Keeping a Bad Knee Healthy While Increasing Speed

author : AMSSM
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Member Question from Tkimble01

"I'd like to increase my speed running while keeping my knees healthy.  I currently train and compete at a pace between 10:30 and 12:30 minute miles.  The goals for my first year were to finish all tris without injury and I did.  My goals over the next two years are to become competitive in my age group in Triathlon as well as to do more HIMs and a full Ironman.

I have had 6 knee surgeries (1983 - 2008) on my left knee including the reconstruction of the medial collateral (1983) as well as the anterior cruciate reconstruction (1985).  Other 4 surgeries were minor to clean knee out or cut out tore cartilage.  I really want to keep my knees healthy while participating in Triathlon.  I began doing triathlons in 2010.  I completed 5 sprints, 1 Oly and 1 HIM with no knee issues to speak of.  I am 50 years old.

My regimen other than stretching is to elevate and ice my knee down after every run.  I elevate my legs and shake them out while icing.  I take a few Ibuprofen before workouts and I keep fresh running shoes (Mizuno Wave Inspire 6 fitted by specialty running store).  I build distance slowly and run at a comfortable pace (10 - 12 minute miles)."


Answer from Christopher Meyering, D.O.
Member AMSSM

With the number of surgeries you've had on your knees, it's understandable to be cautious about your training.  It sounds as though you have done a good job of not overdoing training and avoiding knee problems in your first year of participation in triathlon.

To be able to run faster for a sustained amount of time, you need to add speed workouts to your triathlon training regimen. One of the easiest ways to introduce speed training while still running on your normal routes is a Fartlek workout.  Here are two methods of this "speed play" workout.

The first way begins with a run of about a half-mile to one mile for a warm up at an easy pace. When your warm up is complete, pick a point or landmark in the distance about 50 to 200 meters away from you (any distance if fine). Then increase your pace to about 60-80 percent of your max heart rate.  It should be fast for you, but not an all out run.  Once you reach your point or landmark, slow down to your normal easy pace.  Whatever distance you run at the faster pace, run half that distance for recovery. If you have a running partner, take turns being the leader setting the pace and distance of the intervals.

The second way involves running at timed intervals along your normal routes.  Again run a half-mile to one mile warm up at an easy pace. Run your faster pace at increasing then decreasing minute intervals with recovery runs of half the time of the fast run.  Let me explain this more specifically: first run one minute fast, then 30 seconds recovery; two minutes fast, then one minute recovery; three minutes fast, 1.5 minutes recovery; four minutes fast, 2 minutes recovery.  After reaching four minutes of the faster pace, start to work your way back down to the one minute fast-paced interval. If you still have time remaining in your workout, start to go back up again on the interval times.

Both of the workouts will take around 45 minutes to an hour to complete. Finish up both workouts with a 1/2 to one mile cool down run. Only complete a run speed workout once per week to avoid injury.

I would like to give one word of caution with your current regimen.  I don't recommend taking ibuprofen or any NSAID (the anti-inflammatory class of medication to which ibuprofen belongs) before workouts as there are multiple associated issues with long-term use. Intestinal problems range from stomach irritation to increased risk of ulcers.  NSAIDs can decrease blood flow to the kidneys resulting in increased blood pressure and possible kidney damage. In addition you may be masking injury by decreasing pain signals that let you know when you are doing too much in your workouts.

Good luck with your continued training and enjoyment of your hobby.

Christopher Meyering, D.O.
Augusta, GA

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date: February 4, 2011

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AMSSM

The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

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The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

FIND A SPORTS MEDICINE DOCTOR

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