Runner's Knee (Read 209 times)

had my apt with the sports med doctor and basically, he got me an apt with a runner's PT, so that's good, i see her later this week

but all he had to say was no, it's not tendonitis, no don't wear the brace, yes, keep taking Aleve every day, and basically if i can deal with the pain then go ahead and run through it....not super helpufl

so last week i went out for 11 easy miles over the course of five days, and was fine, no pain. so Saturday i went out for eight easy miles, again, fine, no pain....so this morning i went out for six, and after four miles i had to stop. i ended up walking two miles back home. icing it now. hoping the PT can give me some insight into how i can make this go away and get back to running like i love

Tchuck - i know i tried a bit to much to soon....i was still keeping a tiny flame of hope alive in the back of my mind that maybe, just maybe, i could save this marathon cycle. My SHORTEST run over the past month of training was a nine mile fartlek... running two and three miles a day just seemed worthless and was super discouraging. I was trying to BQ at Twin Cities this fall so that I could run Boston for my 40th birthday. My only chance now is to get this knee recovered and maybe be able to do a spring marathon (but now i have a huge mental block against spring races because every time i have planned for one, the weather has been AWFUL) so i can register next year. It was a super important bucket list type of goal for me, something I was doing just for me and i'll be honest, I've shed some tears over the past couple of weeks. The eight miles on the weekend were so encouraging, i really thought that maybe that had been enough rest. Unfortunately doesn't seem like it, my knee hasn't felt comfortable today. Really hoping the PT and the gait analysis will shed some light, she is a runner herself and she primarily works with runners, but i will hold off on any more running until i see her later this week

i stopped taking the Aleve after taking it twice a day for a solid week. i hate taking stuff like that and especially for a week at a time, i just can't bring myself to take more...

My PT apt was really great, she specializes in runners and running injuries and she was really knowledgable. Unfortunately, no quick fix for me

she tested and manipulated all of my joints and muscles in my legs, she thinks i must have twisted my ankle recently and my ankle has lost some of it's mobility compared to my good leg ( Ha! my left leg is just perfectly fine...) i have dealt with hamstring issues for the past several years and even though it has been "feeling" good and not causing me any problems recently, apparently its still quite a bit weaker than my left side, so basically the PT told me that there is nothing actually wrong with my knee, its just caught between a bad ankle and a bad hammy, but those things are fixable and i already know how to fix them, its just getting consistent with my hamstring rehab again

however, then she did do a gait analysis on the treadmill and that showed that i am still heel striking pretty severely. Many years ago i thought that i had fixed my form so that i was midfoot striking, basically landing flat footed, that seemed to be about as good as i could get it and i thought it worked for me, but when she slowed the video down i am definitely heel striking!!! argh. that is not a quick fix. i ran with a metronome this morning to make sure my cadance was correct and i just did laps around the local track barefoot so i could really feel how i should be landing....

BUT the good news is that even though i won't be racing this fall, hopefully this is a permanent fix and i will be able to run for years after this....Boston is just going to have to wait for a few years

Great info! Glad you found someone who could take the time and analyze properly!

Bill, I would treat this as a tweak or minor injury vs true "runners knee". It happened in an instant like a muscle strain would. Your previous day likely contributed to loading your knee and then the downhill portion put additional load on tissue that may have been stressed the day before. The fact you are improving is an excellent sign. I would keep walking and cross training often to enhance recovery. I would wait 2-3 days after you no longer have pain going downstairs before attempting a run. When you do your first run coming back, get warmed up with a lot of walking and just plan on jogging for a mile or two. That's it. You want to get through one pain free running session to give you confidence. Take one day off from that stress and then try a 3-4 miler easy. If all good from that you can resume your training schedule. Just be aware.

Runners knee is a pathetically vague term. So far the only correct words I've seen written focus on the quadriceps and their relation to the kneecap. The strain is caused by the fact that the tendons of the quads go through the knee. So every time they fire, the quads pull the kneecap back into the femur.

At issue is the femoral groove. If the kneecap is beginning to miss track through it's natural path, that friction is your pain. Wraps to hold it in place may solve the pain, but they don't solve your problem. The primary strain is caused by too much forward lean in your running form which is demanding greater role of the quads to propel you forward to compensate. It also increases friction of the kneecap.

Unfortunately, continue in pain, and you'll permanently grind the walls of your femur and your later years will be extremely painful.

Secondly, being a heel strike runner is a good thing. It's how you land which optimizes its utilization in economy running. Overstriding with your step puts the landing pressures directly on the quads, which of course pulls the cap back into your leg.

Biologically, to cure it requires learning to better integrate your glutes into your running form. If your glutes can pull the femur back with greater force, it reduces reliance on the quads to extend your tibia. Of course, that removes the pressures of the kneecap from your femur.

Since you already understand why heel strike running is more efficient, then learning the firing sequence to optimize that landing process is what you'll be introduced to in the masking tape exercises of this article. I call it the masking tape exercise. It'll teach you how to shift from a quad focused running form to a glutes based one.

https://www.military.com/military-fitness/running/evolution-of-learning-how-to-run-distance

What you've figured out is why a midfoot or forefoot landing doesn't work for marathon running. The most efficient athletes in the world are heel strike runners. Midfoot or forefoot landings and the 180 step per minute crap doesn't work.

https://pubmed.ncbi.nlm.nih.gov/16195026/

 

The tape was a good idea.  Did you have any pain when running?

Yeah, it was a no-go. So was strap and full wrap. Walking is fine, but the full force of patellofemoral compression at midstance while jogging or running is too much for it.

I bumped into my neighbor who's a surgeon while testing the straps and wrap, and he thinks it's strained meniscus. But he's a cardiothoracic surgeon, what does HE know about knees?! Oh yeah, he played tennis in college and has messed up knees.

I guess that's what I get for twisting while lifting over two tons of cement into a mixer in less than two hours.

SCORE! Now I get to watch TV and drink beer for a week! It seems like I'm injured every June. Maybe not last year, because I did a 12hr on July 5th.