I'm Still Running - Running2Run

Week 7 of Hal Higdon’s Novice Supreme Marathon training is completed! And I’m still running – did the song “I’m Still Standing” by Elton John pop into your head? Okay, maybe it was just me. Ha! Yes, still running, but I have had a couple of little problem areas that are concerning.

First, I have a history of ITBS (iliotibial band syndrome) on the right leg, and it has been very tight lately. So tight that it is causing pain on the outside of the right knee. Secondly, I have developed some mild low back pain. Then, I was reaching into the freezer and had a sudden sharp pain on the right side of my upper back. I believe these are all connected in some way and if I don’t do something about them now, they are only going to get worse. And when things like that get worse, they can affect or even prevent running at all.

And this explains it all…definitely connected!!

I have been doing strengthening exercises consistently since January. I stretch and foam roll every single night! I literally don’t know what else I can do. I suppose my form could use some work?? Recall, this is the year that I said I was going to give running my best shot and if it doesn’t work out, then I know I have tried everything. I’m tired of starting over every few weeks. As you know, a diagnosis of Knee Osteoarthritis has kept me from running for the past few years. Armed with more information, I decided to give running this last chance. I have a dream to run Boston one day. I can’t quit now!

So, I decided to get professional help before I can’t run any longer. The type of professional that knows a little something about running and especially running with knee osteoarthritis. And I found a physical therapist that I have actually worked with in the past. Zuzana, who is now with the Runners’ Edge Alaska, is someone that has tried to help me before but to be honest, when her plan didn’t work in a couple of weeks, I just gave up on it. That was probably part of my depression of having been diagnosed (not by her) with knee OA and not being able to run I’m sure. I just felt hopeless.

But, after just one visit, I learned quite a bit, and more importantly, I am open to doing what I need to do regardless of how long it takes.

First, an evaluation of running on the treadmill let her know (my understanding anyway) that although my hips stayed level and my knees didn’t turn out (she seemed impressed by these facts), I didn’t have much of a hip drive. In addition, I tend to run with my knees bent and I have a lot of bounce in my stride. Plus, I hit the ground really hard. When she demonstrated this with a bit of an over-exaggeration, I was worried! My poor knees! I even reviewed a slow-motion running reel that I did on IG a while back and I didn’t even see it at that time. Looking at it now, I see there is more to be concerned about than just that bounce. But, that is why professional help is warranted sometimes.

During that running evaluation, she stated that my cadence (total number of steps you take per minute) was 164. That is about what my Garmin usually reads on average. However, she wants me to bump it up to 170 spm.

Zuzana suggested using music that has a beat equivalent to about 170 cadence. Yes, you can find music online to run to whatever cadence you want practically. “I’m Still Standing” is 177 BPM just as an example. Or you can use a metronome which can be set to whatever cadence you want to run at. I have used the Run Tempo metronome app in the past, but I felt like it was hard to stay focused on the beeping tones so I decided on music.

Run Tempo - Runners Metronome — Run Tempo-Runners
Metronome

I put it to the test. The first graphic below was on Thursday before my Friday PT appointment. On Thursdays, I do like to increase the pace a bit. My average cadence truly is around 164 spm typically. And the “After” graphic was on Saturday. I was so optimistic about my average cadence being at 170 spm. I ran about the same pace as Thursday, but I didn’t feel like it took more effort. Plus, I felt much lighter on my feet. That slight increase in cadence may not seem like a lot but for me it’s huge. I feel like a slug running sometimes. But the biggest thing that happened was that I actually felt a toe push off. When I look at that slow-motion video of me running, I seem to plant my foot, my knee stays bent, and there is no real push-off. Plus, I have been having some mild arthritic knee pain with the last couple of runs and on Saturday, the pain was very minimal to none! Now that’s exciting!

In addition, Zuzana gave me exercises to improve on other areas of weakness that she identified during her evaluation. One of the things I appreciated was when I couldn’t do the exercise 100%, she made some adjustments – maybe by using less weight or as in this photo, keeping my feet flat on the ground and progressing to the toes – with a plan to progress vs just being given an exercise to “work on”. She also clarified how to do a bridge (I have issues with the bridge!) and evaluated return demonstrations on all the exercises.

And the ITB with knee pain was taken care of with dry needling while the low back pain and the pain from the freezer reach just miraculously disappeared after that procedure. I knew they were connected! I also received instructions on the proper use of a foam roller. I didn’t realize I shouldn’t foam roll all the way into the knee area. There was just so much information in that one-hour session that was so helpful.

We even talked about running shoes and how rotating your shoes can help to prevent injury and keep the feet strong. Lots of runners have many shoes in their rotation for different types of runs but I have always just trained and raced in the same shoe. Zuzana gave me options of the different shoe types in the brand that I like which I could add to my soon-to-be running shoe rotation.

Also, I thought as long as I was running in a low heel-to-toe drop shoe, all was good. Apparently, the stack height (the material in the shoe between the ground and your foot-cushioning) is something to consider as well. The stack height in my Altra Paradigm 5 is 34mm and the Paradigm 6 is 30mm. Other Altra options like the Torrin is 28mm and the Escalante is 25mm.

So why do I need to be concerned about stack height? This article from Run Forefoot states… “cushioned running shoes impair foot function, pushing walkers and runners more towards knee-joint dysfunction.” That is all I need to know.

For comparison sake, runrepeat.com grouped shoes into 4 stack height categories:

Barefoot running shoes (the lowest stack height: 3-8mm)
Minimalist running shoes (minimal stack height: 3-13mm)
Regular running shoes (medium stack height: 9-29mm)
Maximalist running shoes (maximal stack height: 30-50mm)

So it looks like my running shoes are in the maximal stack height category. I will say they are very comfortable and I do love them, but if they are not good for my knees, I am willing to try something different.

I am very glad that I decided to get professional help with these running issues. Getting a personalized plan is very important and I am looking forward to seeing how this all pans out. I have a follow-up later this month so I will keep you posted.

And…I’m still running!!