The Four Worst Words in Running

My knees feel it.

Famous Parts Redacted, frame 1 (collage, 2017). When we’re trying to figure out what’s wrong, we sometimes have to block out the obvious.

“My knees feel it”, or some variation, is the kiss of death in running. The other day at the park, a woman I know by sight told me that she saw me running and that I looked “so powerful” but that she doesn’t run as much anymore because “my knees feel it”. I have a colleague at work in her 20s whose knees feel it. I have friends in their 40s with knee pain; I know men and women in their 50s, 60s, and 70s, whose knees sing in a chorus of throbbing, aching, and stabbing pain. 

Sounds awful. 

While some of these injuries are, in fact, knee pain from a damaged meniscus, deteriorated knee caps, or strained ligaments and tendons immediately around the knee, some of them may not be. And if they’re not, no amount of slow runs, time off, or physical therapy at the site of the pain will solve it. And here’s where things get weird: lots of time, the origin of our pain is not where it shows itself to be. 

For example, in 2017-2018 I developed debilitating pain on my right side, starting at the hip attachment of my IT band, down and around my knee. It all started when I got a new job with an aggressive travel schedule. I flew around the country in my 3”, stacked heel Red Wing boots with my laptop stashed in a military helmet bag in my hand, and I wrecked myself. I stopped being able to carry my laptop, sticking it in my roller bag instead. I took 9 weeks off (my longest time off ever!), spending what feels like eons on the arc trainer. Still, when I went back to running, I developed a limp. By early 2018, I was avoiding stairs, even taking the elevator to skip a one flight descent.  

Famous Parts Redacted, frame 3 (collage, 2017)

After about 7 months of this, I dragged myself into my longtime surgeon’s office. “I’m ready for surgery on this knee.” I said. Never having volunteered for anything that would limit running in the 20 years he and I had worked together, he was doubtful. 

He took a look at the knee. “No,” he said. “Not for you. Not yet. I don’t guess you’re the type that would let me give you a cortisol shot just to take away the pain and give you some time to recover?” He asked. 

“Yeah absolutely I would” I said, thinking he was crazy. I had just volunteered for surgery! He wanted to give me a giant shot in the kneecap and thought I’d shrink back? No way! 

After he shoved a needle so large it could be used to make an Acme sweater directly into my patella, his nurse brought him a fully 1” stack of paper. “Here.” he said. “This is what you need to do. I feel like you’ll do them.” I flipped through them; it was a series of weird-o exercises, complete with awkward figure drawings, to strengthen the knee. “Thanks,” I said, resolving to follow his advice explicitly, “I’ll let you know.”

In the following week, I looked more closely at the exercises. There were a lot of them, and I still had that job with the aggressive travel schedule. What could I do to make this happen? I remembered that I had gotten good results from a barre class I had started taking for 4 weeks after my worst turned ankle ever, so I looked around for barre classes in D.C. 

I found one and showed up, prim and focused, like the straight A phys ed student I am. I promptly nearly collapsed on the cork floor during warm up. 

The thing is: my knee was fine. What was not fine was literally everything about my hips and just about everything to do with my right foot. I have knock knees, for one thing, which isn’t a problem with your knees at all; it’s a problem with the rotation of your hips and the way your adductor muscles engage. I had sustained a major injury in my largest, right toe in my early 20s on which I did get surgery after a year of ignoring it, but which further resulted in a collapsed-in and painful knee. 

Famous Parts Redacted, Frame 5 (collage, 2017)

Over several months, I attended barre class two or three times per week as I felt with delight my knee pain lighten and my runs return to lightness. It wasn’t my knees after all; it was all the things around my knees that should have been supporting it, but wasn’t. It wasn’t the way I had used my body in the past; it was the way I was using it all the time, up until I addressed the problems seemingly removed from the pain that were actually causing it.

I had to learn better habits, and I did. I had the pleasure of calling up my surgeon a year later and telling him I had zero knee pain. Stunned, he asked how I did it, and I told him about barre class. He said he couldn’t believe it and laughed, which was nice of him.

Everyone, no matter how convinced you are that your knees are what’s holding you back, need to re-examine the issue. It might be your knees, but it might not be. It might be something adjacent or even in another whole part of your body. The root of our problems isn’t always where the pain surfaces. It’s up to us to be curious, to try things out, and not to just pack it in when we start to feel it. 

So see a doctor you trust. Do your cross training. And for today, remember: go run.