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Pain near knee--any ideas (Read 931 times)

gooddogs74


    Hi,


    I am having an interesting kind of pain that has occurred acutely.  Thursday I ran about 9 miles.  I noticed after the run I had some pain in my left leg.  I can describe it as on the outside of the leg, just below the knee, at the level of the tibial tuberosity, but lateral to that over a bony protuberance (not sure the name of that one)  It doesn't feel like it is in the knee joint itself.  


    The pain was worse on Friday--I woke up quite stiff in that area, but by Friday night was almost gone and there was no pain Saturday or today.


    So I went out today for a run.  Within 10 steps, I felt a sharp pain return in that area with every step.  I ran a tenth of a mile, stopped, walked a few minutes and tried again.  Couldn't make it another minute.  I noted it hurt less jogging in placed and became worse once I moved forward again.  Once I stopped running, it disappeared within a few minutes.  It's not really an area I feel like I can stretch because it doesn't feel like a tight muscle.  I can flex and extend the knee without pain, but when it was painful after trying to run, it hurt to flex the knee and I think there was a very slight click in that area.  


    I typically have been running 15-20 miles +/- per week.  Reasonably consistent over the past 12 years, with some periods of slacking off or bad months.  I have never been injured and run a slow pace, generally between 9:30-10:50 minute miles.  I tend to supinate.  I have cushion shoes (Nike Air Zoom Vomero currently) and have recently started in a new pair of shoes, the same model as the old ones, except I believe they are 4's, and I think the last model was a three.  They look exactly the same to me.   


    Can anyone help?  Thanks in advance!



      Sure sounds like IT band induced knee pain...

       

      Lots of discussions here with good stretches and treatment approaches.  Give it a quick search.

      Always do right. This will gratify some people and astonish the rest.
      gooddogs74


        So that can occur below the knee as well?  Great.  I am supposed to do a 15 K in 12 days.  Maybe if I don't run at all until then?


        I have done a little research and my husband has a foam roller, so I can use that.  Also I am assuming OK to ice.  


        I went ahead and scheduled a Dr. appt for Wednesday, thinking maybe I could confirm a diagnosis and possibly some PT in the hopes of healing speedily.



          So that can occur below the knee as well?  Great.  I am supposed to do a 15 K in 12 days.  Maybe if I don't run at all until then?


          I have done a little research and my husband has a foam roller, so I can use that.  Also I am assuming OK to ice.  


          I went ahead and scheduled a Dr. appt for Wednesday, thinking maybe I could confirm a diagnosis and possibly some PT in the hopes of healing speedily.

           

          I have had in the past a pain similar to the one you describe in the same place.  I never could figure the thing out, but I ended up coming to the sme conclusion as MilkTruck - that it was referred pain from the IT Band. 

           

          If it is, then what worked a little for me was actually focusing your roller and ice not on the pain area but up by your hip/butt/hamstring area of the affected leg.  Time off didn't really help me.  Shoes could be an issue, and green Superfeet did help me (not immeiately, but over a few weeks).  I'm just throwing stuff out there - like I said, I never really did figurte out what the real cause was.  But it eventually mysteriously went away, and it wasn't rest that fixed it. 

           

          MTA: And the "bony protuberence", is that the knob right under your knee?  When I was a kid I had Osgood Schlatter disease (sp) which resulted in a very large lump under the knee that is still there and is still occassionally painful.  I always wondered if this pain was smehow related to that like a bone chip or something. 

          mr train you are a pain, your words - they make me go insane

          they strike my ever-thinking brain like little drops of acid rain

          oh, to my life you are a bane; crazy, mixed up, mr train - r2e

           

          gooddogs74


            Ltrain


            It isn't the bump right front and center under the knee but more off to the side.


            Going to see doc tomorrow--would like to nip this in the bud before it becomes a real problem. 


            Will post update.

              For me, IT band problems manifest as sharp, jabbing pain on the outside of the knee in the area of that little knob / pokee-outee thing that is at the top of the lower leg.  It's where the IT band comes across the outside of the knee and seems to attach to the lower leg. 

               

              Here's an RA thread with lots of folks chatting about IT Band and knee pain.

              Always do right. This will gratify some people and astonish the rest.

                I have experienced what you describe and the physiotherapist diagnosed it as a combination of Patellofemoral Pain Syndrome and ITBS.  What she had me try is run at 170-180 steps/minute, which I had read before but had never adopted.... and the pain pretty much went away immediately.  The new pattern was really uncomfortable at first but it gradually gets more natural.  The idea is that by landing more under you rather than in  front, the knee is not as extended when you strike the ground, so the shock it need to absorb is not as important.

                 

                It's a big change to make, but maybe you can give it a try... good luck with the doc, I hope you have a doc who's a runner!  Mine couldn't do much, except to refer me to a good sports physio, which is all I was hoping for really.

                  I have experienced what you describe and the physiotherapist diagnosed it as a combination of Patellofemoral Pain Syndrome and ITBS.  What she had me try is run at 170-180 steps/minute, which I had read before but had never adopted.... and the pain pretty much went away immediately.  The new pattern was really uncomfortable at first but it gradually gets more natural.  The idea is that by landing more under you rather than in  front, the knee is not as extended when you strike the ground, so the shock it need to absorb is not as important.

                   

                  It's a big change to make, but maybe you can give it a try... good luck with the doc, I hope you have a doc who's a runner!  Mine couldn't do much, except to refer me to a good sports physio, which is all I was hoping for really.

                   

                  SlickySim:

                   

                  I'm assuming your stride frequency before was less than 170, was it not?  So basically you're saying landing more directly under your Center of Gravity and more lightly eased the landing shock.

                   

                  Interesting...  Thanks for sharing.

                     

                    SlickySim:

                     

                    I'm assuming your stride frequency before was less than 170, was it not?  So basically you're saying landing more directly under your Center of Gravity and more lightly eased the landing shock.

                     

                    Interesting...  Thanks for sharing.

                     Nobby, I don't really understand what you're saying here. 

                    If we don’t try we’ll never know. At least I can find out how good I can be.  I can have an answer at the end of the days, and have a hell of a good time with the process. -Desi Davila

                       Nobby, I don't really understand what you're saying here. 

                       

                      I'm trying to figure out if my understanding is correct or not.  In other words, I don't think the "magic" lies NOT in 170~180 steps which we had discussed elsewhere here; but landing more lightly that would do the trick to such knee problem.  170~180 steps per minute is not necessarily a solution; but landing lightly is.  You can take 180 steps per minute and still land hard on your heel if you want to, or if you try to.  But would that be a solution?  I don't know--I don't think so from the sound of it. 

                       

                      If you took what Sim said directly, 170~180 steps is the magic.  For all we know, I don't know if he brought the steps DOWN from 210 steps per minute to 170~180...OR if he brought it UP from 150 steps per minute.  I would assume the latter but wanted to make sure.

                       

                      If the 170~180 steps per minute is the key, they someone with the stride frequency of 210 should slow it down to 170~180?  I don't think so.  Then why focus on the number?  We should be focusing on what that number represent.  That, I'm assuming, is landing more lightly.  If someone lands very lightly at the stride rate of 160, so be it.

                      gooddogs74


                        Update:


                        Went to orthopedic doc today.  No meniscal tear.  Supected bursitis, possible IT band tendonitis.  Problematic to diagnose because it's not really hurting me when I am just walking around.  Radiographs were normal.


                        Sent me to PT.  PT will try to get me in shape for 15K in 9 days.  No running for now.   I am doing the stretching, icing and PT is doing u/s and anti-inflammatory patch.  PT is a runner and will give me an honest opinion about whether or not I can try the race.  I just want to finish it, not worried about time.


                        Thanks for the suggestions, everyone.  I'll keep you posted!

                          this thread has been extremely helpful since ive had identical symptoms all week. thanks everyone for the research and easing my conscience i was afraid it might be worse. the pain has been quite a nuisance, guess ill have to stick to my bike for a few more days.
                          bobby1984


                            Hey all,

                             

                            I just said i would add my two cents because i have had some experience with ITBS over the past few months. This injury means my last five months running is less than my total October distance   However I have found that running slower than normal does not aggrivate the injury so i have built up to doing 10K pain free. if you need to do speed work use a threadmill. I have found that i can run fast & pain free and i think it is because the foot does not have to roll in as much in order to push off with the toes.

                             

                            My injury was caused because i over pronate and i used the wrong footwear (beginners mistake) Gonna have a gait test tomorrow hopefully so i should get the right footwear then. My PT says that I should show improvement in my injury within 2 weeks. I am hoping she is correct. However I spend up to 10 mins everyday streching the IT band and i do foam rolling whenever im in the gym. Hopefully i will get 100% fit soon as i wanna do a race next month. Fingers crossed

                            Run like you stole it

                            2009 Goals: 4M < 28 mins (PR 27:55 04/10/09)

                            2010 Goals: 5K < 20 mins (Best 20:27 15/09/2010) 5M < 35 mins (PR 34:58 17/07/2010)  M < 4 hours (n/a)

                            2011 Goals: 5K < 20 mins 5M < 34 mins M < 3:50 hours

                              My injury was caused because i over pronate and i used the wrong footwear (beginners mistake) Gonna have a gait test tomorrow hopefully so i should get the right footwear then. My PT says that I should show improvement in my injury within 2 weeks. I am hoping she is correct. However I spend up to 10 mins everyday streching the IT band and i do foam rolling whenever im in the gym. Hopefully i will get 100% fit soon as i wanna do a race next month. Fingers crossed

                               

                              Bobby:

                               

                              Sort of intreguing comment here.  Is it "my (ITBS) was cased because I over pronate" or "my (ITBS) was caused because....I used the wrong footwear"? 

                               

                              Do you think stretching is helping?

                              gooddogs74


                                Update:  spent the past two weeks at PT treating the painful area.  Since I was doing a race this weekend and wanted to be able to finish it, he said it may or may not work.  I did not run at all except for 4 minutes on the treadmill in his office on Wednesday, which did not hurt.  So I went into my race yesterday, feeling hopeful, but not really thinking I would be able to run the whole thing.  I was right.  Less than a mile into the race, the pain returned.  I finished the race (15K) mainly by walking.  It was very sad.  I will be going back next week to start a longer process of trying to rehab it, I guess.  The PT did video me on his treadmill and said he saw some pronation, but rec. I go to running store and have them look as well.  It's just weird because I have run in neutral cushioned shoes for 12 years, so I am not sure if that is contributing to the problem or not.  VERY frustrating to not be able to run.
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