Tired legs, knee pain... in search of a cause...

edited October 2012 in Running Injuries
Hi everyone,

Let me start by saying how appreciative I am to have discovered this site. Pete, your blog has been instructive in helping me get back to running in what, up to this point, has been a pain-free way. I made the transition to a forefoot strike very very slowly and gingerly while following a couch to 10k program. I made it through the initial calf tightness and after 4 months I'm able to run 10k in about 48 minutes. I'm really pleased with my progress. I've been running on Kinvara 3s and have been really pleased with them as well. Recently though I started experiencing some knee pain on one of my longer runs (about 60 minutes). It's my left knee and the pain is mainly on the outside of the leg with some pain in front and under my knee. I iced the knee and took 5 days off. I went out again this morning and tried to run on it. It got a little tight around 7km and I stopped at 8km for fear of doing more damage. It's sore now and I've got ice on it. When this has happened, it causes me the most trouble walking down the stairs.

I'm at a loss for a cause. It is possible that my body wasn't used to the distance and I've pushed myself too far. I'm just not sure though. 

In any case I had two questions for everyone.

1) Can I get some advice from the more seasoned among you how I should react to this setback in terms of taking time off or otherwise judging "safe" distances to build up strength?

2) Is it possible that my shoes are dead? I can't have more than 150 miles on the Kinvaras. Here are some pictures of the offending left shoe. To my untrained eye there are no real signs of wear, but given the very specific and concentrated strike area, is it possible that the internal "padding" (whatever there is) is now toast? My legs have been feeling sort of beat after the past few runs.

Thanks in advance for your thoughts.

 - JD
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Comments

  • edited October 2012
    I also had knee pain on my right knee, medial side (not lateral like you) after running 12-14km in the Kinvara 3's.  I don't get that knee pain running in the Saucony Type A5's which has less cushioning and better ground feel.  I now have a pair of Kinvara 3's with 100km on them that I can't run in and they are relegated to pooper scooper duty when I take the dog out to the backyard...

    I also use a forefoot stride and do not have any heel wear on my shoes.
  • edited October 2012
    Thanks JD!

    Are you thinking ITBS on the side of the knee, or more anterior knee pain as in patellofemoral pain syndrome?

    I know of a number of cases where ITBS has been triggered by shoes, it's happened to me twice and went away upon switching footwear. For as much as I love the Kinvara, the sole does seem to break down quickly. I got about 200 miles out of my first pair before the upper blew out when a friend tried them, but I think the sole was pretty much dead even though the wear pattern on the bottom wasn't bad. They are pretty soft and I think the EVA cushion breaks down quickly.

    Do you have another shoe you can try as an experiment,  even something old that will let you see if a change helps alleviate the pain?
  • Pete, 

    It feels like a little of both. I never knew what ITBS was until your comment caused me to google it. This is exactly where I have pain. However, I also have pain below and behind my knee at the top of my tibia - if that makes sense. This is more of a dull pain. What's weird is that I can walk *up* the stairs with no problem but coming *down* is a different story. 

    As far as other shoes go, I'll have to check to see if I've still got my old Saucony Stabils. Back when I was diagnosed as a severe pronator (horrible overstriding heelstriker is more like it) I was recommended these shoes (and got significant ankle and heel pain anyway). They may have gone to Goodwill or the dump. 

    In the event I don't have them, I'll be looking into new shoes. I like the way Sauconys fit me, and I liked the initial feel of the Kinvaras too, both the low drop as well as their initial softness/springiness. Got any suggestions?

    Meanwhile, I'm off to put some ice on it. I found some stretches for the ITBS thing that I'll try as well.
  • You can try the Saucony Mirage - similar fit to the Kinvara,  bit more rubber on the sole for improved durability. If you are willing to move to a bit less shoe, the Saucony Grid Type A5 is fantastic, but I'd rec going up a half size in it from what you wear in the Kinvara.

    Does sound like you may have two issues going on, so if things don't improve I'd recommend seeing someone like  PT who can look at your gait and scan for any imbalances or unusual movement patterns. Knee problems are often related to strength imbalances or weakness at the hip.
  • I think the Mirage is a really nice shoe, but it doesn't have nearly enough rubber on the outsole to justify a $110 price tag.  At 200mi, mine are pretty much dead.  I'll have to post some pics once I take them.

  • edited October 2012
    Pete & Bryan, thanks for your comments.

    I've just ordered the A5s - a half size up per your suggestion, Pete. Been intrigued by them since your review. I have loved the light weight of the Kinvaras (esp in relation to the Stabils). Plus it sounds like these shoes might last longer. When you say "a bit less shoe", what does that really mean though? I see the stack height is lower. does this mean they will provide less cushioning than the Kinvara? I guess this is my main concern.

    I'm a little loath to go to the Mirage. I have no doubt it's a nice shoe and I've read good reviews on it, but I don't want to go to "more shoe" unless I'm forced to do so. 

    Pete - thanks for the tip on the PT as well. I'll see how I do in different shoes and take it from there.

    Thanks again for all your comments. I'll let you know how things turn out.

     - JD  
  • By less shoe I mean less stack height and firmer feel. However, if I were going to run a marathon tomorrow the A5 would be on my feet over the Kinvara.
  • Why would you choose the A5 over the Kinvaras for a marathon? because you want a firmer feel of the road?

  • Yes, I think so. I feel like I have greater control in them since they ride closer to the ground, but really could go with either for the marathon. The A5 just seems to be a good match for where I am in my running right now.
  • jddphd:  are you rolling regularly on a black roller?  It really helps me to roll out my IT bands, quads, adductors and calves after each run.  I even roll prior to a race and that seems to help too.
  • So I ran in the A5s today. They are a little bit firmer than the Kinvaras: it definitely felt like less underneath, but they felt good. (Very funky shoe - there really isn't much there, is there! I've never had a shoe like this.)

    Anyway I got a little over 7k out of them before my left knee started to tighten up. I tried to run through it a bit but I was facing some hills and decided against pushing it. Notwithstanding the knee, my legs otherwise felt good. No calf tightness or soreness or "tiredness" at all and I had no trouble maintaining my regular pace. Just felt it in my knee. I can't say for sure but it feels like the tighter it gets the more my leg moves around even if I try to place my feet and stride evenly. It's really disappointing.

    Steve, I've read about these rollers and I'm going to give it a shot. I figure if there's a way I can loosen this up I'll be in decent shape. I see a lot of variation in the rollers though. Can you (or anyone) suggest the appropriate size and perhaps a decent technique?

    Thanks for the suggestions all.

     - J.D.

  • Here you go.  One other point I wonder about are you training to hard? 
    If all your runs are anaerobic in nature you will get hurt. The body
    simply can't take that over the long term.  I've adopted heart rate
    based training and am getting faster and faster at the same low heart
    rate. 



    Foam roller:  You want a black one.  The others are to soft.  If you
    don’t roll you will get injured at some point.  It also feels really good once
    you have all the tight areas of your body worked out.  Your IT bands will probably scream bloody murder the first two months and then it will be great!



    http://www.amazon.com/OPTP-Pro-Foam-Roller-Black/dp/B001MPU106/ref=sr_1_6?ie=UTF8&qid=1351874196&sr=8-6&keywords=black+rollers+exercise

    http://www.youtube.com/watch?v=-dgoi8UN1Pg

    http://www.youtube.com/watch?v=5lLw81kGeXg

    http://www.youtube.com/watch?v=R3f6wfsAIv0&feature=fvwrel

     

    When
    you get really rolled out weeks from now you will be able to roll on one leg
    only so your full body weight is being used.  Start as they show in the
    videos.  If it feels fine that way, then change it up so you’re putting
    more weight on the roller.



    Also check out this link for trigger point therapy.



    http://sock-doc.com/2012/04/trigger-point-therapy/

    http://sock-doc.com/2012/04/sock-doc-knee-video/

  • Thanks, Steve. I appreciate the links. Will try it out and report back.

    As for my runs being anaerobic, I don't think so. I get a nice rhythm going in terms of breathing. Before this happened I was doing 3 runs per week of varying lengths (usually between 40-50 mins) without problems for about 3 weeks. I had slowly worked my up to this level (having made the mistake of not doing this years ago) and didn't feel at all like I was pushing it.

    thanks again for the tips.

     - JD
  • If things don't improve, really recommend seeing someone who can give you a proper diagnosis and treatment plan. In the meantime, ease back in a bit more gradually - if you can go 5K without pain maybe do that for a few runs and go from there.
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