Hi...I'm stumped..(Running Shoe isse AGAIN) (Read 1060 times)

So, if ya'll remember a week or 2 ago, I had some issues with Patellar Femoral Syndrome (well still do, but is in control with a brace as well as PT) Anywhoo..I also asked a question about my Running Shoes and stated I had gotten fitted. At the time (Novembe 07') she concluded I needed a Nuetral shoe after looking at my feet/arches/the way I walked and the way I ran. Left very happily with my Saucony Pro Grid Triumph 4's. Well I have ran strictly in them and really had no issues to speak of until this recent bout' of my knee flare ups. Recent as in the last couple weeks. SOOO,after some hesitation I was told that it probably was not the shoe as I would have noticed issues much sooner. Okay fine. Well, today at the Physical Therpists he looked me over, feet, blah, blah, blah and told me that he felt I Supinated. He also told me that my heels were extremely tight and I needed to work on my calf stretches as he felt that would help in terms of my heel flexibility when my feet strike the ground. He also stated that my kneecaps both curve inward and showed me some actual kneecap stretches/manipulations I could do to help with that aspect as well. I asked him, well, what the hey?! Would I not have had issues sooner? He says not necessarily (sp?). He did however tell me to NOT get wrapped up in the shoe just yet. Well, sure, your not the one training for a race or running in them. Easy for him to say. So needless to say, I can't help but now think, what to do. Continue to run in them, or go back to the Running Store and talk to her about it?

I've had patella femoral syndrome since i was in high school about 14 years ago. mine was triggered by 7 years of cheerleading which is apparently VERY stressful on your knees. I did the whole therapy thing, even tried shock therapy. I was given some exercises to do but of course never did them as a h.s. kid. it always troubled me for the next years, especially when it would rain or if i was on my feet a lot in a particular day. i still have trouble walking on the beach, but i can live with that. oddly enough, once i started running last year, i have almost had NO knee pain at all. every now and then after a long run i will get achy, but it will only last a short time and i never have to take anything for it. i noticed in your log you only started running in december? if so, give it some time as your inner quad muscles (the ones that are probably under-developed and causing your knee cap to be pulled to the side) will get more developed with running. also, if you are into strength training, try to stay away from any exercies that will tend to develop your outer quads, as this will aggrivate your situation. building up that inner quad is key to pulling your knee cap back into proper position. when this happens, the pain will magically disappear - well, mine did anyway. good luck and make sure you do your exercises and those stretches as much as possible - it really does help!!! p.s. - Aleve has been my best friend for this pain. it was originally prescribed to me back in h.s. for the arthritis that accompanies this syndrome. it works really well

I'd have to admit; I almost EVERYTHING Cewickbe said. It absolutely makes sense; that, if you have a weak spot, you need to strengthen it instead of supporting it. Almost ALL of us have slightly different bone structure, muscle tones, running style... Some of us are knocked-knees; others are bow-legged; some has short legs...;o) But the thing is; as we continue to run, or do some sort of exercise, our body compensate and strengthen weak spots. I kept saying this at various message board; some may disagree...but pronation, or I should probably state "moderate degree of pronation" is a natural movement. Many so-called experts would look at it and tell you that you "pronate" and put your feet into heavily built-up shoes which, by supporting whatever your feet have to compensate this natural movement and consequently make them weaker and weaker (because now it doesn't have to do what it's supposed to do; shoe takes care of it for it). Now you step out of the shoe or wear some dress shoe or one of those cool Puma shoes or whatever; your feet would roll so much that you wanna hide your eyes! Because now your arch is so weak, by being supported by those high-tech shoes, it has become something of arms and legs of those imaginary octops-like aliens (because of advanced technology, their arms and legs lost their use). For that respect, I think shoe has a lot to do with a lot of our running-related injuries. You really understand the mechanism of running and shoes and understand those who might give you some advice (I mean, just because they work at a shoe store, don't assume they're qualified to give you advices). That actually can be said about PT or doctors or some of us internet advice-givers! Make sure what they tell you makes sense! One thing I'd like to question, though, is; when you say your "kneecaps are "curved inward", does that mean your actual kneecaps are shifted medially (inward) and closer together when you put your legs together? Or does that simply mean you're knocked-knees? And is this the same case with you, Cewickbe? I mean, it could be the same patellar issue but it could be turning outside or inside and, depending on which way, the solution could be completely opposite. I mean, if the kneecap is turned "IN", I would think that it's the inside the quads being too strong and pulling the kneecap inward??? If this is the case, you should strengthen the outer quads, not inside. Now, I'm a completely layman. I just said something that sorta makes sense to me. I've been wrong before; you should definitely seek professional opinion. But, depending on which way your kneecap is being pulled and what is causing it; the solution should be determined. But what Cewickbe said is absolutely correct (as far as I'm concerned); after running a while, your legs will strengthen themselfes eventually and compensate whatever the weaknesses you may have. Just go slow and easy for a while. Try to run soft surface if you can. Those uneven terrain would actually strengthen your legs further.

Well, without doing the homework on my part (oops!), I'm sure you're right about the PFS. But if the original poster said what I thought she said, and if her knee caps are actually turned MEDIALLY (inside), then I think it's the opposite. Yes, YOU are right; if the kneecaps are "OFF TRACK TO THE OUTSIDE" (by the way, I'm not trying to give the impression that I'm shouting when I cap the letters! ;o)), yes, you're absolutely correct, you should strengthen inside quads to pull them bak on track. But if the kneecaps are being pulled inside, then the treatment should be the exact opposite. This is where such internet message board can be quite dangerous. We absolutely need to get the terminology straightened up and understand the correct situation. And for that, it would most probably pay to seek the professional opinion or at least someone who can SEE you, perhaps watch you run, etc.

Hi and sorry, I have been busy to check back on my question. I have not just started running in December, but it is when I started logging here. I have been running on and off for years, BUT, just starting training seriously back in August because I wanted to run this up and coming race in April. I went back to the running store yesterday to talk to her about what the PT told me and after looking at me again and watching me run again, she decided that I could indeed use some support. She fitted me with Super Feet which gave me improvement. After I posted I ran and paid close attention to the way my foot struck the ground and I definately was landing on the outside of my foot and rolling inwards- not extreme mind you, but I'm thinking just enough to give me some issues. However, the tricky part is that by looking at my shoes you would not even think I pronate as the typical wear one would see with a pronator is absent on my shoes-go figure. I think we all were stumped. She tried to put me in a stability shoe (Brooks) and the key word is tried, and I hated them immediately. She put me in another pair which were somewhat better, but in the end with my race lingering 6 weeks away, I was not willing to put myself in a position with fooling around too much with my mechanics right now. The inserts treated me well with much less pain than I typically experience during my easy 4 miler today. Someone asked if Im a heel striker, yes, I indeed am a heel striker. As far as my kneecaps- they lean towards the inside. He gave me this visual to explain- Imagine looking at a tent- perfectly straight up and down (of course right?!) well he said my tent tilts to the left. As far as my quads go, I have big legs- muscular- think gymnast..I always thought they were pretty good, but I am figuring I was wrong at this point and will begin to work them as well. I also have very tight achilles tendons which I have been working on furiously to loosen up as well. I'll get this right. The knee brace is for crap as it slips when I run, due to the fact that I am inbetween sizes, so hopefully he will teach me how to tape at my next appt. for extra support- especially during my race. Thanks so much for all the advice! I appreciate it.

oh god, the taping is bringing me back to all those painful memories of shock therapy, knee braces, and physical therapy.......taping actually worked for me a little bit, but its only a temporary fix and it totally freaked me out because you had to manually move your knee cap into the right position and then tape it there. EW!!! by the way, i am totally more confused with the tent comment. but as long as you understand it, then good. i hope verything works out for you with the new shoes and such

Denise, Sounds frustrating. I would be more inclined to trust PT than running store clerk. PT says you supinate and running store clerk gives you Super Feet and has you trying on stability shoes. Doesn't make sense. Should be very clear whether you supinate/pronate or normal. This is crucial. I would go to another running store. If you supinate and are in stability shoes, it may make it worse. Personally, I think your neutral shoes may be fine and it is a biomechanical issue with how you run, your make up or specifically an enhanced Q angle from hip to knee (or maybe not) or you are simply doing a bit more than your body is ready for. Also, as mentioned, a more flexible gastrocnemius/soleus (calf) muscle makes your foot function so much better and this translates up your leg. Also, don't forget to stretch hips, quads, hamstrings. Also, hamstring strengthening is also very important for knee stability. You need balance. I personally have seen more clients have a floating knee cap to the outside which in many cases is a weakness at VMO (vastus medialis) Generally, the VMO (inside) tends to be a bit weaker than VLO(outside). Tends to be more of an issue with females because of Q angle and general weakness. This isn't always the case though. Having naturally bigger quads means nothing. You need to be doing strength training. Not sure what you have heard, but it is a challenge if not impossible to isolate a specific quad muscle as they work together. Also, a misnomer is you can isolate lower abs or upper abs. Just not possible because it is one muscle. Quads are 4 muscles but they all work very nicely together. General quad strengthening does the trick and works VMO and your body want balance so knee cap will slowly come back in. I think a general straight leg raise is very beneficial. Do reps, isometric reps etc. If you can do some partial squats with Swiss ball up against a wall, this would be helpful. Keep knees right above toes. Leg extensions are of value if you can do them without pain. Most can't. If you can, focus on the last 50% of the exercise. A PT should know all of this and if they don't, you need another PT. General treatment for PFS is modify activity and incorporate strengthening and flexibility. If you continue to train hard through it, you may not get it healed until you modify.

If you use your shoes just for running, you can tell what type of runner you are from the wear pattern on the bottom of your shoe. My wear pattern is outside heel striker, which I am told is the way most people run.