Knee injury with 4 weeks to IM ... help

Triathlon Forum
1

I’m four weeks out from an IM and have developed runner’s knee. I’m attributing it to overuse and running too long on a worn-out pair of shoes, but I’m sure there are dozens of other factors in there as well. As of late last week, running more than 30mins led to onset of discomfort, as did any prolonged cycling at Z2 effort or more.

Assuming I’ve self-diagnosed this correctly, anyone have any thoughts about how to modify a training schedule to acknowledge the injury, and arrive at the race in the least damaged condition possible? My original plan called for reduced training this week, two weeks of peak work ahead, and then race week. Key workouts in the next three weeks were to be Saturday bricks of 3h, 6hs and 4hs respectively.

Is it best to just follow the plan, and assuming I feel recovered on a day-to-day basis, just replace any intensity runs / rides with easy aerobic stuff to minimize the risk of reinjury? Or, should I just rethink the two weeks of peak stuff, and replace any running / cycling with pool running to try to maintain my aerobic base?

I would characterize the hierarchy of my priorities as (1) total and full recovery; (2) maintain aerobic fitness; (3) build a bit of speed in peak - - Is this an appropriate ranking?

Advice, comments, thoughts … I’d welcome them all.

2

I’m four weeks out from an IM and have developed runner’s knee. I’m attributing it to overuse and running too long on a worn-out pair of shoes, but I’m sure there are dozens of other factors in there as well. As of late last week, running more than 30mins led to onset of discomfort, as did any prolonged cycling at Z2 effort or more.

Assuming I’ve self-diagnosed this correctly, anyone have any thoughts about how to modify a training schedule to acknowledge the injury, and arrive at the race in the least damaged condition possible? My original plan called for reduced training this week, two weeks of peak work ahead, and then race week. Key workouts in the next three weeks were to be Saturday bricks of 3h, 6hs and 4hs respectively.

Is it best to just follow the plan, and assuming I feel recovered on a day-to-day basis, just replace any intensity runs / rides with easy aerobic stuff to minimize the risk of reinjury? Or, should I just rethink the two weeks of peak stuff, and replace any running / cycling with pool running to try to maintain my aerobic base?

I would characterize the hierarchy of my priorities as (1) total and full recovery; (2) maintain aerobic fitness; (3) build a bit of speed in peak - - Is this an appropriate ranking?

Advice, comments, thoughts … I’d welcome them all.

3

Disclaimer: All of this advice is coming from an average athlete who has been injured alot. I am not a doctor, coach, or very smart.

You’re not going to gain a lot of fitness in 4 weeks, so I would back way off of the running. At this point, the plan goes out the window, you need to focus on getting to the race day not hurting. It sucks, but it’s better than hurting yourself worse. If you can pool run, absolutely do this instead of real running, so long as it doesn’t hurt the knee.

If you’re trying to qualify for Kona, then you might want to consider bailing on the race. You can really screw up your knee for a long time doing an ironman when it is already aggravated. I’m talking like taking next year completely off.

If you’re just trying to finish, and won’t mind walking in the race if it starts to hurt - Don’t do any running for 2 weeks or so, and be ready to not run for 4 weeks if it is still bothering you in 2 weeks. Take some NSAIDS, but be careful, you can injure yourself doing something else like cycling, because you won’t feel any pain.

If the cycling doesn’t hurt it, then proceed as normal with that, but remember, if you’re taking NSAIDS, you might not feel it if the bike is aggravating it.

Also get some massage and ART to try to work out knots in the legs. This might help.

You can afford to take a lot of rest at this point, as long as you aren’t aiming to be stellar. And in my opinion, if you’re aiming to be stellar, you probably just want to bag the race, unless this clears up in a week or so. Just be smart - I know that I can personally talk myself into doing really stupid things that I pay for later when I have some aches and pains. You don’t want to screw yourself up, no matter how worth it you think it seems now.

4

Disclaimer: I have no medical/physical therapy background, but have experienced numerous injuries, esp. running.

At this point, the hay should be in the barn, as far as your training. You may not make any fitness gains with the injury, but you can certainly prevent fitness lost. I’d get in the pool for my running. Yes, it’s boring and after 60 minutes you’ll want to bang your head against the wall, but it works. There have been numerous threads on here and Gordo’s site talking about retaining and gaining run fitness in the pool. If nothing else, it will give you a small piece of mind knowing you’re doing something. You may also want to try the elliptical trainer, if it doesn’t bother your knee. Work on speed and foot turnover, which could also help your run fitness.

I’d let pain dictate my bike training. Ride until it “twangs” and then immediately stop. No point in trying to work through pain. If that’s 1 hour, then increase your number of weekly rides, but make them shorter. I’d probably also add some extra swims, just so I’d feel like I was still training “hard”, but without stressing my knee. I’d also refrain from breaststroke, as that motion can aggravate a knee injury.

Injuries are the bane of any training plan. Don’t fret about modification. The race is not completing the rest of your long rides - it’s showing up healthy and ready to go on race day. Finally, the always helpful “It’s better to be undertrained than overtrained.” Take some Advil, ice if there’s inflammation and REST. It’s not impossible to get past this in four weeks, just be smart about it. You can still have a great race. Hope this helps.

5

If I were that worried about the knee, and it caused problems only running, I wouldn’t hesitate to blow off running all together over the next four weeks.

Your body knows how to run. It won’t forget in four weeks. Maintain your fitness in the pool and on the bike and have a great race.

If the injury heals, it could be the best thing that could have happened to you.

6

I totally agree with both of the above responses…either you’ve done the training up til now and you’re ready, or you haven’t and it’ll be a long day. Don’t make it longer by trying to fit in more running and subsequently causing more pain than necessary during the race. 4 of the 6 Ironmans I’ve done, I had some sort of injury going into it. 3 of those, I continued to train thinking the adrenalin would carry me through. I was right to some extent. It carried me through half of the marathon, but in each case I limped home. For the 4th one where I was injured, I followed the advice I gave you above and had much more energy, less pain, and an overall better race. I think we all overtrain, so look at the positive and realize how much better rested you’ll be with some running time off.

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I’m just getting over the same thing in both knees (if you mean pain just below knee cap). I did the rest, ice, and ibuprofin thing for 2 weeks with little improvement. Then I added ultrasound, glucosamine and stretching and it improved within days even while I was still training pretty hard.

ultrasound: not sure if this accomplished much…didn’t seem to feel better the day after a treatment…had two treatments

glucosamine: not sure about this either but the improvement did occur a week after I started on it just like someone on here said it would

stretching: pull your foot to your butt like stretching your quads…this prevents the tendons from healing too short and being over stressed with the next workout

PS: I could get them warm enough to train each day but they were a killer the next day. I have races coming up so had deciding on a strategy of pain management through the races then complete rest after. Then the recovery caught me by surprise. I did a hard brick yesterday with no pain even after running the night before…Good luck.

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Thanks for the replies - it provides a lot of reassurance knowing my race prep isn’t totally derailed and the loss will be minimal.