Knee Injury: A Breakdown

oprah running quote

I didn’t expect to take nearly two months off from running and blogging when I tweaked my left knee in a 5k race, but injury is an unpredictable beast. I naively believed that I was immune to injury since I did the good core/hip/glute strengthening exercises that runners are supposed to do. As I think about Oprah’s quote, running has been an excellent metaphor for life, because it has given me what I put in most of the time. But there are also times when you do all the things you think you ought to do and the results still fall short, as happens in life.

Most of all, I’m grateful that this injury popped up after the marathon. I have learned a lot from the injury, and I hope the lessons learned will help me be stronger and healthier in the long run.

Breaking down the injury

It took a while to figure out what was actually going on with my knee. I was referred to a great chiropractor who specializes in working with athletes and is an Ironman triathlete. Early on, she did the tests for all the nasty knee injuries – torn ligaments and such – and eliminated anything really serious that could require surgery.

1. Dead Butt

In my first appointment, my chiro tested my glute and hip strength. Thanks to the good exercises, I demonstrated sufficient (if not bodybuilder-esque) strength in those areas. The real surprise came when she asked me to call on my glutes to lift my leg while lying face-down. I couldn’t do it! I thought about contracting my glutes and my hamstring fired instead. Many of you have probably heard of “dead butt,” which is when the glutes just don’t fire. It’s common among distance runners and people with sitting-down-jobs, and is an injury risk factor among distance runners.

2. Poor Range of Motion

My chiro also noticed that my entire lower body was super tight. I had a knot in my left quad, just above my injured knee, that was probably the size of a golf ball. My adductors and IT bands were abnormally tight as well. This problem was totally avoidable – I really don’t like foam rolling or stretching, and don’t do either routinely, even when I’m training hard. Oops.

3. Unbalanced Glute Strength

The third major issue that my chiropractor unearthed was a hitch in my running form caused by a relatively weak left glute, as compared to the right glute. As I understand it, strong glutes provide stability to the running stride, helping the knees to move in straight lines forwards and backwards. My running stride included a slight inward buckling of the left knee, presumably because my glute wasn’t doing its job to keep the knee stable. I also found that this imbalance is causing a hitch in my squat that has been REALLY frustrating to try to counter!

The solution is ongoing, but it predictably involves a lot of glute activation and strengthening exercises, along with flexibility/range of motion work. I’ll write a separate post about all this later.

A frustrating thing about this injury is that it doesn’t fit the common running knee-injury diagnoses, like ITBS, runner’s knee, or patellar tendinitis, so there isn’t a standard course of treatment and recovery. The pain I’ve felt has occurred on the inside of my left knee. It begins as pressure, and progresses to pain if I continue to run through the pressure. My chiropractor thinks that the hitch in my running stride may be causing pressure on my meniscus, and as the pressure persists, it becomes inflamed and causes pain. The activation, strength, and flexibility work I’ve been doing has slowed the pressure-pain progression, and I’ve been able to run 11-15 miles per week pain-free for the past three weeks, with a day of rest between every run. We also think that hills further aggravate my knee, so I’ve walked to a flat area for each run. Next week, I will begin to introduce uphill running (I’ve been told to walk down hills) into my routine to see how my body responds.

Have you ever had a knee or other running injury? 

How long did you sit out from running, and what did it take to get healthy?