How I fixed my knee pain (and then crushed a 47 km run)
Last year I couldn't run.
In September 2023, a friend and I ran the Juan De Fuca on Vancouver Island. It was an awesome experience. 45 km, 2000 m of elevation and 13 hours.
But in July of 2023... I could barely hike downhill. Forget running.
I was dealing with a long-standing knee injury, that came back when I increased my downhill running.
At the time, we were living up at Silver Star. The trails up there are incredible. They're exciting and flowy, and a true joy to run.
They are also uphill or downhill in just about every direction.
This meant that every single run I was hammering downhill, which is a surefire way for me to trigger my knee pain.
My injury is likely my meniscus. I have an old twisting injury that has given me issue in the past.
It shows up as pain along the inside of my knee that SPIKES with downhill strides. It's sharp, and intense and can often take my breath away.
So... when this came up again, with Juan De Fuca already on the calendar, I took it seriously.
Here is the strategy I used:
RESET.
RESTORE.
RELOAD.
Before we get to that, we need to understand why running injuries happen in the first place.
Whenever we experience a running-related injury, we are dealing with an overuse injury. We did too much too soon.
WE ALL HAVE AN INJURY THRESHOLD.
No matter how fit you are, we all have an injury threshold. For you, it might be 25 km. For the next, it might be 10 km. For another, it could be 100 km.
AFTER AN INJURY…
After an injury, that threshold is lowered. We can no longer handle the same amount we could before we triggered the injury.
Here is exactly what I did to fix my knee pain and successfully conquer the Juan De Fuca in a single day:
Step 1: RESET.
This meant rest... but not complete rest.
I still had to train for the 45 km trail run with almost 2,000 m of elevation gain.
But... I couldn't. Instead, I focused on what I COULD do: flat running and strength training. I focused on continuing to build my leg strength so that when I did return to smashing downhill I was strong enough to do so.
In the CALM IT DOWN phase, my main goal was to maintain fitness and strength, while letting my pain triggers lessen.
Step 2: RESTORE.
The goal of Step 2 was to build my tissue tolerance (the resilience of my knee) up beyond the demands of a 10 hr day.
In order to return to running the distance and terrain I wanted to, I knew I needed to build my strength, endurance and tolerance back up.
Since I had been already working on my leg strength, I was in a good spot.
I added in some specific exercises (in this case step downs, pogos, and adductor planks) to target the muscles and parts of the knee that needed it the most.
Step 3: RELOAD.
Then came the fun / nerve-racking part... running downhill.
Thankfully, I had put in the work and was ready to get back to running downhill with speed.
I reintroduced it gradually, on moderate trails, before turning on the jets.
I was lucky because I didn't experience a single flare-up. I was ready for Juan De Fuca.
Result?
Juan De Fuca was a blast (big thank you for the weather on that one).
Now?
It still bothers me on occasion.
But that is inevitably when I have neglected my rehab exercises. I started to experience sharp knee pain and need to add in a few weeks of consistent strength movements.
Here are the takeaways...
When you have pain, take it seriously. Do something about it!
When you are injured, you will need rest. Relative rest doesn't mean you can't do anything, it means you need to do less and modify.
STRENGTH is your ARMOUR. It's your bank account, your insurance policy, and your treatment. It will get you back to activity faster than anything else.
If you are struggling with how manage and treat your injuries, we can help.
-Dr Mark Murdoch
Chiropractor, MS Sports Medicine
Dr Mark Murdoch is a runner, chiropractor, and rehab specialist in Vernon, BC.
Every week he works with runners, mountain bikers, and adventure athletes who want to get back to their sport better than ever.
Request a free consult with him here: CONTACT