Forums >Health and Nutrition>Mystery Muscle Strain Transitioning Into Knee Tickle/Tingling
Hello,
On 5/11 while running I stepped down with my left leg while also slightly changing direction and landed awkwardly and felt a pain shoot up my left leg that made me eyeballs bulge. However, I was able to finish off the last 0.25 miles of my run without noticeable pain or slowing down from running speed. However, hours later I felt a pull/pain in my upper quad that lasted a few days.
On 5/16, in the morning it felt somewhat better and I foolishly decided to push forward with marathon training and ran 4+ miles. I felt the same pulling pain for the beginning of the run but after a little bit it faded and I was able to run normally. However, after cooling down the same pull/pain in the upper quad came back worse.
Then I decided to take it easy and from 5/16 to 5/25 just did some quad rehab exercises and walking. The strange thing was that I was able to do wall squats, knee extensions & kettle bell squats with no pain what-so-ever it was just walking/pivoting/hopping on leg that would give me pain/soreness. At first I struggled to walk without feeling some pain in my upper quad when lifting my left leg to step forward and some pain in my inner thigh (maybe near the groin) when trying to pivot or change direction when walking. I also should note that I felt pain (maybe 3-5 out of 10 while trying to hop on my left leg). As the days progressed I was able to walk better.
On 5/25 I wanted to test jogging on a treadmill. After walking for a bit I upped the speed to jogging and sure enough I felt the same pain/soreness in my left upper quad area. I went 0.5 miles and while it seemed to get better I did not want to push through. After slowing to a walk the pain/soreness was heightened and I felt it for the rest of the night at a heightened level.
The last 2 days I have rested and not done anything but what is concerning to me is that yesterday afternoon I developed a tickling/tingling sensation in my left kneecap that I feel when walking (landing and pushing off). This is bizarre as I have felt nothing in my knee this entire time until yesterday and now today. I am concerned that perhaps this is all related to significant ligament damage but I also know that most people will know right away (due to their knee buckling) that a MCL/ACL tear has occurred.
I do have an appointment with a Physical Therapist next week and my normal Doctor in 2 weeks but I was hoping to get some sort of peace of mind and/or advice. My brain keeps thinking I have destroyed my leg and will need surgery and a long recovery time. It's tough to stay positive when you don't know for sure and I don't have a way to get an instant MRI or anything like that for peace of mind.
Based on my above story and anyone else's experience is there reason for me to be hopeful that this is just a random knee pain part of my overall healing process from a grade 2 quad/groin strain? Or is this just the first sign of a signficant knee injury that took 2 weeks to rear it's ugly head.
Any words of advice or insight would be much appreciated.
Thanks,
Andy (devastated injured runner)
Hey Andy!
Sorry to hear you are going through this. I can't say for sure obviously just from what you posted, but it does not sound like a ligament tear to me...at least not a full tear. You could have sprained it, but even though I don't think so.
There are a number of muscles that attach below the knee and then up on the pelvis. Some of them help to stabilize the pelvis and the hip when we are standing on a single leg. My guess from reading what you wrote is you strained a muscle or tendon, which is creating the pain and other sensations you are feeling.
Like I said, I cannot be for sure without testing things, but based on what you wrote, that is where my initial thoughts go.
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UPDATE:
The tickling/tingling pain in the left knee has changed to a more moderate pain that seems to feel like it's on the top of my left kneecap. I feel it with every step as I walk and it occurs when I lift my leg up to move it forward.
The pain is not severe but is causing me to limp slightly.
I know this is my second post but the reason why I signed up was I wanted to find Running Message Boards & Running Groups just to see if anyone else experienced something similar to this. I plan on getting checked out but if anything was seeking reassurance, advice, insight. It also has been tough to self-diagnose. At first I was thinking a grade 1 or grade 2 muscle strain in my upper quad or maybe groin....but now it seems all the pain is focused on the knee (the last 36i-sh hours). Before the knee pain (and me trying to jog on Monday) I was able to walk fine and definitely did not feel anything in my knee.
I suppose jogging could have somehow impacted my knee but it is also strange that I did not feel any pain in my knee when I was jogging or even immediately afterwards.
Getting it checked out is the move and I will go from there but in the meantime was looking for any signs of hope that this isn't ACL/MCL/Meniscus or something that (from my user story) screams surgery.
Andy (Devastated Runner & Not A Spam Bot)
Welcome to RunningAhead, good to see you're not a bot (g).
I'm no sports med expert and speaking only from my experience with knee injury, I doubt you're having a meniscus issues -- these tend to present with pain in the back or side of knee and clicking as the joint moves across the tear or damage.
Thanks for the reassurance.
It does seem, if I had to guess, this is on top of my kneecap or inside of my knee. Who knows...maybe some sort of nerve damage?
To further specify I feel the pain not when I lift my leg...I can do standing leg lifts with no pain. However, it is when I am beginning to step with my left leg and I am pushing up with my body weight to step forward.
It's only been 48 hours like this, but it has worsened from a faint tickle sensation to a more moderate pain.
Since this is limiting my walking mobility (more so than immediately after the Acute Original Injury on 4/11) I'm not even sure what is going on in my upper quad/inner thigh which was the original & only source of pain from 4/11 to 4/26. I don't want to test different exercises at this time to try to trigger the pain in my quad/inner thigh so I'm not even sure where that aspect of this stands.
Has anyone heard of a delayed onset knee pain (like I'm describing in my knee starting from a faint tickle to more moderate pain when doing the same walking movement) that just kind of appeared and then improved on it's own? I'm holding out hope that continuing to limit my movement and sleeping will have it improve but at this moment I feel more concerned than when the pain was isolated in my upper quad/inner thigh (4/11 to 4/26).
My knee also has not been swollen at any point during this whole ordeal (even last 48 hours). Should I just try the RICE method regardless? Would that be worth a shot? Any recommendations for things I can try from now until Physical Therapist/Doctor Appointment would be much appreciated.
SMART Approach
First instinct is to panic. So may things can go wrong. If no clicking, locking, giving out then less risk of meniscus or ligament of a significant degree. But even tiny meniscus tears can be symptomatic but are not surgical. Ligament tear would likely lead to swelling. Your rectus femorus muscle attaches at hip and crosses knee joint. This muscle may be involved based on your symptoms. My knee blew up in November with extensive swelling after a run without a real injury. I was off running 3 months but did not have any significant injury at all and x-rays and MRI were fairly normal but swelling lasted 4 months. Thing happen. My doc said don't panic it will resolve. Here is good article.
https://www.howardluksmd.com/sometimes-our-joints-just-hurt-and-its-ok-not-to-know-why/ What you need is to look for progress. Over next week don't do anything that would irritate it and don't keep testing it. Movement is your friend. Phooey on ICE and RICE which is outdated. If walking irritates it then just do normal activities. If you can walk without issue do it. It is valuable. If not then easy biking, elliptical is good if no irritation. Knee extension, hip flexion etc. Move surrounding muscles through day. Don't over stretch or over roll. Let it calm down and evaluate in 7 days. If worsening or no progress then a doc visit is warranted.
Run Coach. Recovery Coach. Founder of SMART Approach Training, Coaching & Recovery
Structured Marathon Adaptive Recovery Training
Safe Muscle Activation Recovery Technique
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First, I'm not a doctor and this is not medical advice. Sounds like you potentially dislocated your kneecap. A transient patella dislocation could explain what you are experiencing. A sudden twist when the leg is planted could have moved the patella out and back. The severity would depend on how far out it went. It's also possible that it's still slightly 'out of track' with the way it is supposed to move. Generally speaking, you'd be looking at 6 weeks or so to heal, but it's always a good idea to get it looked at. A patella dislocation can cause other issues like ligament tears.
Good luck! Let us know what you find out.
be curious; not judgmental
UPDATE
So the feeling of tingling/numbness in my left knee (seemingly on the top of the kneecap/front of my leg) that started on 4/24 got worse and worse to the point I was limping and the pain was more moderate than a tickling sensation. It was the worst on Friday (4/27) evening. It also is interesting...at one point I had my friend touch my kneecap and by touching it they were able to cause me to feel a sudden, shooting tickling pain sensation start in my kneecap and shoot downwards but then it went away after they removed their hand (and I gasped). At that point I was very, very concerned.
However, the next morning (Saturday 4/28) I woke up and the tickling/numb knee pain was gone...and I was able to walk without feeling that tickling in my knee. That same day I traveled from Buffalo NY to Toronto to go with my non-injured friends who completed the Toronto Marathon.
I was worried I would be very depressed but was able to walk around downtown Toronto Saturday and Sunday without any knee issues and just some soreness in my inner thigh (which can be drawn back to the original pain I felt after original injury onset on 4/11).
I got back home yesterday with both of my friends (who also were devastated that my injury meant I could not run in the Toronto Marathon) convincing me to to register for the Buffalo Marathon taking place at the end of May(26 days from now). The registration was closed but I was able to snag one of the final spots by agreeing to raise $500 in charity before 5/23 to earn my bib.
I have my an appointment with a Physical Therapist tomorrow. Today I still can walk around without the pain...but I do feel a subtly tickling sensation behind my knee...however this is more subtle than the one that occurred ONLY when I would walk forward last week. It is interesting though that I feel this very subtle tickling/numbness behind my knee even when I am stationary. This differs from last week.
Perhaps it was overly-ambitious and reckless to register for another Marathon in the immediate future but part of me doesn't want to wait for the Fall or next year. I don't necessarily view myself as a runner and just like testing myself in all aspects of life. TO BE CONTINUED...
After I returned from Toronto the tingling/tickling returned (after a brief 2-day hiatus) except it was now BEHIND my knee and it was more subtle. Also, I felt it non-step regardless if I was sitting, standing or prone. However it did not prevent me from sleeping or anything. This lasted from 5/2-5/3.
I went to Physical Therapy yesterday with a massive spreadsheet log of every day since original injury onset on 4/12. Including Pain Region, Pain Rating, Exercises, Injury milestones, etc. The PT said he had never seen anything like it before and called over others to check it out. I didn't think it was that uncommon for a patient to show up with a highly detailed pain log but who knows.
After several stretches and squatting related tests we were not able to recreate any pain symptoms in my quad/thigh/hip or even in my knee. However, I could not do a pistol squat at all on my left side and my form for deep squats was off. I also was struggling to balance on my left leg.
They believe that I originally strained my quad (which is what I thought initially too) but then further exacerbated the injury by trying to run on it too soon (multiple times) which caused me to run awkwardly and rely on passive muscle areas which likely let to some nerve strain/damage (tingling/tickling in my knee).
I told them of my goal to run in the Buffalo Marathon on (5/29) and asked if they thought it was possible. They said it was too early to tell but that it could be possible. Next we did a series of exercises and they gave me homework. They also said I can target running 5 miles outside on Sunday at a slower pace than what I had been to test before my next Monday PT appointment. This will be a HUGE milestone!
If I succeed I will try to get in a 10-mile LONG RUN and then maybe a 20-mile LONG RUN in mid may before a modified TAPER. All while continuing to work on left leg strength & stability exercises. Obviously this is not ideal as they said typically they would like to work with me for 8-12 weeks but I am fine with temporarily setting myself back just to attempt to run in the Buffalo Marathon.
Last night when I went home I posted my Kaleida Health Heart-To-Heart fundraiser page with a "Personal Message" that took me 8 hours to write and gave a detailed physical & emotional account of my Marathon Training experience since January 2022. I have a DARK sense of humor and wanted to make it entertaining for those that would have the time to read it (IT IS LONG).
Within one hour of posting it I had raised more than $500 and now I have a bib and entry into the CLOSED Buffalo Marathon.
IF ANY OF YOU LIKE DARK HUMOR AND HAVE THE TIME PLEASE CHECK IT OUT HERE: https://runsignup.com/mullyandrew
It is an emotional rollercoaster and perhaps can help others in terms of what NOT to do when getting injured during Marathon training. I'd be thrilled if any of you took the time to read it and gave me feedback. I'm not seeking donations at this point just merely curious if people who don't know me would find it entertaining or not.
THANKS,
ANDY
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Finally getting back on here from last week. So happy to see you got into see a physical therapist and are starting to make progress. Based on what you are sharing, I agree with the assessment of the PT - quad strain and then another injury from compensations. (And I also agree that most people are not as detailed as you are with tracking symptoms and everything else. It can be so difficult to get any details from people most times.) Good luck with your continued training for the upcoming marathon.
Warm up well before your 5 miler. Also, don't feel the need to do a 20 miler. It is so ingrained in plans and just isn't necessary and especially in your case with your issue. Save your best effort for race day and not a training run. Good luck.
Any recommendations for a modified training schedule assuming I can make it through the 5-mile run this Sunday (5/8) with no symptoms?
I had been training since January, and my longest LONG RUN was end of March (19 miles). My last LONG RUN attempt was 20-miles on 4/1 that ended earlier than I wanted to due to lack of proper nutrition (hit the wall at 16).
My injury occurred on 4/12.
The Buffalo Marathon is 5/29 (24 days away).
I also plan on going to PT several times from now until then just to ensure progress with strengthening my weakened left side of my body. I have the following "homework" rehab exercises to do 3 times a week: Sideplanks on Elbow | Clamshells | Sidelying Hip Abduction | Standard Plank | Side Stepping.
At this point I need all the help/tips/tricks I can get. I feel like finishing is a possibility, I just also need to work on gaining my confidence back as the end of May approaches.
The big question is how many miles were you averaging per week prior to your injury? What was your highest weekly total?
You really are not going to improve fitness much in a few weeks. You should probably focus on getting your weekly mileage up and run easy. You can't afford a setback. Then shoot for a long run of 16 or so miles just for confidence purposes as much as anything. On race day, you will need to temper your expectations. Run slow and steady (take walk breaks if you need to) and just gut out the 26.2 miles. Expect it to be tough.
The big question is how many miles were you averaging per week prior to your injury? What was your highest weekly total? You really are not going to improve fitness much in a few weeks. You should probably focus on getting your weekly mileage up and run easy. You can't afford a setback. Then shoot for a long run of 16 or so miles just for confidence purposes as much as anything. On race day, you will need to temper your expectations. Run slow and steady (take walk breaks if you need to) and just gut out the 26.2 miles. Expect it to be tough.
Before injury, I ramped up to 30-40 miles per week.