The 1-year Running Injury
Hi it’s me, dusting off the cobwebs on my newsletter again. What prompted this post was seeing my favorite creators documenting their experience for years, where you can see a clear arc in their journey from where they began to where they are now, and how far they’ve come. So in that spirit, here is an update on my running journey.
Since my last running update in February, I’ve made a huge breakthrough in my long-term knee injury. Here’s an overview of the whole thing.
Timeline of events
Injury (August 2022)
In August 2022 I ran the Double Dipsea and a section of the Four Pass Loop. This totaled 34 miles and 9,000ft of climbing in 2 weeks. At the end my left knee really started flaring up, to the point of not even being able to run.
Denial (September-December 2022)
The knee got better enough to run on. I thought I could “run through the injury” 🤡 and kept running 15-20 miles a week. Things did not improve.
Physical Therapy (January-May 2023)
As the new year rolled around, I decided to fix this once and for all and head to PT. Each time I visited my knee felt better, but the pain always came back. I yo-yoed like this for months.
Abstinence (May-July 2023)
I decided to stop running altogether and rest, picking up weightlifting and lap swimming instead. The knee initially got better but I hit a plateau where I still had dull pain that never went away.
I got to the point where I started to accept that I may never do any serious running ever again. This bummed me out a lot.
Breakthrough (July-August 2023)
After two full months of zero running, I came to a realization. Acute injuries should get better with rest, however this one was not. So maybe this was being caused by something more chronic.
Additionally, I paid more attention to my gait and noticed that I was favoring the outside of my left foot and avoiding my big toe. I got a referral to a podiatrist. They took 1 minute to diagnose the root cause: flat feet.
I learned from the doctor that the foot should arch on two axes: the big (medial) arch, as well as a smaller arch (transverse) along the toes viewed from the front. Both of my arches were flat, which caused issues all the way up the chain of muscles and tendons from my foot, to my ankle, to my knee. This was also causing limited range of motion in my big toe, something that might require surgery in a decade or two if not resolved.
Despite the diagnosis, I was super happy that I finally found the root cause of not one but 3 of my running injuries from the past few years: 1. this knee injury, 2. a sporadic shooting pain on my left ankle, and 3. my toe’s limited range of motion.
A new hope (September 2023-present)
When I started running again, I changed two things: I got more supportive shoes, and added only one mile per week, all while staying in zone 2. I’m up to 14 miles this week and the knee feels great.
What I learned from all this
The pain isn’t always the root cause
I treated the symptom (knee pain) for 11 months, without making any major progress. Attacking the problem from a different angle led to a breakthrough and gave me so much hope and optimism.
Doubling down is not the answer
Historically when something wasn’t working, I would try ratcheting up the magnitude of that thing. For instance, if the physical therapy exercises weren’t helping, I would do extra exercises and add heavier weights. If rest wasn’t helping, I would add more weeks of rest.
However, none of those instances helped. What actually helped in the end was pausing and critically thinking about the problem at a higher level.
Take Born to Run with a grain of salt
Despite my long-term preference to “be one with nature” and wear the most minimal shoes possible, I came to terms that this is not the truth for myself. It was my SF running buddies who helped me realize this — few of them wear minimalist shoes.