain. It isn't worth permanent damage to such a vital joint.

[StephanieZ]

IMHO . . .

 

You only need to get to one 10 mile run a week or two before the race. You can do a HM on that long run. Your taper and the race energy will get you the full 13.1.

 

You still have 3.5 weeks and are already close to a 10 mile long run. You can do this!

 

DOWN hills are hard on your knees. I'd say don't run down hill any more until the race. If you have to run on hills for your training, run up, walk down. I know this sucks. But, it is a lot safer. Run on flats if you can.

 

Speed work is also hard on your body. Skip it. No more speed work until the race. Instead, only run easy and slow, with SMALL SHORT steps. Aim for a quick turnover of your feet. Ideal is 90 steps per foot per minute. Slower than 85 is a lot harder on your legs. Think "light, quick, soft, easy" with your leg turnover -- little soft quick steps, landing under your body, not out front.

 

Take the next few days off running. Cross train instead (on the bike). If any of the non-running things you do hurt, STOP and do something else instead. Take up to 7 days off running if you are still feeling pain after 3-5 rest days.

 

ICE ICE ICE everything that has/does hurt. 3-5 times a day 20 min COLD so the skin turns red and bumpy.

 

For the next 7-10 days, take it easy running. Run only on flats. Maybe run every other day for 3-5 miles (after taking the next 3-5 days completely off running).

 

Plan to do a 10 mile run 7-14 days before the race.

 

So, this week, don't run any more.

 

Next week, run 3/3/5

Then the following week run 5/3/10

Then, the last week, just run 3 miles 2-3 days before your race. Then your 13.1.

 

Stretch well after your runs.

 

Don't up your strength training right now, as you might hurt yourself with that, too. BTDT.

 

(After your HM, consider focusing on hip strengthening exercises, as weak hips are a common cause of lower leg pain in runners.)

 

You can do this. Your pain doesn't sound severe. If you back off a bit right now, then slowly and gently ramp back up, I think you'll be fine.

 

Meanwhile, if the pain gets more severe or increases, despite backing off a bit, then, yes, you can always bail on the race at the last minute. But, I think you can do this.

 

At the end of the day, only you can know what your body can handle. So, listen to your body, and change up your plan as needed.

 

The only really critical run you have in the next 3.5 weeks is one 10 mile run 1-2 weeks prior to the race. You can replace all the other training with biking if needed, and you'll still be able to do your HM. So, if, after a few days rest from running, when you return to running, if the short runs are hurting despite going slow and avoiding down hills, then replace more of those short runs with cross training . . . and then try again a few days later . . . So long as you can handle one 10 miler in a couple weeks, you'll be OK.

 

Good luck!!

[Momof3littles]

If there is any way you can get in to a PT it would be well worth it. I had tendonitis issues over the summer and the only solution was to stop running completely until the pain was gone. Once there was no tenderness at all I was able to get in to a PT who watched me run on a treadmill and suggested some strengthening exercises plus changes in body mechanics to prevent a recurrence of the injury. I have now been running without pain for 4 months.

 

I wouldn't try to do the half with knee pain. Honestly, I wouldn't even try to do a 5k with knee pain. It isn't worth permanent damage to such a vital joint.

Yes, sometimes you really have to break the inflammation cycle in order to get anywhere with something like tendonitis. That may mean stopping or doing alternative exercise until you break that cycle.

[Mama Anna]

I again appreciate everyone's replies. I'm hearing that I need to get to a PT if at all possible. I'm not sure it will be, but I can try. The no insurance=no doctor issue comes from the last time we had no insurance and tried to get into a doctor's office; they insisted on a $100 physical at the first appointment - and didn't even address the problem my dh went in for. (That would have needed a follow-up.) We have about $300 for med. expenses for the forseeable future, without dipping into our emergency fund. This is why I'd rather not see a doctor and why I must not sustain a bad injury. A PT might be different. I have friend who is an athletic trainer if all else fails . . . :D

 

Thank you all for your interest and advice!

 

 

The only really critical run you have in the next 3.5 weeks is one 10 mile run 1-2 weeks prior to the race. You can replace all the other training with biking if needed, and you'll still be able to do your HM. So, if, after a few days rest from running, when you return to running, if the short runs are hurting despite going slow and avoiding down hills, then replace more of those short runs with cross training . . . and then try again a few days later . . . So long as you can handle one 10 miler in a couple weeks, you'll be OK.

 

Good luck!!

 

I especially appreciate your post, StephanieZ - the detail is what I'm looking for!

 

To not push too hard is the key. And to let the whole thing (half and 5K) go if I need to - despite my goal-driven nature - that could be the hardest part!

 

Thank you all!!

 

Mama Anna

[nono]

I again appreciate everyone's replies. I'm hearing that I need to get to a PT if at all possible. I'm not sure it will be, but I can try. The no insurance=no doctor issue comes from the last time we had no insurance and tried to get into a doctor's office; they insisted on a $100 physical at the first appointment - and didn't even address the problem my dh went in for. (That would have needed a follow-up.) We have about $300 for med. expenses for the forseeable future, without dipping into our emergency fund. This is why I'd rather not see a doctor and why I must not sustain a bad injury. A PT might be different. I have friend who is an athletic trainer if all else fails . . . :D

 

Thank you all for your interest and advice!

 

 

 

To the bolded YUCK! That's seems so ridiculous! I figured there was something I wasn't understanding. So sorry it is like that where you live. :grouphug: DEFINITELY ask your athletic trainer friend for any ideas!

 

Good luck!

[Coffeetime]

I wouldn't try to do the half with knee pain. Honestly, I wouldn't even try to do a 5k with knee pain. It isn't worth permanent damage to such a vital joint.

 

:iagree: I always say... Runners are generally people who are goal driven, like to push themselves, and are perfectly willing to deal with pain in order to reach their goal. :D

 

I ran through the pain of a mildly pulled calf muscle and ended up putting myself completely out of commission for 3 full months. :sad: It was horribly depressing.

I doubt you would have to wait a full year for another opportunity at a half... at least around here during the spring/summer season there are races everywhere.

[Momof3littles]

Yep, I'm a PT and an ex-runner. In high school I was extremely competitive and pretty hard-core. I kept running on an injured leg and ended up with a stress fracture in my fibula that progressed to being a full fracture. It showed up clearly on an xray, no bone scan needed. Not good.

 

I am trying to get back to running.