One of the most common problems patients have this time of year is exercise related injury. Recently, one patient, Ann R., as a New Years’ resolution, vowed to go running at least three times per week to help lose weight. The training was going quite well, until she began to experience left knee pain both during and after running. She’d been training to run a 10-mile race in the spring and had gotten up to 5 miles once a week while doing shorter distances on her other two weekly runs. First, we talked about how she was going about her training. Was she running too many hills? Was she running too frequently without enough rest between runs? Was she running to fast? These are common mistakes runners make when trying to do too much too fast. Particularly, in today’s world, where people may be trying to stay in shape and work a full-time job simultaneously, overuse injuries have become very common. Before long, the person is “out of commission”, and putting weight back on due to the inactivity. It can be very discouraging.
What was causing the pain?
In this patient’s particular case, we determined that her 8 minute mile pace was simply too fast at this stage of the game. When she’d run in college 10 years ago, she was clocking 7 and a half minute miles. Understandably, the patient wanted to come close to her “glory days”. However, 10 years, 2 children, and 15 pounds later, that goal was determined to be a bit ambitious. We decided that she’d try doing 8:45 minute miles for her long runs and 8:20 to 8:30 minute miles on her shorter runs. That worked somewhat, but she still was complaining of knee pain. She didn’t want to completely stop running for fear of getting out of shape, gaining weight and not being able to do the 10 mile race in the spring. We also tried icing the knee after running and taking ibuprofen one hour before and 6 hours after runs. Still, there was not complete relief.
Luckily, there was a solution. There are ways to keep cardiovascular conditioning optimized, especially for runners who are injury prone, while avoiding the overuse type syndromes that plague even the most seasoned athletes. Cross-training is a term which refers to exercises other than the “primary exercise” that helps improve performance of that primary exercise. For Ann R., we decided to use an exercise with minimal weight bearing on her knees that still was able to get her heart rate up to goal. She started to do stationary bicycling at her gym one to two times per week in lieu of her shorter runs. Based on the settings of the bicycle she used, the cycling workouts could be rather intense, or less so, depending on her goals for that session. The cycling put less impact stress on her knees, and the pain resolved almost completely. She was still able to do her long runs once weekly with minimal pain and was able to increase the distance of her long runs as well. With the slower pace, and cross- training on the stationary bike, Ann R. Should be able to complete the 10 mile race while minimizing injury.
Any repetitive exercise done over and over can lead to injury for even the best athletes. Cross-training allows for “mixing it up” while still maintaining, or even, improving performance levels for any individual. As always, please consult your healthcare provider before initiating or making major changes in your physical activity.