Postpartum Inner Knee Pain When Returning to Running

You're listening to the Restoring Human Movement podcast, where movement experts discuss the latest evidence-based practices to help you and your clients move with mastery. Hey everybody, welcome to the Restoring Human Movement podcast. This is your co-host, Dawne Costantino. And today's episode, we're going to be going over knee pain affecting a postpartum mom's ability to return back to running. That's what we're getting into today. We're going to read the email that was sent to us, dive deeper into some questions that she had, and I'll give you my insights on, thoughts on that, and ways to move forward.

So let's get into it. I actually just got back to, I got back from getting coffee with a personal trainer that I just met at a gym nearby, and just kind of wanted to share with you how refreshing it was to have this conversation with this specific person, because it's really, really hard to find health workers out there or strength coaches or personal trainers who go beyond just what the certificate testing requires of you, right? You read a book, you take some tests, you pass the exam, and now you can go train people. And so finding those out there who continue to dive deeper into educating themselves beyond what the test requires of you is really, really refreshing to find.

So that's where I'm coming from right now. That's the state of mind that I'm in. I'm really happy to have met this person. And I think it's important to share this with you guys, because if you are looking for some, you know, referrals, you have questions on who to see, reach out to us, because I think that we're building a really awesome network of people here, people that we trust, people that we've worked with. So if you need some help, go ahead and reach out to us. We can refer to you in the area. We also have a pretty big network outside of California as well. So just don't be afraid to reach out if you guys have any questions on who to see, things of that sort.

So let's hop into it. I'm actually going to start off by reading you this email. The subject reads, knee pain affecting my running. Hello, I hope this message finds you well. I'm reaching out to share my experience and seek advice on a challenge that's been affecting my running journey since giving birth a year ago. Before my pregnancy, I was an avid runner, especially enjoying the hills. It's around my neighborhood. However, since returning to running post-pregnancy, I've been dealing with persistent inner knee pain. I don't feel it much throughout the day, but it comes on quickly during my run and gets worse the longer I go.

It's starting to affect my mental state because running is how I deal with my stress. I also have some hip discomfort. This area is persistent ache in my hips, especially after longer runs, making it hard to maintain my previous pace. Pelvic instability. Sometimes I feel like a lack of stability in my pelvic region, particularly the groin. I also have some muscle weakness that I've noted. Certain muscles, particularly around the core and the lower back, feel weaker and feels like it's affecting my running posture. These challenges are disheartening because I value staying active and want to work back to the fitness level I had before pregnancy.

I've tried various stretches and strengthening exercises, but the progress feels slow and the frustration is building. I would greatly appreciate any insights, exercises, or strategies you recommend to help me navigate this phase. Hearing from others who have faced similar challenges would also be comforting and motivating. Thank you for the time to read my message and I look forward to your guidance. We get emails like this a lot, actually. And I think it's really helpful to know, for those of you listening, that you can reach out to us that way. If you just want to give us a little rundown of what's going on with you and allow us to read it, we can always reach back out with any follow-up questions that we have.

Or we can even just, you know, talk about ways to move forward. So let me dive into the first thing that this person made really important was they wanted any insight. So I'll just give you my initial thoughts. Every time I read an email like this, I always have just initial questions, like follow-up questions that pop into my head because clearly there's only so much information that's given to you on an email. And what's important for us as somebody who's going to help you is to have follow-up questions to know a little bit more about what's going on. So I can't diagnose this person just based on information on an email, but I would want to know, is there anything else throughout the day?

Do you feel it getting up and out of a chair? Is it only with revving? How about going up and down stairs? Is there any popping or clicking happening in the knee? Because popping and clicking with pain can really tell us a little bit more about what structures of the knee could be involved. Is there swelling? Is there not swelling? Because she mentioned other areas going on like hip discomfort, pelvic instability, muscle weakness around the lower back and the core, I probably would want to know a little bit more about those areas because the knee joint, I'm sure all of you have heard at this point, is typically a dummy joint.

There's something else going on above or below that joint that isn't functioning properly. And that's why this knee isn't feeling so good. That's not always the case, but it's pretty, pretty common that that is the case. So my initial thoughts here are, is there something going on in the pelvis there that's not functioning well? And a postpartum mom trying to get back to activity, typically that's where we're going to start. What kind of ways have you built back core stability? What ways have you strengthened that area after giving birth? What types of things have you tried as far as pelvic stability?

Is there any other things going on like urinary issues, incontinence, prolapse, pelvic pain, pain with sex? These are all things that we want to know about the pelvis when you're in your postpartum phase because we do have to get a handle on those symptoms before we can return to running. And I'm not saying you can't run at all, but it might not just be where you were before, right? You can't just go back out there and expect to run five miles and not have any issues there. So diving into what's going on with the pelvis there would be really, really important. So what kinds of things have you tried is another follow-up question that I have.

When we read inner knee, I want to think ligament. I want to think cartilage, right? I want to know if there is a meniscus issue going on there. Because there's lower back and pelvis stuff going on, I'm going to think nerve too. There is a nerve that supplies into that area. And you'll probably hear me mention this a lot because we see this a lot in here with our runners. There's not a lot of great support around the pelvis in our long-distance runners. And it can create some compression around a specific nerve that can refer pain down to the knee. And that nerve path typically feels like low back tightness.

It can feel like oblique tightness, lower abdomen, groin, quad, inner knee, tightness, pain, burning, sharpshooting. These are all areas that can be felt when this nerve is affected too. So those are my initial thoughts when I think inner knee discomfort there. And so that's what I would want to know a little bit more about before I recommend anything specific for this person. But when we're going to go on to the topic of postpartum mom, we have to come back to the core. We have to come back to what types of rehab have we focused on there? How long did we focus on that? Did we just, you know, work breathing and side flanks and then go right back to running?

Did we progress that in any sort of way before we return to running? So there's a few steps before we can get back into this quote unquote, where I was before my pregnancy. Certain suggestions that I have right off the bat here, you know, again, I need to know a little bit more about this person, but I would, I mean, if I'm going to throw a few things out there that I think would be really, really helpful for this, I'd start with some diaphragmatic breathing to start to eccentrically load the pelvic floor. This can be done in different positions to challenge the body and the nervous system. This is a really good way to start to build back strength and pliability and awareness of the pelvis and the pelvic floor and the core.

Take that skill and put it into things like a side plank, normal plank, glute bridges. How about some farmer carries, some regular body weight squats, some things that look like a deadlift. When I say look like a deadlift, you don't need to go pick up a heavy barbell, but something that looks like, you know, hinging through the hips, bending over to pick something up. Can we take that skill and can we build it into those day-to-day things? Can we start to add some load to it? Maybe some light load at first and then get a little bit heavier. Just really starting to challenge the body in a progressive way so that we can better tolerate the impact of running over time.

It sounds like this person's knee might be taking on a lot of load because the areas that we consider team players, meaning they should function along with the knee when we're running, like the core, like the pelvic floor, like the glutes, like the low back, all of these areas should be working efficiently to be able to accomplish this activity. So suggestions that I would recommend, number one, just go see somebody. I really, really think it's super helpful to just have someone assess you and really figure out what the cause of the inner knee pain is because if it's a meniscus, it's going to be a completely different approach than if it's a low back nerve referral.

So to know what's going on and to have somebody give you that diagnosis, I think, can be really helpful. Or even just going and seeing somebody like a personal trainer who's really good with stuff like this, who knows how to overload you, progressively overload you in a way to get you back to this sport, would be a really good option too. They can look at your movement. They can see in what ways there's areas for improvement and they can take you through that. The reason I always recommend going and seeing somebody and not just doing stuff on your own is because I do that too. Even with all the knowledge and all the people that I've helped, I always ask for help when there's something going on with me because I think it's really hard to be completely honest, hold myself accountable, push myself as hard as I need to, to see the change.

And it's really hard to get yourself out of your own brain and really look at your own movements. Having somebody else look at it and just guide you, I think, is just easier that way. So go see somebody, go ask for help, have them take you through a program and get you back to this. A really good start too that I want to recommend for you, especially when it comes to suggestions of exercises in the postpartum realm, when you want to get back to activity, this doesn't necessarily only go with runners. If you want to just get back to some strength training, Pilates, yoga, any of that stuff, there's always some steps to get you back there.

And I created a free PDF if you guys want to take advantage of that. It's probably in the show notes. So go ahead and download that. It's really basic. It's nothing too crazy complicated. It's just some links that'll take you to some videos that'll show you how to perform these exercises that I think are pretty basic, pretty baseline of what you need to be able to perform efficiently before we can get back into activities like running or strength training. So take advantage of that if you're interested. And if you really do just want to know, you know, who should I go see? I'm not in California.

I can't come see you. We do virtual stuff as well. Within California and outside of state lines, we are licensed in different states as well. So if you want a little bit more information on whether or not working with us is an option, we offer a really affordable discovery session. So 30 minutes, let's have a conversation. Let's take you through a movement assessment. We'll tell you what we see, how we would approach this, give you kind of a rundown of what the program would look like. Go over prices. Talk about if we know anybody near you that we could refer you to. Do we think that we would be a good fit or should you go see somebody else?

All of that would be a part of this discovery session. So take advantage of that as well, because that's why we're here. We're here to guide you. We're not, you know, here to say, good luck. We can't help you. Go find someone else. We want to guide you down the right path if we can. So again, coming back to postpartum mom, trying to get back to running. I think we need to pay attention to some of these other areas that she's mentioned. Not just the inner knee pain, which could be a few different things. Reviewing what that could be. It could be cartilage. It could be ligament. If she's returned too quickly, it could be stress fracture or stress response occurring there.

It could be nerve referral. But it also could just be the fact that something above, which to me, based on this information, something around the pelvis and core probably just isn't functioning properly. And that knee is just taking on way too much load when she's trying to run. We may go over what the warmup looks like before she gets back into running. We might give her a threshold to respect for a little while before her body adapts to it. And then we can start pushing her back to where she wants to be. What are your goals? What are we trying to get you back to? So very general topic today that we're, that I'm talking about.

I just think it's really important that when people send in emails like this, there are always like these initial thoughts of like, try this, try this, try this. Could be this, this, this, right? We don't know until we get an assessment. We don't know until we see you. We don't know until we know what your goals are. So if this sounds like you, if you want to know a little bit more where to start, start with the PDF if you want to. Go ahead and shoot us an email with some details about what's going on with you. We're probably going to just recommend setting up that discovery session and seeing in what way we can guide you down the right path.

Talk to you guys soon.