Yes, you can run a half-marathon after knee and back injuries
(CNN) — At 47 years old and with a list of bodily injuries that reads like a medieval saga, I never thought I could finish a half-marathon.
I’m the mom of two very active young boys. I have a work schedule filled with national TV appearances, the completion of my next book and my private medical practice.
But more serious: How could I possibly run 13.1 miles at my age and with all my injuries? I have a 30-year history of knee and back problems, including three surgeries and dozens of injections.
I always dreamed of running a half-marathon, but I didn’t think it was physically possible. The list of reasons why I couldn’t was simply too long.
Despite all this, in a momentary lapse of judgment, I joined a group of moms who were training for a half-marathon.
I now feel like the poster child for “Yes, you can still run a half-marathon, despite what ails you.”
At age 16, I tore my right knee’s ACL (anterior cruciate ligament) while playing soccer. I was in full leg immobilizer for six weeks. The severity of the injury was unknown, so they didn’t operate.
During my third year of medical school, without an ACL, my knee essentially dislocated, and I could barely walk.
Surgeons repaired it using a hamstring graft, which at the time was newer and showed faster recovery. Six years later, I tore the meniscus in that same knee. When the surgeons did the meniscal repair, they said my ACL graft had failed.
I have poor stability in that knee joint, as I opted not to repair it again. It would have required significant down time, and the surgeon said that if I kept my supporting leg muscles strong, I would probably be OK.
The pain has been chronic on and off. I’ve also had several injections for the pain, and I always wear a brace during exercise to support that knee.
During the second year of my medical residency, after a kickboxing class, I was walking down the hall at the hospital and noticed that my left foot was not flexing properly (it was making a flapping noise on the ground).
I was in surgery two days later for a massive disc herniation in my spine; 85% of the L5 disc was protruding into my spinal column and pressing on the nerves, causing my neurologic symptoms, which included weakness and numbness.
The surgery lasted seven hours due to extensive scar tissue surrounding the disc (I had been in pain for years and never had the pain evaluated), and the recovery was very long and slow.
My neurosurgeon warned me that I was going to have to be much more careful in the future with my exercise regimen or I would have even more significant back problems.
In 2014, after the birth of my second child, I had a severe flareup of back pain radiating into my right buttock (this is fairly common after pregnancy due to the loss of abdominal muscle strength plus the increasing weight and imbalance caused by the growing baby), and I had to have a series of 13 injections in my back before I was pain-free and could carry my newborn son more than a foot or two.
Train my way out
As a physician who has worked with dozens of athletes training for endurance events, I knew a fair amount about what’s required to train properly.
But training with significant orthopedic issues and a jam-packed schedule proved to be far more challenging than I expected. It also turned out to be an incredible learning experience, and I took the opportunity to reach out to several experts during my journey.
At a veteran mom and marathon runner’s suggestion, I began my training by doing run-walk intervals (run five minutes, walk one minute). Experts agree that this is a great approach when you are starting out or dealing with an injury. It allows for physical recovery and rest while helping prevent injury or injury aggravation.
This type of interval training — not to be confused with high-intensity interval training, which is short sprints interspersed with short periods of recovery, often used for weight loss and to improve cardiovascular fitness through a shorter, more intense workout — also helps build both endurance and confidence because it allows you to train longer with less fatigue and less continuous joint and muscle strain.
Since I was training with several old injuries, it helped me tremendously. I found that as I fatigued, my form suffered, and my pain increased. The one-minute recovery intervals really helped me maintain better form during my training.
Using an app called Runner’s Interval Timer helped me monitor these intervals and made training much easier. I was able to build up to 3 miles the first week.
Another challenge was that I had only about two months to train. All the experts I spoke to recommend allowing at least three to four months to build up to a half-marathon. With training, your heart muscle strengthens, allowing you to more effectively pump blood and oxygen to your hardworking muscles.
I knew that it was important to build up slowly but consistently, so I set a goal of running three times a week: two shorter runs (3 to 5 miles) and one longer run on whatever day my schedule allowed. I tried to increase my longer runs by 2 miles each week since I had to ramp up more quickly to be race-ready in time.
All the experts and experienced runners I consulted emphasized the importance of cross-training to build strength and flexibility and to prevent overuse injury. So I tried to squeeze in one yoga session and one Spinning class per week. In retrospect, I wish I had made the time for strength training, as I know now that it would have helped me maintain better running form.
I also found the time to make it to the running store to be assessed for better running shoes. My chiropractor, Dale Fernandez, treats a lot of “weekend warriors” and new runners like myself. He explained that “good running shoes will complement the efficiency of your gait/stride and even offer symmetry in your running.”
He also suggested that I meet with a running coach, but at the time, I didn’t appreciate the importance of this recommendation, especially for someone with a history of orthopedic issues.
Five weeks into my training, things were going surprisingly well. I wasn’t pain-free all the time, but I had completed a 10-mile run, and I managed to recover fairly quickly. After each long training run, my knee got very inflamed. I had a hard time walking down the four stairs in my house, but it always got better within two days. At one point, my left knee even started hurting for a week or so, probably due to gait issues caused by my right knee pain.
My back was holding up much better than expected, and while it was challenging finding the time to run, I adjusted my work and family schedules to fit training into my day. This is a suggestion I have made to thousands of patients over the past two decades.
At this point, I was getting the weekly mileage in, but I was running very slowly, and my former high school athlete side got the best of me. I decided to push myself and try to go a little faster on a 3-mile run to see whether I could improve my time. And that is when the trouble began. I felt OK immediately after the run, but the next day, I could not stand up straight and was suffering terrible back pain.
I went to see my chiropractor, who told me that in my current condition, it was very unlikely that I would be able to run the half-marathon in 3½ weeks.
I didn’t have any major “red flags” — none of the neurological symptoms including weakness or numbness that I had before my surgery two decades ago — but I still needed to take at least a week off from running to let my back recover. He strongly suggested (again) that if I really wanted to complete the half-marathon, I should hire a running coach to see whether there were issues with my form that might be contributing to my pain.
Desperate to reach my goal, I agreed, but I was not optimistic that anything could be done so late in the game. I mistakenly assumed that running was a basic skill that didn’t require coaching.
After one 90-minute session with Pose Method-certified running coach Christoper Drodz, I realized I was completely wrong. He took videos of my running form at the start of the session and showed me all the ways in which I was placing added strain on both my knee and my back, in addition to forcing my body to use more energy than required with each stride.
He gave me a crash course in the pose method of running and put me through a number of exercises and drills to improve my running form. I felt the change immediately: much less strain on my back, and my running felt faster and more effortless.
Since the race was only two weeks away, I didn’t have time for a second session, but I felt confident that despite my setbacks, I was going to finish the race.
I completed the half-marathon without too much suffering, and I even managed to sprint to the finish with one of my fellow moms! Even more surprisingly, I had no knee or back pain the following day, just really sore muscles.
Getting a medal at the finishing line was a highlight (how often do we get medals as adults?) and seeing the proud faces of my husband and kids near the finish was a joy.
I’ve already signed up for my next half-marathon in a few months, and I’m confident that with everything that I learned, and with the benefit of additional training time, it will be even better.
I’m not suggesting that everyone can or should complete a half-marathon, but what I learned is that you shouldn’t let past injuries or a crazy schedule get in the way if it is something you have dreamed about. Just be sure to get the training and medical support you need to avoid injury.
Not only was training for this event a fantastic way to build weekly fitness and training goals, it was a great way to ease the tension and anxiety in my life. The sense of accomplishment I felt crossing the finish line was one of the highlights of my adult life.