On this episode of RUN with Coach Parry we help Gillian Walker build strength in her knees to get her running pain free once again.

BRAD BROWN:  Welcome back to yet another edition of Run with Coach Parry. I'm Brad Brown. Good to have you with us again.

We've got Lindsey Parry with us once again as well, and we've got another guest, another runner that we're going to help achieve some goals on today's podcast.

Lindsey, welcome back. Nice to touch base.

COACH PARRY:  It's always a pleasure talking to you and the runners Brad.

BRAD BROWN:  Awesome stuff. Our guest today is a member of the Coach Parry online community. She's a recent member and I'm quite excited because we've got a really wide spectrum of runners. Obviously there are a lot of runners out there who are running the Comrades Marathon and ultra marathons.

We're starting to pick up a good few runners who are getting into the sport and setting some really awesome goals. I think Gillian is one of them. She's got some pretty cool goals she wants to achieve.

Gillian welcome onto Run. Thanks for taking the time to chat to us this morning.

GILLIAN WALKER:  Thanks very much for having me.

Get inspiration to keep going

BRAD BROWN:  Gillian before we get into your athletic history and some of the stuff you're doing, why are you a member of the Coach Parry Community? What's the story? Why did you join us?

GILLIAN WALKER:  I think that I need the inspiration to keep going. I've started with keeping up the commitment in the past and I'm trying to get more involved and educate myself more on running generally so that I can achieve my goals.

BRAD BROWN:  Fantastic. Let's talk about some of those goals. What's the plan? What are you hoping to achieve?

GILLIAN WALKER:  In the meantime it's just running comfortably for 30 minutes without any pain in my knee. Just to get back into it. Then I'd like to set interim goals along the way and ultimately get to the Comrades Marathon.

BRAD BROWN:  That sounds awesome. I'm going to hand you over to Lindsey now.

Lindsey you've got Gillian's questionnaire. We send through a questionnaire before people get on the call so that we know a bit of the running history; what the activity levels are right now and what some of the goals are. So I'm going to hand you over to Gillian, Lindsey if that's cool then we can take it from there.

Proprioceptive exercises and strength training for a knee injury

COACH PARRY:  Gillian, before I give you the opportunity to ask me the questions that you've prepared, I want to ask you, besides rest, what else have you done in terms of rehabilitation for your knee? And also, when you injured your knee originally when you were rowing at school, did you get an actual diagnosis? Do you know what the actual injury is in the knee?

GILLIAN WALKER:  At that stage, I was about 15, I saw a physio and they said it was Chrondomalacia in my patella. More recently when I saw a bio, they said there was an imbalance in the strength of the muscles. Some muscles are very weak and then others are much stronger and so they're compensating. I have got a stretching program from a bio that I am trying to do, and I'm just trying to foam roll my legs.

COACH PARRY:  So no strength training or proprioceptive exercises to help? Because effectively the chondromalacia patella, if you had that, you can't diagnose without actually looking underneath the patella. Really what that means is that you've got sand paper for cartilage on the underside of the patella.

Manage your injury for improved performance

What you had then and have now is what we call patella femoral knee pain. So whether that cartilage is roughed up or not, we don't know. But what is definitely happening is that there's contact between your patella and either the inside or the outside of the groove where your femur is, where the kneecap runs. We need to stop that otherwise as you get to a certain point in the mileage, what happens is that the rubbing eventually becomes too much and it gets sore.

The easiest exercises to do to ensure that you have proper patella tracking are very simple, 30 degree single leg squats. Step ups onto a low step and knee extensions, but literally only the last 30 degrees of the knee extension. We're trying to strengthen the little muscle on the inside with those exercises.

So if you do those 3 exercises you should create enough strength in your quadriceps that they will help that patella to run through the groove as it should. Then the other thing to do is to do some balancing type of exercises. So you're going to put down some pillows, or if you do go to a gym you use the hedgehogs or bozi-ball or airex pads.

Build up slowly after an injury

You're looking for a slightly unstable surface. You stand on that bare foot in a stork stand so you basically balancing on one leg. And when you get really good at that you start doing it with your eyes closed. And you'll do that on both legs. Both sides regardless of which side is sore and then ultimately, if you can get someone to throw balls at you while you are balancing to totally throw you out so that you really teach the muscles to turn on and off at the right time so that you create a very stable knee. Again, the idea of that is so that the patella moves nicely through that groove.

The second thing you would do to combat that, which you are doing anyway, and that is following a very progressive program that will allow you to build up slowly. And if it allows you to build up slowly enough, then it should also contribute to strengthening the right structures so that you don't go back into a point where there's a particular weakness.

GILLIAN WALKER:  How much can I push my body? Because beforehand I could just run 40 minutes after not running for a while and I could do that with no problem. Or once I built up I was running for 2 hours with no problem at all. And now, after not running for a long time I'm impatient with the shorter distances and I want to just keep on going.

So after I do the session where I'm walking for 3 minutes and running for 2, for 20 or 25 minutes, I feel like I can just carry on going further. So what I struggle with is actually stopping and saying no, that's enough.

Increase your cardiovascular workouts

COACH PARRY:  In the short term you need to. It just goes back to exactly what I've explained now. On a cardiovascular level you could quite possibly do a lot more than what you're doing now. But on a physical muscular, skeletal level, that is why you keep running into problems. In particular with the knee.

What you could do to alleviate some of the frustration and not being able to get the cardiovascular work which you'd like to do, is to do these sessions close to a gym so that when you're finished you then jump onto a bike. You can then work yourself quite hard cardiovascularly on a bike or an elliptical or on the Stairmaster. Do something that does not require high impact. That will then protect your knee.

In the short term possibly the Stairmaster may also be a little bit hard. But if you do a little bit of Stairmaster, a little bit of elliptical, a little bit of cycling and you do those all fairly hard. Then you will get good cardiovascular benefits from that while you then just gradually build up the running. So that it gets to the point for that knee to feel like you've done some exercise and get satisfied.

Practice patience in the build up to your marathon

But in terms of the running, this little saying that I've got is that the slower you progress the more sustainable the running will be. So if you are really patient, the thing is it's really only the beginning that is this frustrating. Once you get to the end and you actually get to running 10k's, the transition from 10k to 21k is quite quick and there's a lot of running involved in that.

Someone who does come from a slightly competitive exercising background, once you get to that 21k level, you could then start looking at getting a more advanced program for either running a very fast 10 or running a very fast 21, before progressing onto a marathon. Or it can just be like a very gradual step wise progression up to the marathon.

But from now, we're sitting in June, giving yourself a year to get to 2018 is very possible. Certainly there's very little chance that if you build this up slowly that you won't be able to tow the line in 2019. But I would say, at the very least, you would be running marathons around April, May next year. That's 8 months. It sounds like a lot but 8 months goes really, really quickly. So I think be patient for the first 12 weeks. The next 12 weeks will progress quite quickly and suddenly at the end of the year you will find yourself fit and enjoy running. And running pain free which I think is quite important for you.

GILLIAN WALKER:  Okay great.

Too much too soon leads to injury

BRAD BROWN:  I'm not sure if you have any other questions for Lindsey Gillian. Are you quite happy with that?

I think just so you know you're not alone in thinking you're frustrated because you feel like you could be doing more. And I think that's probably one of the biggest mistakes people make when they first get started Lindsey, is they feel exactly that. They think this can't be working because I feel like I could do more.

Then they do more, they then break down, get injured or get sick and then they have to start back at square one. Consistently building slowly then starts from scratch and you never really progress further than what you have done in the past.

COACH PARRY:  The greater your cardiovascular conditioning is, the greater your risk is of picking up an injury. Because the greater the chances are that you're just going to do too much. As an example, if you haven't run for 18 months, you think 5k's is nothing.

But if you go out and do 5k's, you've suddenly increased from 0 to 5000 steps. So that is 5000 repetitions or 2 and a half thousand on each joint, on each muscle, on each ligament. That is a very big jump from nothing to 5000, and that's why you need to be patient.

The slower you build up the lower your risk of injury. Then the greater your chances of really enjoying it once you do start to get muscular skeletally fit. When that starts to catch up with your cardiovascular fitness, then you really do start to enjoy running because it's comfortable.

Progress slowly for a sustainable run

BRAD BROWN:  Yes, absolutely. And a good example would be my story last year with Ironman South Africa. I struggled with a back injury and because I was fairly fit on the bike and fairly fit swimming wise, I thought I could just go and run 10 or 21. And I just kept breaking down.

4 Weeks before race day I said that's it, I'm starting from scratch. I'm walking 30 minutes a day, 4 days a week. I took that training program that you're on right now Gillian, that's on the Comrades Coach Parry's website, and started from scratch. Where I was walking and it was as frustrating as ever. I absolutely hated it but I was running pain free 8 months later. And I was back to the distances that I wanted to be doing which was amazing.

So, you're on track. As frustrating as it can be at times you're definitely on track. If anybody is listening to this and you want to download one of those training programs, the website to get to is coachparry.com/start.

I don't know if you've got any other questions? We've got the forums; you can hop in at any time. Lindsey is in there every day as well and you can get your questions asked. I think that is one of the big benefits of being part of that Coach Parry community. You can go to coachparry.com/join, if you want to join.

Gillian, anything else from you?

GILLIAN WALKER:  No, that's all. Thanks very much. It's very helpful.

BRAD BROWN:  What a winner, chicken dinner. Lindsey thank you for your time once again. Much appreciated. We'll catch up in the forums I'm sure.

COACH PARRY:  Yes. We will. Have a good one Brad.