When I was a kid, I had bad knees. Really bad. I'd run a mile and limp for weeks. Well past my teenage years and into my early twenties, I thought I was just stuck with these knees. But then I found a way to fix them. It was one of the hardest things I've ever done. Here's how it happened.
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The Bad Days
Brief disclaimer: Everyone's body is different. This is what worked for my specific knees and their specific problems. You may have different knee problems, which means that what worked for me could hurt you. See a doctor or a physical therapist.
Here's a brief history of my body. Starting around age 12, I started getting knee pain. When dealing with me, a lazy, pubescent boy in the early 1990s, a doctor would just say, "Osgood-Schlatter. Case closed." No x-rays, no testing. It'll go away in a couple years, they said. But it didn't. It got worse.
By the time I was in high school, it was so bad that I couldn't do the five minutes of jogging at the beginning of P.E. Instead, I did push-ups and crunches while everybody else ran. Eventually I was doing sets of 70 pushups, and I looked like I was in pretty good shape. But nobody knew that I couldn't jog without keeling over. Long walks weren't any easier. I started spending weekends inside with ice packs on my knees.
When I was 20 years old, I finally got some real health insurance, and I was able to see an orthopaedic doctor. He and a physical therapist spotted my problem almost immediately: I didn't have Osgood-Schlatter, I just walked funny. My toes were turned out outward (a condition known as pronation). As I walked, my outer quads were over-compensating, and my inner quads were weak and under-used. My iliotibial (IT) bands were so tight that they were actually pulling my kneecaps out of alignment and off to the sides.
They prescribed a course of physical therapy, which contained three basic routines that I practised until I became a mobile biped again.
Loosening the IT Band
This was by far the most painful component of my rehab. My IT bands (the tendons on the outer side of my quads) were like overwrought piano wire. They had to relax. But your body won't bend in a way that stretches them deeply and directly. Enter the foam roller, my tormentor.
The exercise is simple. You lie on your side, with your body weight pressing your IT band into this big foam dowel. You move up and down along the ground, and the roller travels up and down your leg. Sounds like nothing, right? No, you will want to die. It is eye-crossingly painful, and you have to do it every day. You're essentially giving yourself a deep-tissue massage directly to the tightest, angriest part of your body. It's brutal, but it's cheap, and it works. It really works.
Two at a Time
With my outer quads getting looser, it was time to develop my inner quads, with a balance of strength being the eventual goal. I began with a wall-sit regimen. I put a large ball between my back and the wall, and then put a small ball between my knees, to keep them perfectly parallel, squeezing inward. Dip down, bend the knees are a 90-degree angle, then come up. Repeat into infinity. It was blow-your-brains-out-boring, but it really worked. Then, I found something even better.
Shortly after beginning physical therapy, I moved to a fifth-floor walk-up in New York. It turns out that was the best thing I could have done for myself. As my legs got stronger, I realised that if I took the stairs two at a time, it was pretty much the equivalent range of motion of a wall sit. But it doubled the weight, since I was just doing one leg at a time. Being careful to keep my knee tracking in line with my toe, I started doing one flight, two steps at a time. Then two flights. Eventually I was doing the whole climb two at a time.
This is when I felt my progress skyrocket. Instead of struggling to motivate myself to do boring, repetitive exercises, all I had to do was go up the stairs. I was doing my rehab work every time I came home. It's something I still do every time I go up stairs, even if I have a full backpack. It keeps my inner and outer quads balanced even if I don't do anything else.
Learning to Walk Again
While the foam roller may have been the most painful, it was nowhere near as hard as correcting the thing that had destroyed my knees in the first place: my manner of walking. Having walked in one way for roughly 19 years, my habits were deeply ingrained. I had to start from scratch. The physical therapist guided me, carefully. Strike with the heel, then roll down the outside of the foot, then step through the ball of the foot. Repeat. He had me walk back and forth across a room, agonisingly slowly. "That's it," he said. "That's how you have to walk now."
For the next month, I had to pay attention to every single step I took. I was used to walking fast — now I felt like I was crawling. Heel, roll down the outside, forefoot. Heel, roll down the outside, forefoot. It took months of being hyper-conscious of something I'd been doing unconsciously for most of my life, but eventually, it became natural. I conquered the walk.
The Final Frontier
I walked pain-free for over a decade, but I still had never learned to run. Now, I'm 32. I recently decided: It's time to do this thing. So, I read Born To Run, by Christopher McDougall (I highly recommend it), and then I started researching this whole barefoot/minimalist running thing.
The idea is simple: When running, you land on your forefoot (or midfoot) first, instead of your heel, which cuts down on the impact shock on your knees, hips and back. You take more steps, ideally averaging 180 steps per minute. This helps your stride minimise bounce, allowing you to redirect the energy toward moving ahead laterally. You focus on maintaining good, straight posture, and you lean forward at the ankles. I had to work into it slowly — my lower calves have never been so sore in my entire life. But I've been running twice a week now for over a month at increasing distances, and I haven't had any knee pain at all, for the first time in my life.
This summer, I will run an olympic-length NYC Triathlon to raise money for the Leukemia and Lymphoma Society (shameless fundraising plug). It's a 1.5K swim, 40K bike, and a 10K run. I've never done any of those components individually, let alone all three in consecutively. I've never been anything resembling an endurance athlete. This is the year I change that.