My friends would have heard the Story of My Knee – I had a complete dislocation of my left kneecap back in 2005 (which was not running-related; if anything, it was probably dance related). That old injury has left me with weakened muscles on the left leg since, in addition to periodic aches on the right leg due to strain when I attempt (usually without realising) to ‘compensate’ for the lack of strength on the left.
The long road
I hear the alarm bells ringing in your head – why is this woman running marathons, with bad knees? It may surprise you that I in fact took up running after recovering from the kneecap dislocation.
However, ‘taking up running’ didn’t mean that I just decided one day to put on some running shoes and start running on a track. It entailed reading up a lot on running mechanics and body awareness from various books and online resources, starting with very small goals (like 100 metres!) and experimenting with altering my gait based on what aches or pains I felt and where they were (and reading those books all over again, in particular the ‘how to run injury free’ and ‘common running injuries’ sections). At the same time, I also started taking up Pilates, which helped me a lot with my running posture (which is also an important link towards being injury-free when running).
It took me several months before I could run continuously, pain-free, for 30 minutes. And then a few months more before I attempted a 5K.
Let’s fast-forward that 5 years. I completed my first Marathon, 42.195KM, in 2015, injury-free, in about 6 hours and 40 minutes. I wasn’t quick, but I finished in one piece, and it was a major landmark for someone who was hardly ever associated with sports in school, and who has what her friends jokingly refer to as ‘removable kneecaps’.
Other than the occasional achy hamstrings or iliotibial bands not uncommon to runners, I am extremely thankful that there have not been setbacks from any running-related injuries (in 2013 I had a possible hairline fracture on a toe – from a major stubbing against a heavy wooden bench on my way out of the house for a run – I hereby declare that that would NOT count as a ‘running-related injury’! 😂)
I signed up for CrossFit Foundations in the beginning of 2016, whereupon my coach noted some imbalances and general weakness in my lower limbs, something I was urged to get checked out with a physiotherapist, preferably before I lifted anything much heavier. That was when I contacted sports physiotherapist Lip Qin. I had heard about Lip Qin from the studio where I had been going to for pilates for many years (Pilatique in Kuala Lumpur), as well as from the testimonies of friends in performing arts and running who had seen him for various ailments from frozen shoulders to patellofemoral joint syndrome.
The weekly sessions of treatment and rehab pilates with Lip Qin have been a real eye-opener. First of all, within the first half hour of my first session, he had identified and corrected, through myofascial release, issues with my posture arising from the shoulder area that had caused my hands to go numb for 4 days due to nerve impingements after an attempt at overhead squats , which had had my CrossFit coach baffled. For the first time in years, the sides of my elbows could actually touch the floor when I lie down with my hands behind my head!
I also learnt that I had been doing squats wrongly all this while to the detriment of my knees, partly as a result of the muscle weaknesses associated with my knee problem. I slowly also learnt that I had become accustomed to many atypical postural and centre-of-gravity positions picked up over 9 years of ballet during my schooldays, which, coupled with other specific issues such as joint hypermobility, meant I was putting a lot of unnecessary stress on my knees.
A lot of fundamental ‘re-training’ had to be done. I was prescribed exercises, kinesio-taped, and my progress was assessed each week.
My second 42K
After about 6 weeks of physiotherapy sessions once a week, I was back in Sabah to run my second Marathon distance, on the same course as my maiden outing, at the Borneo International Marathon 2016. Training-wise, I had considerably less mileage under my belt for this year’s marathon compared to 2015, and I was therefore quite apprehensive. My furthest distance run during training was only 21KM. I was prepared to walk the route and take the sweeper bus if I had to.
To my surprise, I managed to improve my 42K time by a whopping 20 minutes. The only post-marathon aches I had were those of my protesting calves and hamstrings, and a bit of a headache from the heat. My joints were absolutely fine, my knees weren’t protesting at all, and I didn’t have any of the lower back-aches that would usually hit me if I didn’t pay extra attention to my form even at a Half Marathon distance. The aches and the associated DOMS (delayed-onset muscle soreness) later were more significant on my left calf – which was not unexpected since I still have a comparatively weaker left leg – but I was in great shape otherwise.
The physiotherapy sessions had been a great help in contributing to my performance. My conjecture is that if I had trained at levels equivalent to those of the last year, I would probably have gone straight to a sub-6 hour finish – which is what I will target for at the Standard Chartered Kuala Lumpur Marathon later this year.
But of course this deserves a drawing!
Till then, I’m continuing on with my physio sessions, which are now focusing on strengthening exercises.
From my earlier experience, I had come to associate physiotherapists with immediate post-injury or post-surgery rehabilitation in a room, usually in a hospital, full of equipment and patients in casts and bandages who have been sent there by their orthopaedic specialists, each telling one another their war stories in a “running [or other sport] is bad for your knees” sort of environment. Guess what? A sports physiotherapist who knows the mechanics of your sport is quite unlikely to say that, and might even help you do better at that sport.
I have had so many questions and revelations and questions after revelations that I hope I haven’t been treating my physio like an on-call medical encyclopaedia.. 😀
The drawing by me below is dedicated to all sports physiotherapists who impact so many lives with the good work they do in their profession. May you not have too many clients who go for their sessions only for the good massages thrown in! 😀