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?

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5 thoughts on “Knee Injury: A Breakdown

  1. Wow. I can’t believe your backside can be such a big deal with running. But did they say how to strengthen those weak points better? Will you have to go to physical therapy? I think it’s hard to know what to work on and try and strengthen and then weigh that against a worry that you might overdo or tweak something that could have been left well enough alone. But my “if it’s not broke, don’t fix it” mentality could get me to crash on a random 5k too. What to do!

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    • Seriously, it’s wild how the slightest thing in one part of your stride can mess up something seemingly unconnected. I’ll write more details soon, but the AHA! moment in the doctor’s office was when she had me lift my leg 6 in off the floor while lying on my stomach. See if your glute or hamstring does the work; if it’s your hamstring, you might have a dead butt. If your butt is super dead, it could be hard to even contract your glute when you consciously try to squeeze it! Another thing to try is a bridge with your feet and knees together (shoulder, not backbend). If you’re wobbly from side to side, you’re probably not activating the glute/hip muscles.

      I’ve been doing PT exercises that range from glute activation to strengthening and I’m writing a post detailing them now 🙂

      One welcome side effect of getting the glutes in on the game is that they make running faster easier!

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  2. OH man!!! Sounds like you are strengthening and working on what you need to work on!! It is every runners nightmare!! I have been really working on hips/glutes too!! My right ITB was bothering me so I haven’t run in a couple weeks. Hopefully the exercises have been working! 🙂

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  3. Pingback: My Recovery from Knee Injury | Racing Oprah

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