Update, started week 4. Knee problems creeping... - Couch to 5K

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Update, started week 4. Knee problems creeping back :(

Elenive profile image
11 Replies

Finished week 3 on Saturday and things were going really well. Woke up on Sunday and the knee pain I had before was back.

I used to run a few years ago but stopped when I developed chronic knee pain. Checked it with a doctor last year and was told it was likely to be chondromalacia patella. I was advised to do daily cycling (I have an indoor exercise bike) to strengthen my leg muscles and was referred to a podiatrist who checked my feet and prescribed some insoles. A good few months later, my legs are so much stronger (fighting fit!) and I'm used to the insoles now so the podiatrist advised starting couch to 5k to gradually build the running back up again. I've been following the course with military precision, been really enjoying it too, well until the pain came back. The advice on here about stretching, hydrating and being slow and steady has been super useful and I've been incorporating it into my routine!

Anyway after the pain on Sunday I decided to rest my knees and not do anything until it felt better. The pain was almost gone yesterday but decided to give it an extra day before trying the next run.

This morning it felt fine so went out and did my first run of week 4. I warmed up and then took it very slow and steady, opted for a gravel trail instead of the road too. I felt a few niggles early on but after a while it felt fine. After the run I did a full stretching session and rehydrated. I'm planning to do a light cycling session tomorrow to keep the muscle strengthening going too. All-in-all the knees are not too bad today and I'm glad to have done the next run on the course!! Although still worried about the pain but hopefully my slow and steady approach along with my stretching routine and daily cycling will help keep it away!

Before this week I had been doing: Mon-Run, Tues-Cycle, Wed-Run, Thurs-Rest, Fri-Cycle, Sat-Run, Sun-Rest. Going to change it now I've had a few days rest with the pain and instead use a 'listen to my body' approach to decide on the day whether I should run, cycle or rest. I really hope I'll be able to keep running and manage this! I'd love to complete the course, I'm not so bothered about completing it in the 9 weeks, I don't mind if it takes longer I just hope I'll be able to run 3 times a week without pain in the long term. I'm a healthy weight and in my late 20s so a little frustrating but I don't mind as long as I can manage it somehow!

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Elenive profile image
Elenive
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11 Replies
Shuffling_Saturdays profile image
Shuffling_SaturdaysGraduate

Hey, have you tried icing your knees after your runs (after stretching)? It helps mine if they're feeling a wee bit niggley after a run. I usually ice both knees for 30 minutes, sometimes 2-3 times a day.

I also wear patella straps on my knees when running to provide more joint support. I do all of my runs on the trails to reduce impact - an NHS physio once told me never to run on roads.

You may also, like you said, want to build in some more rest days. I took 12 weeks to finish c25k, taking 10 days for Week's7 & 8 and 11 days for Week 9 to give my knees a rest from the increased running time.

It does sound like your doing a lot of exercise, with all the cycling too, and even though cycling isn't impactful on the knee joint, it still requires the joint to move through each revolution, creating force through the knee. I'm a cyclist and to be honest have largely stayed off the bike whilst doing C25K (with the exception of two short mountain bike rides) as I wanted to give my knees as much rest as possible. Might be worth you experimenting by taking a week off the bike to see how your knees cope on your runs.

Elenive profile image
Elenive in reply toShuffling_Saturdays

Thanks. I have tried icing my knees before but it didn't seem to do anything. Never tried a strap though, I'll look into that, thanks!

Yeah, I mean cycling isn't really my kind of sport (I much prefer running) but the doctor I saw highly recommended daily cycling to build up my leg strength and said that in his experience cycling is much more effective in strengthening the leg muscles than individual physio exercises which do work but can take much longer. I have an indoor bike (spin bike) and was using it 4/5 days a week initially (in the months before I started back running again) but as you say when I started running I thought hard to try and balance it and not over-do the exercise. I've been planning and going about my exercise so carefully.

Based on what the doctor told me I think it's important to keep the cycling going on in the background while I try the c25k (the podiatrist told me I should now try c25k as I've been doing the cycling and had the insoles for quite a bit of time now). I read that cycling in the off days between runs can work quite well and still have a complete day off in the week (and the cross-training nature is really beneficial to your body too), but I'm being cautious. I decided to have 2 complete rest days and in the 2 cycle days go very light on the bike, as a middle-ground. I do 20 mins at a moderate speed and a pretty easy resistance, nothing ridiculously easy but nothing strenuous either. Since the pain came back after my 3rd run of week 3 and having had 4 complete rest days, I'm now going on a 'listen to my body' approach and try to continue with c25k and gradually build up to the 30 min runs whilst keeping the light cycling on in the background. It's a really difficult one as I've been following all the advice I've had pretty much to the letter and am super keen to get this fixed.

Shuffling_Saturdays profile image
Shuffling_SaturdaysGraduate in reply toElenive

Sounds like a good plan! All the best for the best phase of the programme and do let us know how you get on😊

Elenive profile image
Elenive in reply toShuffling_Saturdays

Thanks! Will do! I'm really enjoying each run so hopefully can keep the pain away!

Elenive profile image
Elenive

Hey, thanks Niepowiem! I don't know what you mean though, can you explain :)

Elenive profile image
Elenive

Ah ok, no worries! I understand you now, although think you may have misinterpreted me there. I'm a super meticulous plan freak so have been doing/thinking/reading all sorts to get this sorted! My kitchen sink has been through the mill with this one lol. The 'hope to keep the pain away' comment was more a let's stay positive and socially friendly remark than my rehab approach! Not sure if you read my main post above instead of the reply but I listed what I've been doing there.

I've had this problem for a while now and been super obsessed with trying to fix it. I hate not being able to go out and exercise (I'm in my late 20s), to be honest it's been affecting my mental health a bit too. I saw a doctor last year who suspected chondromalacia patella and advised daily cycling to strengthen my leg muscles, he also referred me to a podiatrist to check out if there's anything going on with my feet. I invested in a spin bike at the start of the year and was cycling 5 times a week from Jan-April. My legs are noticeably stronger which is super encouraging and I enjoyed being able to exercise rather than sat feeling sorry for myself. Knees were holding up okay with the bike. I went to see the podiatrist, she checked everything out and prescribed some custom insoles. She also checked my shoes and said they were fine for me, and they're relatively new too so not much wear and tear. She advised me to wear the insoles in gradually and, after 4-6 weeks or so, to start the running back up again slowly using the couch to 5k program.

So, once I'd got used to the insoles (6 weeks later), I started C25k. I'm not an expert runner by any means so not entirely sure on correct running form. I had a read on a few running sites before my first run and tried to keep my stride short (high cadence), my body tall and shoulders relaxed, and have a slight forward lean. I walked to my local country park so I could run on trails rather than the road. I did do a couple of my week 2 runs on the road to see how it went, although decided to keep to the trails. It was a bad idea to run on the road, and will keep to the trails. My local park is essentially flat so no hills, and all on trails. The walk to the park is a good 10-15 minute walk from my house so thought that'd be a nice warm up and warm down. I brisk walk for the warm up but walk back at a normal speed for my warm down, although my normal walking speed is quite fast anyway!

I do a fair stretching session when I get home, I probably don't do all the stretches but my stretching routine is: calf stretches (gastroc first, then soleus), hamstring stretch, quads stretch, glutes stretch, and the starfish-like one for the groin/inner thigh, sometimes I also do the IT band cross legs stretch but not always. I hold each stretch for 30 seconds and do 3 for each leg. I hydrate throughout the day, I'm usually pretty good on that front anyway regardless of exercise, but on exercise days I make sure I drink more throughout the day, especially post-exercise.

Because the doctor advised cycling, I wanted to keep that going alongside the C25K. I thought long and hard about it at the start but decided to do the following: Mon-Run, Tues-Cycle, Wed-Run, Thurs-Rest, Fri-Cycle, Sat-Run, Sun-Rest. So that's 3 runs, 2 cycles and 2 complete rest days. I did a light 20 minute cycle on the cycling days on a moderate to easy resistance (nothing ridiculously easy but nothing strenuous either) and kept my speed within 60-70 rpm. I read that cycling on the off-days between runs can be very good for recovery and the cross-training nature is super beneficial. Also, since the doctor advised cycling rehab in the first place, I thought it was best to keep the cycling bubbling in the background.

The running initially went okay the first few weeks of the program. During the first week I had some minor niggles at the start of each run but they subsided as the run went on and the following day was fine. However, it was just after week 3 when I started feeling pain again. I finished run 3 of week 3 and all was fine, although the next morning was when it started. It wasn't severe pain by any means (I'd say probably 3/4 on the 1-10 pain scale) but it didn't disappear for the next few days. I had 4 complete rest days before the pain had gone again. Now the pain had gone I decided to, cautiously, do another run to gather some more information and see how the knee faired. By this point I'd stopped the original 3 runs/2 cycles/2 rest days plan and went on a 'listen to my body' approach instead. Realising that week 4's run duration is quite a bit longer than weeks 1-3, I was wary about that effect on my knees, so cut the final 5 minutes of the run to 1.5 minutes instead. The run went ok but have decided to rest completely for now.

To be honest, based on my week 4 run last week and how I'm feeling this week, I don't think the cycling rehab and insoles are working per se. The pain is much as I remember it from before (although not as strong, I mean if I kept running it would be strong but I'm being super careful). Super frustrating as I've put a lot of effort into this, but onwards and upwards. I have a follow-up appointment with the podiatrist this week and then with the doctor next week, both of which I'm really looking forward to. For the time being I'm resting and might get back on the bike this week if I feel up to it but sadly I think it's best to stop C25k for now, and hopefully I'll be able to pick it up again at some point down the road. Super frustrating, but hey-ho.

There's so much conflicting information online that it can be an absolute minefield but I've learnt to take each with a pinch of salt. I'd be grateful to hear your thoughts and any pieces of advice! Happy to gather as much information as I can! Although my main focus point is my doctor/podiatrist.

nycrunner profile image
nycrunner

HiSometimes knee pain can be a mystery as to the real cause or source.

One solution I found beneficial was having the abductors properly massaged.

Sometimes these muscles tighten up and pull the knee out of alignment.

I recall some years ago having all sorts of treatment directed at the patella etc to no avail.

A good sports massage particularly of the abductors solved the problem.

Cheers

Dave

Elenive profile image
Elenive in reply tonycrunner

Hey, thanks! I never considered that. I have a feeling I have some muscle imbalances and tightness in places so would be good to get that checked out and massage sounds a brilliant idea for that too. What type of problem did you have? What did you try and was it the massage that finally fixed it?

Elenive profile image
Elenive

Thanks, I'd love to go to the gold coast!! Yeah it's super depressing, each time I get somewhere the pain comes back. It's a battle in itself trying to find coherent information on what the problem is and then how to fix it. At one stage IT band syndrome was in the mix, foam rollers were talked about and used, I've been to a physio a few times and have done all sorts of different physio exercises... unfortunately all with the same result. I was optimistic about the approach this time around as the daily cycling and insoles were something new, especially as my leg muscles/glutes are noticeably stronger. Although, each time something fails the more information we have moving forward and the closer we are to fixing the issue - at least that's the positive way to go about it! I've read many articles on knee pain surrounding running and sounds like the consensus is that most of the time it's a mystery to what the main cause is.

Yeah I agree with the taking a pinch of salt approach to the doctors too, although it's the best source of information I have and would be silly not to listen to the professionals.

It's super encouraging to hear you're pain free and you're much older than me, so that's super positive!

Do you mean associated rather than assassinated?! Although, got a funny image of the muscles around the knee fighting and trying to assassinate each other!

Elenive profile image
Elenive

Yeah I've had an x-ray and ultrasound. I have my appointment next week so super looking forward to it! Thanks for the advice, I'll have a read and take the information on board, but the professionals I have an ongoing rapport with are my first port of call. As you say, logic applies here.

Elenive profile image
Elenive

No worries, good luck 🙂

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