Knee injury at 3 months (13 weeks): Return to running

Last week I was officially 12 weeks out from my knee injury, which sports medicine considers to be 3 months (1 month = 4 weeks). This week I’m at 13 weeks, and 3 months as far as the calendar is concerned (I injured it on 2/27). At 3 months, I was cleared to return to running. And that is exactly what I did.

Of course, I was cleared to return in very slow, baby steps. My doctor told me that at 3 months I could start “run/walking,” starting at 30 seconds of running every 5 minutes for 30 minutes total, and adding 30 seconds every time I ran until I was running the entire time. If you do that math, it would take 10 runs to get up to a consistent 30 minutes of running.

Last Tuesday I had my final physical therapy appointment. My physical therapist was happy with my progress. He gave me balancing, jumping and lateral movement exercises now that my fracture is officially healed. We also worked on flexion. He agreed that I could return to running, and said to make sure I was listening for the sound of my foot hitting the ground. He said that if I can hear my foot hitting the ground, my knee joint is taking the impact.

The day after my PT appointment I put on my new Brooks with my new premium personalized insoles and I headed out on the trusty trail by work. I was nervous, sure, but I assumed all would be fine. On the second foot fall my knee started hurting. It hurt on the inner side, which is a place it never hurt before; my meniscus sprain was only a grade 1 and my fracture is on the other side of my knee. I was so bummed out when it started to hurt, but I assumed the pain would go away. Of course it didn’t and I finished up the “run” feeling pretty despondent. I knew it was going to be hard for me to take it so slow coming back, but I never really considered that my knee would hurt when I ran. Since that is not how I injured it, I didn’t think it would be an issue returning to it.

I spent a considerable amount of mental energy keeping myself out of a spiral of despair on Wednesday. I told myself that it was probably the PT that made it sore (we worked a lot on flexion, and my knee still hates to bend all the way). I also wore my compression sleeve when I ran I and I don’t normally wear that, so it might have been the culprit. I decided to try again on Friday, without doing any knee bending work before I went, and without wearing the sleeve.

Friday definitely went better. I was up to 1 minute of running and 4 minutes of walking. But I realized my “walking” was really jogging. Or something inbetween power walking and jogging. Trotting? It definitely felt more like a trot. My feet stayed very close to the ground, but there was definitely a moment in my gait when both feet were off the ground. When I got to the 1.5 mile mark in 15 minutes I knew for sure I wasn’t walking. I stressed out quite a bit about whether or not I should really walk, but my knee felt fine and my “trot” kept the muscles around my knee totally engaged, so I decided I’d keep doing it and see how things went. Also, the combo of running/trotting got my heart rate up and made me sweat – it almost felt like going on a real run – and I knew that if I kept it up, I’d be more likely to slowly add running time over the next ten runs.

I will say, the uncertainty of how to proceed has been hard for me with my knee injury. I’m a rule follower and I always want to be a “good” patient. I also know that I’m impatient and prone to pushing myself through pain, and I didn’t want to re-injure my knee because I wasn’t willing to let it rest and heal. It’s been a mind-fuck all around, honestly. The martial arts test also forced me to walk lines much finer than I would have liked. I will be so glad when this is all over, but I also appreciate that I’ve learned a lot about my mental and physical capacity to come back from an injury.

I ran again on Sunday and a fourth time yesterday. I felt twinges in my knee both times, but they always passed. I’ve never felt the consistent pain on the inner side of the first run, though I do sometimes I notice it for a minute or two. I’ve never worn my compression sleeve again, and I got Shokz open ear headphones so I can better hear if my foot is striking the ground too hard upon impact. When I run tomorrow I’ll be at half/half run/trotting. My trot is turning into a full fledged jog, but I’m telling myself it’s okay as long as I keep the muscles around my knee engaged. The whole point of this ramp up is to make sure that my knee can take the strain of impact, and if it seems okay after each run, I’ll assume it can handle it.

I will say, it has been SO wonderful to return to running. The weather has been beautiful and the effort is enough that I’m getting a taste of those amazing endorphins. It has been a very positive experience, and I’m so grateful that my knee has been able to manage the strain of such a high impact activity. If I keep running 2-3 times a week, I’ll be up to normal by mid-June! But now that I’ve upped my “walking” to trotting or jogging, I’m okay with the slow ramp up. When I run I think hard about my foot falls and it’s a little mentally exhausting. I’m glad I’m also learning how to jog in a way that requires less mental work to feel safe.

I’ve stayed on a trail that is flat and even. There is one by work (Sawyer Camp Trail) and one in the city (Great Highway) and each is the perfect length. I think once I’m back to a full 30-40 minutes of running, I will try my favorite spot in the city, which is a park closer to home, but has some hills and uneven trails.

I honestly can’t really believe I get to run again. I really hope the ramp up continues without issue.