Snapping hip & knee pain with minimal running? (Read 1506 times)

I ran regularly a few years back and eventually tried to train for a half marathon, when what was diagnosed as ITBS and patellofemoral syndrome sent me to PT.  The PT exercises didn't seem to do the trick (yes I kept doing them for a good long while), I was never convinced by the diagnosis, and eventually I just gave up on running and transitioned to cycling instead.

 

Now, my husband and I are trying to lose a bit of weight and are "training" for a 5K.  I actually switched to minimalist style shoes (Kinvaras) this time to see if it would make a difference with my knee pain.  We run very slowly (though it is a bit hilly) and haven't gone further than a 5K distance.  

 

If anything, its worse.   There's a lot of instability/pain in my knee, and when I do the ITBS stretch (crossing one leg over another and shoving your hip out) I can hear a REALLY loud popping noise in my hip.  That makes me think maybe hip bursitis, although there's no pain in my hip -- but the knee pain seems to be directly tied to how much popping my hip is doing. 

 

I'm so frustrated.  I'm only 27, I'm no more than 5-10 pounds overweight -- I don't understand why I can't handle jogging 10 miles a week.  I do my best to do the foam roller and it doesn't help much.  I haven't run since Saturday but my knee burning and hip popping is incredibly unpleasant today.  (I've biked, but that's about the only time it doesn't hurt).  This also just frequently bothers me on a day-to-day basis independent of running, although running always makes it much worse. 

 

Does anyone have insights as to a diagnosis or suggested treatment plan?  I'm ready to swear off running forever, but I really don't want to. 

First of all, sorry to hear about your issue; we certainly feel for you--we've all been there.  It is interesting, to me, that we seem to be in the cross road where this "minimalist idea" had become a popular "fad" while most so-called "professionals" (PTs, podiatrists, doctors) follow "old" conventional ideas.  Most "professionals" still recommend "cushioned" shoes in order to alleviate the "shock" of landing of running.  And they will most likely tell you that if you run "too much" (which is about 30-40 miles a week), you'll have a hard time walking by the time you're 50 because your legs will be a wreck.  I believe there was the most recent research had come out a year or two ago, and if I remember it correctly this was one of the longest-lasting research as well (about 50 years???), that running did NOT have any ill effect to your knees at all.  If anything, it strengthens your knees.  For one, to me, having run for more than 40 years, most of them in more or less minimalist shoes, quite a few of them at about 100-miles-a-week level; and my knees, while they pop once in a while and I have "knobby" knees, knees are one area I have least problem with.  Be careful with a quick diagnosis of ITBS or PF or whatever popular injuries that you hear so much about.  Study what you can about ITBS (internet?) and don't just blindly take what those so-called "professionals" might tell you.  As far as I'm concerned, whenever those "professional" use a term "syndrome", that often means they have no clue what it is.  Also, while internet is wonderful in a sense that we get so much information and we share so much experience with so many willing people (like right here at RunningAHEAD); but at the same time, you also have to weed out misinformation as well as some people who may be over-eager to share his/her experience without fully understanding YOUR situation.  

Second, while I am an advocate for wearing more minimalistic shoes, just because you switch to minimalist shoes, that does not necessarily mean all the problems would disappear.  In fact, in some cases, it may backfire them.  Now, what's his name again (Rick?), this guy switched to minimalist shoes and started to land more mid-foot.  He posted that he had shin splint problem and somehow we got connected...  I suggested him to film himself and send it to me.  It turned out, while he was landing mid-foot, when you look at it in a bigger picture (not just landing but the way he was moving his entire legs) and, coupled with the fact he was running mostly on treadmill, that very thing (landing mid foot) was the cause of the shin splint.  As soon as he "corrected" his running form, within 2 weeks, his shin splint was gone.  I don't know the way you run but running over undulating courses with newly switched minimalist shoes may not be the right thing to do particularly to your knees.  I'm not saying that is the cause of the issue.  But it may not have been the right direction.

Thirdly, particularly if you're a beginning runner, you really need to differentiate the beginning injury and growing pain.  Our knee is one of the most complex and fragile joints in the body.  It's a big one; but really not much to it and it's mainly surrounded and supported by muscles and ligaments.  In other words, if those supporting muscles are not strong, it can be very fragile.  If you hadn't engaged with weight-bearing exercises such as running in the past (it really doesn't matter ow much cardio exercise or aerobic exercise you had been doing; all the swimming in the world may not strengthen your legs as much as you'd like to support your gravity defying pounding taking kind of exercise like running), you need to work extra hard to strengthen your legs.  The process of this "strengthening" may take some level of "pain".  Usually (not always), if the pain is isolated and you can pin-point, it's not a good sign.  If the pain is broad and dull, it's a growing pain.  Keep it warm during the day (and night) and ice it several times a day, particularly right after exercising.  Also, if the pain grows stronger, say, 15-30 minutes into running, stop.  If the pain subside as your body warms up, continue.  I often see people say; "I get sore so I cut back my running..." when their "running" is 10-20 miles a week, 3 times a week or so.  You may actually be better off if you run more.  Some pain means your body is trying to get stronger.  Instead, they chop off the opportunity for the body to get stronger.  There are several general rules to principles of adaptation.  If the work load is too much and/or recovery not enough, you get injured or chronically fatigued.  But if the work load is not enough or you have too much time in between, you really wouldn't do much to your body.  Often, even though you have some pains, being smart about it by using common sense and being persistent about it, you'll overcome.

I'm not really sure how much help I can be seeing as I was searching for results for a similar issue when I stumbled across your post. I am a beginning runner, training for a half-marathon. I've had knee pain for the past 6 or so years off and on. When it hurts, it's usually a tight, full feeling and sometimes dull, throbbing. Having it hurt under normal circumstances makes me more cautious when working out. Today, though, I tried running, hadn't even made it half a mile and noticed the pain again accompanied with a pop in my hip. I don't know what this could be, but it did make me think. I asked my coach the other day ways to best safeguard my knee so I don't do any further damage and could hopefully strengthen it during training. Besides the standard simple exercises she talked about, she mentioned two thinks that hadn't really ever crossed my mind: One, I should be fitted for shoes. I'm doing the minimalist shoe too (I hate the way padded shoes feel on my feet), but she told me about a running store (in South Carolina, it's TrySports, but I'm sure there are others out there) that studies your foot arch, your stride, etc. to fit you for the perfect shoe. Two, she told me my hips may be too closed off. In hindsight, this could account for some of the popping I'm experiencing today. Apparently the shock your knees cannot absorb, end up being the responsibility of your hips and ankles. She didn't exactly give me any great advice how to fix it, but I'm going to discuss it with my yoga teacher next class.

So in other words, I'm not sure if this helps, because you may have tried at least one of these prior to starting running. It probably wouldn't hurt to get fitted for shoes or to be careful of your footfalls as Nobby mentioned. Perhaps incorporating some yoga into your stretches might be beneficial as well. Warrior I, Warrior II, and Utthita Trikonasana are some good hip-openers right off the bat.