Stick To What’s Working

Running with knee osteoarthritis is challenging, but when you find a running shoe that is working for you, stick to what’s working, right? I have been running in the Altra Paradigm 5 this winter. With its ultra cushioning, this shoe is incredibly comfortable and it has worked well when running in the snow (I did use Kahtoolas too). However, while running on drier pavement recently, the shoe started to feel a bit clunky. My thinking was that a little more heel support and a lighter shoe might be necessary for the drier and less soft road conditions. So transitioning to “typical” running shoes seemed like the appropriate thing to do at this time.

Altras are not typical running shoes. They have a very wide toe box to allow the toes to spread out naturally and they also have a zero heel-to-toe drop platform meaning that basically the heel and forefoot are the same height. In comparison, the “typical” running shoes can have anywhere between 8-14 millimeter drop with 10 millimeters being pretty much the standard (there are a few brands that are in-between these measurements). For the metrically impaired (me) – 10 millimeters is equivalent to 0.393701 inches! That volume doesn’t really seem that significant. If you added even a half an inch to the heel of your shoe, would you really even notice? Would it really matter that much? Well, apparently it does, at least for me anyway. Of course, other factors could be at play here as far as the type of shoe and materials that the shoe is made of.

With this idea of transitioning to a different running shoe, I decided to try my New Balance 860s. New Balance was the very first real running shoe that I owned and I have run in it off and on throughout the years without any major problems. So, it seemed like a practical choice. It does have a 10-millimeter heel-to-toe drop and its toe box is wide, maybe not as wide as the Altra but comparable. While on the run, one thing that really stood out right away was that the New Balance didn’t have the springiness of the Altra.

With a history of low back tightness and mild to moderate back pain, I have been lucky enough to not have experienced any discomfort since the start of the return to running program. And before this particular trial with the New Balance shoe, there wasn’t any knee pain or back pain. After the run, I was miserable. My low back was killing me and although I can have some mild knee pain at times, it hasn’t been anywhere near this painful. I’m not blaming the shoes, they are great shoes. They are probably just not the best choice for someone who suffers from knee osteoarthritis and who has some muscle weaknesses. I should be blaming my lack of strength training throughout my running years. That is probably what has led to most of the problems I am having today.

So, what to do. There just isn’t a lot of information on the web to support or refute wearing lower heel drop shoes for runners with knee osteoarthritis. Most articles seem to support a more cushioned shoe with a higher heel drop, but they don’t list any sources for these recommendations. There are a few articles like this one that has reviewed studies and have come to the conclusion that lower heel-to-toe drop shoes have less of an impact on the knees than shoes with a higher heel drop.

“The lower drop will load your ankles and Achilles more, the higher drop will load your knees and hips more. “

So, even though the Altra Paradigm 5 feels a bit bulky, I am sticking with them! Any type of shoe that has been identified as one that can put more load on the knees is definitely not the shoe for me. Plus, I wasn’t experiencing any additional knee pain or back pain with the Altra. Obviously, Achilles or ankle issues could become a problem since that is where most of the load will go, but having taken the time to transition over the winter with walking, then walk/running, and most recently running 2-2.5 miles should limit those problems. The lesson: Don’t make changes to things that are working!!

Running and Strength Training

• Sunday Rest Day
• Monday Stability and Strengthening Exercises
• Tuesday Running 2.0 miles – super easy
• Wednesday Stability and Strengthening Exercises
• Thursday Running 2.3 miles – super easy
• Friday Stability and Strengthening (added more reps)
• Saturday Running 2.6 miles (this is the trial run with the New Balance shoes)

My last blog post can provide a description of the exercises. I added more repetitions on Friday’s workout. As usual, I do a dynamic warm-up prior to each run and then a 10 min walk along with a 5-10 min cool down. I also do static stretching almost every night.

My plan is to move to the next (harder) chapter of Anatomy For Runners while continuing to do the above exercises as well. I will probably just add a couple of exercises at each workout. The challenge is to keep moving forward without getting overwhelmed.

As for running, obviously, I will be running in the Altra, and I will stick to 2-2.5 miles the first part of the week. If all goes well, I may bump up to 3 miles later in the week. At some point, I do hope to add another running day.

Until next time…

Happy Running