I recently had a setback running – something new that I’d not experienced before. A little frustrating when my training felt good and I had just made one of those breakthroughs, where you can feel the work pushing you onto somewhere new. However this at the cost of too much, too close together, when not all was right in my body.
I begun to notice an ache in my right knee cap, which got progressively worse after every run, until a break was in order. I was curious as to what this could be so went about investigating. One of the challenges is not being able to see what is under the skin, relying on nervous system feedback (or pain) to guide as to what has happened. So part of this is best guess, but this is the process I went through to begin to piece together what could have been happening and why.
My first thought was to much load in short succession, leading to tissue break down and exacerbation of a problem. The issue was around my knee, top inside, so I could something wasn’t supporting my knee in tracking – rather allowing it to dive inside my foot / big toe when landing. In which case I wanted to look at what the foot / ankle was doing and what my hip was doing.
First up the foot – was it supinating & pronating, was it allowing the foot to accept the load and redistribute ground reaction forces. Testing this I could see it was OK, not great, but definitely som movement in both directions or supination / pronation. So up the leg to the hip. Here there seemed to be 2 things to notice. Firstly my femur was pretty internally rotated at rest – leaving my knee externally rotated and limited in it’s movement, secondly as I brought my weight forwards, my foot pronating, my knee tracked inside my foot, having no support from my hip & my pelvis rotating slightly to the left. Taking this movement and extrapolating out thousands of footsteps, weight being smashed into the inside of my knee, this compensating for a lack of work being done at the hip and BOOM I had a part of the answer. My right hip wasn’t doing the job / as much of the job that it needed to.
What seemed to be contributing to this was a lack of movement in my hip – and a need to get movement in the hip joint, to stimulate length in the hip complex muscles and once working take the load from the knee.
Step one done – now for what to do next. Thankfully here I had some wonderful support / advice from the marvellous Dom Koch of https://www.decrypt-bodywork.com/ (one of the best bodyworkers I know of) following my findings and gave some pointers as to where I could go and what to do next.
What really reinforced the lack of hip support was trying to learn a glute bridge & finding massive cramping on my left side – so clearly both of my hips a challenge to work – a painful and welcome discovery to help me rectify.
As with Boston marathon in 2023, I’ve got close to an unbroken training schedule, but failed again. So I’ll be interested in seeing how I rehab / build / protect / strengthen my body over the next few weeks. Strength / mobility & cycling will be on the cards. An ultrasound to ascertain how serious this all is (which may be helpful, may not). What I do know from Boston is that if I get to the start line, going out hard on the basis of bike fitness is not sensible. Missing that mechanical stress of road running needs a far greater level of respect to the marathon, if I get to the start line. A greater goal is running the 55k PDA at Val D’Aran in July. However, based on my Boston experience I’m not writing off running London. Getting back on the bike is exciting, I love it and just hope that the knee is OK on a bike (a calf problem last time was absolutely fine).
