Runner's Knee.. (Read 2747 times)

more cushioning in the shoe = less impact on the knee.

Oh, to be sure.  Some would argue that cushioning leads to impact.  I apologize if I was not clear; I was referring to the posts that immediately assumed that the OPs problems, superficially described as they were, could be cured with minimalism.  How can you prescribe a cure without a sense of the diagnosis?

Your quads can be "fine" and super strong and you can still have runners knee.  Runners knee is a patella tracking problem often caused by an imbalance.  It could be due to quads that are too weak or too strong or too tight compared to the hamstrings or one side compared to the other, or caused by hamstrings or calf muscles that are too tight, or any number of things.  A lot of time it's caused by over-striding, but not always either.  It's much more common in newer runners but it affects lots of experienced runners too, usually after significant change in training but not always even that.  It can be maddening in that sometimes it can appear to just come and go with no obvious cause.

When I started running 10+ years ago after a many year hiatus, I struggled mightily with runners knee for the better part of a year.  My quads were probably stronger than they are now (at least they were bigger) from years of mountain biking including racing, but they were strong in a different way and probably not as balanced for running as they are now.  And certainly my muscles and connective tissues were not as used to the repetitive, weight-bearing, impacts of running.  What worked for me was: ice, continuing to run, and going back to some quad strengthening exercises I had been taught in high school track (I really can't be sure if they helped or I just got stronger from running more.)

I also noticed that shorter, quicker strides seemed to help, so doing anything that develops your stride including incorporating some strides and/or hill charges into a routine probably helps--I do these things all the time anyway, not specifically to prevent runners knee but I suspect they help.

Your quads can be "fine" and super strong and you can still have runners knee.  Runners knee is a patella tracking problem often caused by an imbalance.  It could be due to quads that are too weak or too strong or too tight compared to the hamstrings or one side compared to the other, or caused by hamstrings or calf muscles that are too tight, or any number of things.  A lot of time it's caused by over-striding, but not always either.  It's much more common in newer runners but it affects lots of experienced runners too, usually after significant change in training but not always even that.  It can be maddening in that sometimes it can appear to just come and go with no obvious cause.

 

When I started running 10+ years ago after a many year hiatus, I struggled mightily with runners knee for the better part of a year.  My quads were probably stronger than they are now (at least they were bigger) from years of mountain biking including racing, but they were strong in a different way and probably not as balanced for running as they are now.  And certainly my muscles and connective tissues were not as used to the repetitive, weight-bearing, impacts of running.  What worked for me was: ice, continuing to run, and going back to some quad strengthening exercises I had been taught in high school track (I really can't be sure if they helped or I just got stronger from running more.)

 

I also noticed that shorter, quicker strides seemed to help, so doing anything that develops your stride including incorporating some strides and/or hill charges into a routine probably helps--I do these things all the time anyway, not specifically to prevent runners knee but I suspect they help.

+1.  This is pretty much me.  I have really strong quads and hamstrings in both legs, always have.  Prior to running, I was into powerlifting and worked out my legs pretty hard.  After finding running, I eased up alot on the strength training for the legs but still did some to maintain some strength.  Never had runner's knee in the three years I ran until this past January.  It was a month after my first marathon.  Came back pretty slow, but started speed training and really ramping up stuff in early January for a March HM.  Out of nowhere the knee pain started.  The first month was really bad.  Had to stop two runs after a mile because of the pain.  Went to several people to look at it and all said I have very strong leg muscles, but the left quads were a little weaker than the right.  Even flexing you could tell.  The left were smaller than the right.  Runner's knee was diagnosed due to weak quads on the left leg.  I believe it was the VMO that was the weakest.  Anyway, I've been doing alot of quad strengthening workouts at the gym (3 days a week), X-bike classes two days a week, and ramped up the mileage from upper 20s to low 30 mpw to 40 mpw and the pain has been decreasing the last two months.  I'm also running only slower miles now.  No speed.  I've even PR'd two HM's and a 5K during this time. 

Like Mike, I now concentrate on form and stride and have a quicker turnover with a shorter stride.  I looked at some of my past photos from races and had my wife videotape me and I was definitely an overstrider, especially during races.  I was big-time heel striking.  I was pretty much putting on the brakes with each stride, and with weaker quads in one leg, the knee finally couldn't handle it.  Bottom line, find out what's causing the problem and fix it.  I had been in the same shoes since I started running (Mizuno Wave Riders) so I knew it wasn't the shoes. 

Your quads can be "fine" and super strong and you can still have runners knee.  Runners knee is a patella tracking problem often caused by an imbalance.  It could be due to quads that are too weak or too strong or too tight compared to the hamstrings or one side compared to the other, or caused by hamstrings or calf muscles that are too tight, or any number of things.  A lot of time it's caused by over-striding, but not always either.  It's much more common in newer runners but it affects lots of experienced runners too, usually after significant change in training but not always even that.  It can be maddening in that sometimes it can appear to just come and go with no obvious cause.

I stand corrected... by you and by my chiropractor. That is indeed my diagnosis. Posterior right pelvis tilt + lots of recent hard, long races = very tight right vastus lateralis + relatively stronger vastus lateralis vs. vastus medialis = imbalance pulling on the patella.

The good thing, in my case, is that the treatment seems fairly clear, and there's no reason to think there's any long-term problem that needs addressing by altering my stride or shoes. Though I may work on strengthening that VMO. But damn, it really sucks to not be able to go more than 3-4 miles without pain. I am ready for this to be gone.

I have had runner's knee due to tracking issues and IT Band flareup.  Runner's knee I could run through, IT Band I could not.  Needed a couple weeks off IT band and some serious deep massage.

In my opinion...

 

I think the cause of  "runner's knee" is too often attributed to complicated-sounding pseudo-medical jargon.  Patellar misalignment, excessive (ant/post) pelvic tilts, excessive pronation or supination, ITB dysfunction...blah blah blah.  Depending on what healthcare professional you are going to, they will feed you their theory, even if research suggests that a large percentage of people with knee pain (whether it is labelled ITBS, runner's knee, PFPS, etc) do not see huge improvements with their brand of therapy (be it chiro, physio, acupuncture, etc.).

 

If you happen to see someone who sells orthotics, I guarantee they will find the root of the problem at your feet and sell you some fancy orthotics plus expensive sneakers.

 

If someone tells you that your quads are weak or your hams tight, I would wager that the differences between your two legs would not be readily appreciable to any "professional" using typical manual testing techniques.  They will argue differently.  (If you went in to get your knees assessed based solely on strength and muscle length and didn't tell them which knee hurt, I think most professionals would pick the wrong knee 50% of the time.) 

 

In my own experience (both personal and clinical), in general, I have found that a combination of (relative) rest and a glute (especially med./min.) strengthening program to be most effective.  A closer look at the patient's recent training regimen is usually quite helpful as well.  Often, people over do it and mileage (or intensity) needs to be cut back and appropriately ramped back up again symptom-free.  Perhaps a recent change in some aspect of their protocol is to blame.  I know that I transitioned from treadmill running to outdoor running too quickly a few years back and paid the price.

 

(I prefer one-legged-hip-hiking ex's and single leg stance with sustained isometric glute contractions.  Go to fatigue.  I think the exercises should be performed in the position in which the muscles will most likely be used.  In this instance, we all run in an upright, standing position.  The exercises don't have to be fancy, and one does not necessarily need to see a professional to try these at home.)

 

My two cents.

 

http://www.healthzone.ca/health/dietfitness/fitness/article/960175--researchers-get-hip-to-the-root-of-knee-pain-for-runners

Yeah, my primary physician always lumps every problem into one category.  Knee hurts, it must be this...... elbow hurts oh thats bursitis  No x-rays, no mri until your leg or arm falls off.  Seriously.  My back I had to have nerve injections and been on pain meds for 3 years, but not from my primary.  He gave me prescription motrin.  SERIOUSLY?  and an x-ray and said your fine.