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"Runner's Knee" = weak inner thigh muscles? (Read 2616 times)


Needs more cowbell!

    I'm starting to get twinges of the sort of knee issues I had last Summer. At that time my problems were mainly due to shoes that weren't right for me (Asics Kayanos--I believe they were just too much shoe, too much stability...problems developed after about 50 miles in that model and disappeared within a week or so of taking the shoes out of rotation). This time I think it's simply a matter of hams and calves that are relatively stronger than my quads...or at least I think this is the case from what I've been reading. My symptoms are mainly a clicky right knee that is a bit sore. I have had some relatively mild pain and weakness during runs that is somewhat below and outside the kneecap, kind of a semi-circle of pain. I'm starting to work some specific strength-training into my workouts to help treat and prevent this sort of thing. I'm guessing that I should especially be targeting the inner-thigh muscles--does this sound correct? What sorts of exercises would be particularly helpful? I'm doing some "sumo squats," lunges, and a few other things that target the adductor areas. I'm also doing some wall sits, but I'm not sure that these will help the inner thigh muscles quite as much. Are there any sorts of exercises I should avoid?

    Kirsten - aka "Auntie Kirsten"

    '14 Goals:

    • 2 olympic distance duathlons -- 6 days apart -- PR at least 1

    • 130#s (and stay there, gotdammit!)

      When I had runner's knee it was due to weak quads, definitely. I did these exercises and they cured it for me: Standing Leg Lifts Stand with your back against the wall. Lift one leg up as high as you can with the knee straight. Hold for five seconds, then bend your knee to relax, hold for five seconds. Straighten your leg again, and do five of these before switching to the other leg. Over time, see if you can build up to ten seconds. Foot Turns (these REALLY helped!) Lie down or sit in a chair and stretch both legs out, knees straight and feet pointed up toward the knees. Tighten your thigh muscles and turn your feet out as far as you can, holding for ten seconds. Now turn your feet in as far as you can and hold for ten seconds, keeping your thigh muscles tight for the entire exercise. Do three of these sets. Foot Press Either sitting or lying down, put one foot on top of the other and pull up with your lower foot as you push down with the upper foot. Hold that for ten seconds, and then switch feet and repeat. Try five sets of these. I also practice yoga, so I avoided any yoga poses that would strain the knees (kneeling poses, etc; and any squatting poses hurt me, but everyone is different...)...other than that I am no help on what to avoid. Healing thoughts coming your way! Smile
      Egg


      Arrogant Bastard....Ale

        When I had runner's knee it was due to weak quads, definitely. I did these exercises and they cured it for me: Standing Leg Lifts Stand with your back against the wall. Lift one leg up as high as you can with the knee straight. Hold for five seconds, then bend your knee to relax, hold for five seconds. Straighten your leg again, and do five of these before switching to the other leg. Over time, see if you can build up to ten seconds. Foot Turns (these REALLY helped!) Lie down or sit in a chair and stretch both legs out, knees straight and feet pointed up toward the knees. Tighten your thigh muscles and turn your feet out as far as you can, holding for ten seconds. Now turn your feet in as far as you can and hold for ten seconds, keeping your thigh muscles tight for the entire exercise. Do three of these sets. Foot Press Either sitting or lying down, put one foot on top of the other and pull up with your lower foot as you push down with the upper foot. Hold that for ten seconds, and then switch feet and repeat. Try five sets of these. I also practice yoga, so I avoided any yoga poses that would strain the knees (kneeling poses, etc; and any squatting poses hurt me, but everyone is different...)...other than that I am no help on what to avoid. Healing thoughts coming your way! Smile
        Don't really think any of these exercises are working mainly your quad. Squatting and lunging should do what you need for quads, although I am not sure what a "sumo squat" is. Keep things balanced though. Don't just target one muscle group, always do the entire leg.
          Don't really think any of these exercises are working mainly your quad. Squatting and lunging should do what you need for quads, although I am not sure what a "sumo squat" is. Keep things balanced though. Don't just target one muscle group, always do the entire leg.
          No, they definitely work more than just the quads! I got the exercises from here: http://www.coolrunning.com/engine/2/2_5/183.shtml#quads The cured my runner's knee, that is for sure!
          JellyFish


            My knee act's up mostly to tight muscles. When stretched they feel slightly better and when i'm going to the gym working them out they feel great. I work everything related to my legs! And typically when I go to the gym regularly that really helps!
              May be stress reaction to increased miles. Keep on eye on this. It is a challenge to just fire the vastus medialis. I would do the wall sits w/ close stance and squats with various stances - a closer stance will fire quads a bid more. A seated straight leg raise with toe out a bit and really squeezing the quad muscle thinking/focusing on medialis will be of benefit. Walking lunge with stepping a bit more to outside each step is also a great exercise. Ease into all this. Also, really get your quads nice and lose pre-run and perhaps throw in running on grass or dirt. Hot bath or whirl pool will get them loose but obviously time consuming. Try it once! Go to gym and test your quad/ham strength. Use leg curl and leg extension. Ideally a 3:2 ratio quad to hammy strength is recommended. Take a weight you anticipate you can do 12-15 reps and rep out. Then test opposite muscle group. If you mess up, recover 5 minutes and repeat with a different weight.

              Those who try, fail! Those who do what it takes to succeed, succeed!!


              Needs more cowbell!

                May be stress reaction to increased miles. Keep on eye on this. Also, really get your quads nice and lose pre-run and perhaps throw in running on grass or dirt.
                I read one thing that suggested that a lot of runners experience patella issues around the same time that they first hit 40 miles...go look at my log. Wink Seriously, it was about the same time that I approached this marker that I first started having knee crankiness, again. Coincidence...maybe. The dirt thing is also interesting. On my run yesterday I felt great...no knee twinges at all, until I did a 1 mile stretch on sand (some semi-packed, with a bit of loose stuff on top). Once I was back on asphalt my knee was happy again. I thought that was sort of odd. So far it's not a serious pain issue, just a little nagging annoyance here and there, but I definitely want to nip it in the bud. I know this sort of thing can gradually progress into an injury that can be completely sidelining. I start marathon training in 2 weeks, so I don't have time to be benched. Smile

                Kirsten - aka "Auntie Kirsten"

                '14 Goals:

                • 2 olympic distance duathlons -- 6 days apart -- PR at least 1

                • 130#s (and stay there, gotdammit!)


                fear the Col Sanders

                  There was an interesting thread a while back on coolrunning about running on loose stuff and how it can be hard on the legs. I can't find it now (thanks Active.com!) but I'll keep trying to find it. If I remember correctly, the poster said that running on uneven and loose surfaces can irritate joints as the forces generated during running (and the impact of them transferred through the body) are different than on flat, even surfaces. They claimed that it can be harder on the joints. I'm pretty sure this launched a fantastic flame fest that periodically went on at CR. Anyway, it could have been 100% bunk but it was interesting to me since I had just protracted a nice case of ITBS by running down a mountain (on a VERY uneven trail full of loose dirt, rocks, etc). I'll try to find some more information on that. I don't know how uneven the trail portion of your run was but your mention of it sparked my memory...

                  Just because I look dumb doesn't mean I'm not...


                  The Greatest of All Time

                    Zoomie, You know I have bilateral runner's knee that has me completely sidelined. The cause of runner's knee differs from person to person. It can be caused by hamstring or calve stiffness or late firing of the VMO (vastus medialis obliquus), or even weakness in the VMO. There are other biomechanical causes as well. You are correct in that you need to get this under control now. All I can tell you is what my physical therapist has told me. Work on hamstring and quad flexibility. I stretch at home 2x per day. Then you need to strengthen the VMO. As someone pointed out, seated straight leg raises with your toes pointed out is great for isolating the VMO. I also do leg presses, walking lunges, squats, etc. If you have access to a stationary bike that would help too. Do not, I repeat, do not take this lightly. My doctor told me that the rate of running injuries increases dramatically at 40 MPW, or where you're at right now. So, don't play around. I would also ice regularly and take NSAID's as needed for acute pain. Kudos to you for catching this early! Read here for some more info: http://www.aafp.org/afp/991101ap/2012.html http://www.sportsinjurybulletin.com/archive/patello-femoral-syndrome.html
                    all you touch and all you see, is all your life will ever be

                    Obesity is a disease. Yes, a disease where nothing tastes bad...except salads.
                    Jamie PT


                      Hi. Don't attempt to strengthen your "inner thigh" and inner quad (VMO). That is very 80s / 90s rehab thinking. Newer research shows that stretching the hip (hip flexors / psoas, hamstrings, quads) and strengthening the outer thigh muscles (*gluteus medius* especially) will really help you. Sidelying leg lifts (Jane Fonda style) are the best. Google "gluteus medius exercises" for tons more. Remember, the hips aligns the position of the knee! Cool
                        Well, where is this new research? Do you have links? I have "Runner's Knee" and I've had it for quite a long time (I'm 36 and was diagnosed with chondromalacia at a ripe age of 13-14). It was probably mis-diagnosed, but whatever. I had some serious crunching in my knee and it hasn't really worsened over the years. It just swells alot when I run 20 milers. Just this year I had my knees X-rayed for the first time ever. Noticeable ridges apeared on my femur on each side of the patella on the "sunrise view" X-ray: http://www.kneeguru.co.uk/KNEEnotes/node/825 After the X-ray, I commenced 2 weeks of PT and discovered some pretty good exercises for strengthening both my outer AND inner thighs, plus single leg squats to strengthen my glutes and quads. For me, the overall strengthening of my hips and thighs, even my hamstrings, has helped.
                        Scout7


                        CPT Curmudgeon

                          Get them removed. I can put hinges in for ya.
                          C-R


                            Get them removed. I can put hinges in for ya.
                            Forget the hinges and call this guy at MIT. "Herr wears robotic limbs with motorized ankles and insists he doesn't want his human legs back because soon they'll be archaic. "People have always though the human body is ideal", he says. "It's not"."


                            "He conquers who endures" - Persius
                            "Every workout should have a purpose. Every purpose should link back to achieving a training objective." - Spaniel


                            The Greatest of All Time

                              I commenced 2 weeks of PT and discovered some pretty good exercises for strengthening both my outer AND inner thighs, plus single leg squats to strengthen my glutes and quads. For me, the overall strengthening of my hips and thighs, even my hamstrings, has helped.
                              Same, same.
                              all you touch and all you see, is all your life will ever be

                              Obesity is a disease. Yes, a disease where nothing tastes bad...except salads.
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