in Life

How I Eliminated Running Knee Pain Using The 180 Formula and a Minimal Barefoot Running Approach.

I’ve been a casual runner for the past 5 years, bouncing along in a trusty pair of Nike Air Pegasus. Like most runners, I’ve never ‘learnt’ how to run properly and as a result developed lazy form and technique, and have been injured. A lot. Firmly touching wood and not trying to tempt fate (I’ve been reluctant to even write about this) I’ve now been running, injury free, for 1 year. This post tells you how I’m doing it.

What’s the story?

Previously my knees had been in pain for weeks on end, and like many I’ve had my feet analysed by an expert, spent £250 on a pair of custom moulded orthotics, performed hundreds of knee exercises with heavy duty elastic bands and googled ‘Iliotibial Band Syndrome’ and even the dreaded ‘knee surgery’ (which still makes me want to puke) to look at my options.

But ultimately worst of all, I reduced my exercise to short lazy sessions to avoid knee pain after running. Considering I was otherwise a physically fit, healthy 30 year old able to hit a sub 7-8min/mile… this restriction was immensely frustrating.

Every time I pushed a little harder, the left knee went. Every time I did that extra mile, the right knee was pounding the next day. Every time I skipped a rest day, I was reaching for the ice packs a few hours later. In short – it sucked.

But when I wasn’t injured, I loved it. I loved the moments in running when everything clicked into place. Feeling like a well oiled machine as the heart rate, breathing and rhythm sync and the miles just drift by. Not to mention the flood of endorphins and sense of achievement after returning from every outing.

I didn’t want to let go of those moments. So after recovering from the latest injury, I decided to mix it up.

Mixing it up

I started filling up the Kindle with various books and started to attempt to change my technique to use a mid foot strike, avoiding the load on my heals.

Here’s a useful demonstration showing proper form by Eric Orton. Running is just like jumping, but instead of going up, you propel yourself forward:

Heart Rate Training – The 180 Formula

Next on my list was this paper by Dr. Phillip Maffetone. The paper outlined the basic principles of reducing injury by training within your limits, by building a foundation of frequent, low intensity, heart rate limited running sessions with the 180 formula. Just subtract your age from 180, and operate within a 10 beat window. For example, I would train between 140 > 150, but never over 150.

The more I researched into Dr Phillip Maffetone, the more evidence I found of this 180 Formula being an effective way to develop an aerobic base, for ‘slow twitch’ muscle development. This, in turn, enables your body to burn fat, not sugar, and ultimately allows you to increase speed while maintaining the same level of exertion.

I was convinced Dr Phillip was someone to listen to – so bought his book on the subject for the finer details. This Trail Runner Nation Podcast is also well worth a listen.

Having already purchased a Garmin Forerunner 910XT a few months prior (as I left running, frustrated, to focus on swimming) I was all set to try the heart rate regime. Every run from now on was at granny pace (or more formally ‘recovery pace’) by which I mean almost walking to keep my heart rate within the 140>150 window.

It was painfully slow and I was coming back from ‘runs’ having hardly broken a sweat, I didn’t even need to shower! But I persisted. For weeks I didn’t let my heart rate step over 150 and I churned out a 12minute/mile (7-8min/km) pace…SLOW! Often I would have to walk up hills and steps, and stop completely to wait for my heart rate to drop under 150.

But then, amazingly, I began to speed up…whilst still keeping my heart rate under 150 BPM.

I was soon comfortably hitting sub 10min/miles. As the weeks and months rolled by, this tumbled to sub 9, and then the 8min/mile (5min/km) window. I was amazed.

Using a slower pace also helped to focus on using the correct running form, and my knee was doing much better – not shooting with pain, but more limited to the odd ‘creak’ in the mornings and the first mile out on fresh runs.

In short – the 180 Formula rocks!

Born to run… ?

Then my running bubble took another turn when I read the next book in my library, Born to Run. As it turns out (I had no idea how popular this book is) Born to Run needs no introduction. The author, Christopher McDougall, outlined the exact same symptoms I’d been having, and goes on his own journey to find a solution.

Some brief takeaways:

  • Humans have been running just fine, injury free, for thousands of years without running shoes. A tribe called the tarahumara still do it today, but over ultra marathon distances:
  • Modern running shoes mask pain, allowing you to easily develop bad form.
  • Todays solution to fix knee pain (by using expensive orthotics) is flawed and a quick fix – the problem will just move further up your body.
  • “Eat like a poor person” Things like chia seeds, corn pinole, beans. You’ll run further and reduce your risk of injury and sickness.

Regardless of whether you are even remotely interested in running, read this book. It’s fantastically inspiring and a truly great read. For those that do like running, and have been injured (which is, well, everyone), you’ll be grinning and nodding the whole way through.

The author is a strong advocate of the barefoot running mantra, and builds a solid case against todays problems with modern running.

I haven’t been able to fault it – we don’t need cushioned shoes. Or orthotics. We can run just fine without all of that stuff.

If a bridge needed strengthening, would you fill the void of the arch with concrete? Surely you’d strengthen the components of the bridge.

Finishing Born to Run I was inspired to ditch my running shoes and try to work barefoot into my lifestyle. I was sure this mindset and approach would solve my runners knee.

Baby steps

I first ventured out for a walk, and along a gravel path, flipped my shoes off. It was pretty uncomfortable. Having 30years of protection from this type of stuff, it was inevitable stones would hurt. But this was my first step. Much to my wife’s delight, I started walking around the house barefoot. My 16mth old son followed along too.

A week later I went out for a gentle jog into the forest (a mix of gravel/stoney/mud pathway) and kicked the runners off and did a few loops barefoot. It felt odd, and still pretty bloody painful as I stomped down on edged stones and sticks. But I ran completely differently, and there was something there – I was lighter, feet pitching away from the heal and spreading the load below me on autopilot, plus it was fun! Maybe there was potential.

Despite my enthusiasm, it became obvious due to where I live and the running routes available to me – true barefoot wasn’t going to cut it for a very, very long time.

Researching further, I looked for a light and minimal shoe that offered some protection against the elements.

Enter the Vibram Five Fingers

I felt this was a real gamble – with the court case (which I think was Vibram being a bit stupid and naive) and reports of people getting injured and destroying their feet, I was on the fence on how effective they would be. Thats not to mention how weird they look. But I was determined to try something and I would take this transition super slow.

I plumped for the Bikila Evo which seemed suited to the mix of running I do.

IMG_0757

Putting Vibram’s on for the first time is something quite unique. Its a glove, but for your foot. Once you’ve shuffled and picked your toes into the right ‘fingers’, it feels pretty natural, despite how it looks. Pull the laces tight and stretch out your feet, and it starts to feel really, really comfy. You have all the flex and movement you have going barefoot, but with a tough layer of protection underneath your sole. Its only a few millimetres of tread, but it makes a world of difference.

The first outing I ran 100meters down the road. The feeling is fantastic – light, fast and totally liberating. You feel everything, foot muscles and movements I never knew existed. And you instantly stop heal striking – its far too painful. The foot is automatically pitching and adjusting to what feels right, over time I can tune my technique.

Had I gotten that feedback in cushioned running shoes? Definitely not. It would have been masked for weeks, and I’m sure would have manifested into a busted knee.

Over the following weeks I added the Vibrams into my weekly training (1-2 outings a week) with the rest being done in my Nike’s. My feet creaked and stretched – which felt fantastic, massage like, as they started to gain strength and adapt to their new surroundings. I was amazed at how different it felt going for a run.

You become ‘gazelle like’ when you change gear, pitching forward onto your toes and pacing up a hill in these things.

I’ve slowly started to build up the distance – but I haven’t ran further than 5miles in the Vibrams. My feet have had 30 years of padding and pampering, so I’m taking this transition real slow. But increasingly when I do run in my Nikes, its like strapping on two giant pillows onto my feet and bounding off down the road, spaceman like.

I feel entirely disconnected from my feet with normal running shoes.

But guess what, I haven’t had any knee pain since I started this new program 8months ago. Feet ache and my legs need a good stretching – but thats all manageable and gone after a rest day.

I’m sold on this for the long term

As I build up my Vibram mileage, the next logical step was to switch my standard ‘day to day’ cushioned fashion trainers, with some minimal barefoot style replacements. I felt it can only help the transition to say goodbye to knee pain for good. Hitting the interweb I was seduced by the offering (and marketing) from Vivobarefoot.

Again weighing the pros and cons of these overpriced school plimsole lookalikes, I went for a pair of Evo Pure road trainers.

IMG_1140

They look a bit more like ‘normal’ trainers, and combined with jeans don’t raise too many eyebrows. They have absolutely no heal and a very wide area for your toes.

Slipping them on you immediately feel this space extra space, and they feel incredibly comfortable. I also noticed how much critical work my big toe is doing all the time.

Want to feel like a ballerina crossed with a ninja? Try minimal running shoes.

I’ve been using them for a month now, travelled on planes, trains and buses – they feel every bit as good as the Vibrams but more geared for city life. Running in them also feels good, totally flat and only a few MM of tread – your feet have plenty of room to move and breathe, giving you the necessary feedback.

But I’ll leave the sales pitch to Vivobarefoot.

So far, so good.

This is an ongoing transition that will take many years to complete.

Today, I’m still using my Nikes for the longer (7+ miles) runs and mixing up the shorter stuff with the Vibrams and Vivobarefoot. My aim, one day in the next 1-2 years, is to bin the traditional running shoe completely and run long distances with the minimal shoes – or maybe even totally barefoot.

I will get injured, I’m sure of it. But so far, after 8months, I’ve had no knee pain and my legs and feet are stronger than they’ve ever been. The disciplined heart rate training and feedback I’m getting from ‘going minimal’ are key factors to this improvement as I hone and improve my form.

When I walk around for a few hours my feet no longer ache. I don’t need to ‘put my feet up’ or dunk them in a hot bath after a long day in the city. The morning after they are almost tingling with excitement and refreshed to get going again.

I sure hope it stays that way.

Thanks for reading

Andrew

  1. Had the same problems with running and would always go too fast and try and break my pbs. would be a broken man after short runs. now training much slower using 180 formula and much better ,, am getting faster but heart rate staying low. nice write up andrew , keep on running buddy.

    • Thanks for comments Floris, great to hear you are having success with the methods!

  2. Great post. With regards to the Vibram court case…I guess people will do anything to scam a dollar from a successful company. When I first heard about minimal shoes, I researched, and found out about Vibrams, those “funny toe shoes”. The next thing I did was spend the day researching about people’s experience with “transitioning”. Boom, done. A few hours out of one day. How anyone would think that it would be a smart idea to go most of their lives with essentially casts on their feet, to running marathons or halves barefoot (without significant periodization), is beyond me. I call that stupid.

    As I read through the article that you linked, “people getting injured,” it became clear that the author is also clueless. Minimal running isn’t a fad as much as 13mm drop, stability controlled running sneakers. Let’s not forget about human history, persistence hunting, Zola Budd, and what kind of footwear each one of us is born with. I personally have found that the more I transitioned from a grinding, heel-striking, “i’m gonna push through this run no matter what” runner, to a for-to-midfoot landing minimal runner, wearing thin, light, zero drop shoes, I experienced fewer and fewer aches, pains and injuries. Running, walking, jumping, climbing…you name it… became so much more enjoyable. David Abel, the author, seems to fall into the category of people who are crusading against nonconformity. But the big question is, why?

    • Thanks for the comment Sean, good insight.

      I’m sure the mainstream running magazines are still heavily influenced by their advertisers, you won’t see a negative stance toward ‘normal’ running shoes if 99% of the magazine is funded by these same companies.

      Maybe this was the case with Abel – ultimately we have test and decide for ourselves.. Reminds me I’ve got a new tin foil hat I need to go try on.

  3. Great improvements with your 180 formula Andrew, stoked for you. Keep it up! Cheers

    • Thanks for stopping by, Flo! Love the knowledge you are sharing on your blog. Congrats on Boston – fantastic time!

Comments are closed.