My visit to the osteopath about my knees

[Steve_L]

Long post alert - though I think it's worth it!

I thought it might be helpful to the runners and aspiring runners here to share my experience today.

I started C25K on 26th January this year. I'd never run seriously before (I'm 58). I took what I thought was the smart move to go and get my gait analysed before starting, as I know I have flat feet, and yes, it was confirmed I over pronated, and I got some running shoes with support. They felt comfortable.

Nine weeks later, I graduated. On my first run after that, at the end of the run, as I slowed to a walk, I had a sudden pain on the inside of my left knee. I hobbled home and iced it. Although I wasn't going to be stupid and risk damage, I didn't want to stop running, so I got some tubular bandage and went on an exploratory run with the knee supported a couple of days later. It seemed to work, and I've been running with knee support since, without any real trouble, though I do often feel a bit of tightness on that spot. I moved onto a more purpose made support with velcro fastening. Since graduating, I've been running three, four, and lately five times a week, mixing 5k and 10k runs, sometimes further, some 30-40km a week. I ran an organised 10k race a couple of weeks ago, and am signed up for the Oxford HM in October.

Last Thursday, during my morning run, I started to get sharp stabbing pain on the kneecap of my the other knee - bummer! It wasn't consistent, and I did carefully run it off. At the Parkrun on Saturday, it was hurting me during warmup. I moved the knee support from left to right knee, and started the run prepared to abort if it hurt, but it didn't, and I had a decent run.

I decided, though, that it might be prudent to get some expert advice about my knees and how to manage them. The last thing I want to do is get injured and have to stop running for a spell. Off to my local osteopath who specialises in sports injuries. A very interesting experience.

In summary - my knees are in very good condition. There's nothing wrong with them. Ditto my hips. It's my flat feet. The running shoes provide far too little support, and the feet are causing lateral movement of my knees which the ligaments don't like. He manipulated my legs to check everything out, and worked on the inside of my knees where one of the ligaments is (ouch!)

The knee is a really simple joint. Just a hinge joint with cartilege and four ligaments. The ligaments don't have a blood supply, so when they get damaged, it takes a long time to heal.

Running doesn't exercise the leg muscles (particularly the quads) very much at all, despite what you might think. Muscle condition is important for stability of the joints when you run. As you get older, the muscle bulk naturally reduces. If you want to even stay still with muscle condition, you need to exercise outside your running. I've got a programme for squats to follow, and advice for other things I can incorporate into life to work the quads, like running upstairs.

All in all, that was £76 well spent (including a set of orthotic insoles) I know there's nothing wrong with my hips or my knees, and it's a matter of addressing my (very very) flat feet. I have more confidence in my body, and I understand it better now. First run with the insoles tomorrow!

[Vixchile Graduate]

thanks for sharing your experience!! I think there is some very valuable information in your post

1) squats -now who is it that told us to squat everyday!?!

2) the importance of correct trainers

3) the importance getting a professional advice

I am glad to hear that you are on the road to recovery

[Steve_L Graduate in reply to Vixchile]

I feel a little smug that I did this before I really had anything to recover from. All I'd had so far was some niggles, really, but hopefully I can avoid real damage in the future.

[Pigivi]

Glad to know your knees are ok - bad knees are really a pain. It may be a simple joint but when it goes wrong it's no fun... My right one "clicks"every time I pedal on a bike

I hate squats - but force myself to do them exactly for the reason you mentioned.

I also find that hillwalking is great - going up and down steep tracks/stone steps and irregular ground gives your legs (and glutes) a great workout.

[Hidden]

Thanks for this. Really informative and def worth the long read. I also have flat feet but unlike you didn't get a gait analysis. Still running in my £25 karrimors from Sports Direct, although I did select them for the seemingly supportive instep and square toe box. At one point I tried adding orthotic insoles into the mix, but that was when I started getting massive blisters on my inner soles, so I stopped. I think I'm overdue a visit to a running shop for gait analysis and some high arched running shoes, as I'm very keen not to damage my knees, esp as left knee and hip are less than perfect due to various teenage bike crashes!

[Usain_Balti Graduate]

Glad you bit the bullet and took professional advice before you did some serious damage and it sounds like it was money well spent Steve.

I'm pleased to hear about your hips and knees but it looks like you might need to find a new gait analyst for your next set of shoes! FWIW I went to one in the Wheatley area.

God knows what pace you'll be doing with those insoles.

Happy squatting ; )

[Steve_L Graduate in reply to Usain_Balti]

I think the problem is that the mainstream running shoe manufacturers provide quite limited support - probably ok for 95% or so of overpronators but not for people like me. The osteopath remarked "you HAVE got flat feet, haven't you?"

The insoles are markedly more supportive than the running shoes.

[runswithdogs Graduate]

Interesting read Steve. I also have flat feet. I was suggested custom orthotics, but they're very pricy ($400 Cdn) so I'll be interested to see how your insoles do. What kind are they?

My chiropractor suggested buying the neutral shoe next time, in part because no two people pronate the same so the adjustments may not be right for me, and in part because if i go NB the custom orthotic route the insoles work better in the neutral shoe. Did yours mention anything about neutral vs pronating shoes?

[Steve_L Graduate in reply to runswithdogs]

I took my running shoes with me - he was able to compare me standing in bare feet and with the support shoes. He could see there was still a lean. He did say I was quite lucky, as most people with flat feet find their knees rotate inwards when standing or walking, and mine didn't.

The insoles are Foot Science "Express" 3/4 length insoles. They were about £30. He was able to check them out in my shoes.

[Anaverageman Graduate]

Well it DOES make for interesting reading for sure... I guess the ' proof of the pudding is in the eating' .. if it work and prevents injuries..then the advice was right. certainly (as a long time advocate/ practitioner of working out in the gym ) i wouldn't a disagree that other ' strength ' exercises are useful beyond/with running - Personally Id say not JUST squats but also working on hamstrings, calf muscles ( leg lifts and raises, calf raises etc.) and some upper body work is good overall.. ( but there are a limited number of hours in the day/week and you cant do it ALL)

My own word of caution would be as follows. As we age our cartilege in the knee degrades ( i understand) and knee pain at this age can often be caused by either small bits irritating the knee or generally increased level of friction due to cartilege degradation.. I understand he probably looked at this but without an MRI/Xray not sure he could tell if this had caused problem or not.

As i say, if it WORKS , brilliant - worthwhile lesson!! Keep us informed?

[Steve_L Graduate in reply to Anaverageman]

He did say there was little sign of wear in my knees, which was good to hear.

[Anaverageman Graduate]

well thats good.. but how can he tell that? ( was my point)

[Steve_L Graduate in reply to Anaverageman]

I understood your point, and you may well be right, but he seemed to know what he was talking about, and did have a thorough play with my knees

[Anaverageman Graduate]

Well I certainly haven't had a ' thorough play with your knees' SO I couldn't possibly comment!

[misswobble Graduate]

Oh good! I do hope that puts paid to your problems and you can run on unhindered by pain.

[poppypug Graduate]

That's really good to hear Steve, must be a weight off your mind ( or your knees should I say :-))

Thanks for the insight, very interesting read that !

Onwards ! There will be no stopping you now with your super speedy insoles ! xxx

[ajwyld Graduate]

Also have flat feet and also have orthotic insoles (in my case from a podiatrist). In my case the knee pain came from arthritis, which I didn't know i had before, but the insoles have kept me painfree for over a year now.

I use the insoles all the time, not just in my running shoes.

[AncientMum Graduate]

Those quad strengthening exercises are so important for runners joint health. I think we should all bombard new members of the forum with quad strengthening advice when they first post, regardless of what they're posting about. It could be a bit alarming for them but might prevent a multitude of injuries.

How did the osteopath feel about you running in knee supports? The surgeon who sorted out my husband's knees was dead against exercising in knee supports. He felt that they stop you building up the muscles necessary to protect the knee joint.

[Steve_L Graduate in reply to AncientMum]

He didn't really comment on the knee supports, but I'd guess it was better to run with them for a time. Hopefully I'll be able to stop using them now.

Agree with you about the quad strengthening. I've done my squats session for today!

[dagshar Graduate]

I am very flat footed too and went to a podiatrist a few years ago when i got plantar fascitis after 7 sessions of fencing. He took a cast of my feet and I have been wesring custom insoles ever since (i had had insoles back in Germany 27 years ago but eventually stopped using them, so his diagnosis was not exactly surprising). I paid £150 consultation and orthotic, but as I say they were not off the shelf and overall I went 2 or 3 times. When I went running shoe shopping it turned out that my orthotics in neutral shoes are better than just a shoe for overpronators as a support shoe is not custom made to my feet...My knees have been pretty good since I started wearing my orthotics in my neutral asics. Started having a few little niggles last week, but i know that is most likely a side effect of the nice weather as I wear my orthotics less in the summer because they don't fit in sandals and some other summer shoes.

I also make sure I do some stretches and exercises to strengthen the knee related muscles. Had a great (=hard) exercise session at work this morning again with lots of squats and other stengthening exercises!

[Neeseydriveway Graduate]

That is good news that your knees are absolutely fine! I know how you feel. I don't want to get injured and have to stop running. A little extra effort on off days is worth it. Thank you for responding