Knee pain
publish #needswork - add date and do a quick skim bc it’s long Opened DATE. Related to My medical history.
Predominantly in my right knee. It’s been preventing me from going on >=5mile runs since mid-2021. Running theory is muscle atrophy from working from home for so long, plus my uneven gait. I guess that makes sense. But why only my right knee?
2022-03-29: Went for a 2mi run and my knee tingled. Specifically it feels like there’s a tendon stretching over the top of my kneecap that gets moved uncomfortably when I run.
I could tell my knee was going to be an issue from the very beginning of the run.
2022-04-20: I’ve worked out 3 nights in a row, twice including 45s wall sits, and haven’t noticed any serious pain in my knee. Although I feel pressure within it ambiently.
2022-04-25: I was at Coachella all weekend and walked ~52.5 km according to Pokemon Go. No knee pain whatsoever; didn’t even think about it!
2022-04-26: Ok, I might finally understand the issue with my posture.
I ran 3 mi today and felt no pain (although a decent amount of pressure after the run). I paid extra attention to my posture and noticed…
My right foot hooks inwards when I run. When it hooks inwards, the exterior of my foot strikes the pavement first, pinching my knee joint on the same (right hand) side. Visual aid:
Maybe the way I cross my legs at my desk causes this same knee posture?
What’s funny is that as soon as I corrected the posture, my left foot started making the same error (or “misstep”? Heh):
Unfortunately by the time I got home I felt pressure in both knees. But I was able to achieve a rhythm of sorts several times during the run whereby focusing on my posture, I could eliminate the pressure sensation on both knees. The pressure returned after taking a break or failing to maintain posture due to tiredness. Possibly related to feeling better (though I hope not): I was on 10mg of Ritalin for this run which at a minimum probably helped with being so acutely aware of my posture.
Anyways, the rhythm came when I followed these rough guidelines:
- Keep my thighs very close together, like 1-2” gap from touching.
- A result of this is that my feet can’t easily hook themselves around since they don’t have space. That seems like the main benefit.
- Push off each step via the first three toes on the foot (big toe through middle toe).
- Hunched forward on knees.
- Not sure about this one since it seems counterintuitive.
2022-04-28: Possible original root cause: I was too cocky in the past and ran despite not being to handle it with bad form.
Supporting evidence: I can probably run 3 mi again today but it’s hard to do while keeping form. So I turned back. Past Warren may not have.
Another thought while talking with Maddy - maybe I have too much cushioning on the Hokas, causing my knee join to consistently handle the brunt of the stepping force.
2022-05-02: Went on a 4 mi run that ended semi badly. It might be caused by me wearing the Hokas? My knees alternated in pain starting at the 2.5 mi mark as I played whack-a-mole fixing each side of my gait. I ended up running home despite the pain because I felt a slight hit of runner’s high returning (perhaps more descriptively: emotional joy of running). I haven’t felt that in months.
I considered shoving something in my shoe to fix my right side toe since that seemed to be a big issue with my gait. You can actually see on my marathon shoes that there is an indent on the right side toe where presumably I’d been placing all my weight.
Walking between each exertive set helps with my gait problems. I think I should start with walking next time I run.
2022-05-04: I decided to bring my marathon running shoes to Europe instead of the Hokas. I did a demo walk through the kitchen with Sharon watching and I kept ending with bad walking posture. I think they might be partly to blame for my issues.
2022-06-05: Went for a 5 mile run (3 miles turned into longer as I felt good). This was really great. I think walking around Europe strengthened my legs. However, some things to note:
- This run definitely had the potential to go poorly had I not carefully adjusted my gait in the beginning. I had to take a few tries at it before I got to the gas station. The sensation is sort of like screwing a cheap plastic bottlecap onto a water bottle; when you misthread the cap, you notice so immediately. I had to walk, wait, and “rethread” my gait thrice before getting into a healthy rhythm.
- Again, I felt a pressure underneath my left kneecap. I ignored it but it never quite went away during the run — I think I simply forgot about it. After the run the pressure subsided. Not sure what to make of this.
2022-08-08: Mild pain arose again in my left knee and I felt I was extending that leg too close to my center. My weight was on my right knee too much. I tried 3 times to “rethread” my gait. The third time was successful. What I did differently: ignore foot, knee, and calf placement and focus purely on lifting my thighs up while running. Using only my thigh muscles led to a healthier gait.
2022-08-18: Went for a 5.3 mile run which was a risky jump in distance since I hadn’t run in a while. I felt tingling underneath both kneecaps around the 2.5 mile mark and occasionally spurts of pain. However the trick from yesterday seemed to fix it. The following day my knees feel fine… I occasionally feel a sensation underneath the kneecap but I might be imagining it.
2022-10-13: Had a huge insight on my walk to work. My gait on my right foot was different and I couldn’t shake it even when focusing on it. I checked the straps on my Google intern backpack and found the right hand strap had slipped to its usual at-rest position of max length. This has been happening forever only on the right side. Could my backpack be the issue?
My notes document the pain beginning mid-2021, but I would have gotten my backpack end of 2019. 2020 was spent predominantly indoors and I definitely put my running routine on pause, so perhaps the issue wouldn’t have surfaced that early?
To be clear btw. Even if this isn’t the only root cause I’m certain it’s a factor. Having a loose strap on the right side of my backpack means my right foot, which normally touches the pavement from big toe to med arch to heel, must overcorrect itself further left to carry the weight, causing it to touch the pavement middle toes to lateral arch to heel.
… which aligns with my insight on xxxxx that the pain is less bad when I bunch my knees closer together. It’s basically forcing my feet to hit the pavement across the med arch.
Update (2024-06-05, aka way in the future): Yep, it was the backpack strap. My knee pain is fixed! There is a medical benefit to journaling…