Forums >Health and Nutrition>Knee pain- insight/help
Any insight, experiences, advice would be incredibly appreciated!
In early March I developed some outer knee pain in my left leg. Felt like IT band pain and ended up getting a coretisone shot in early April... as I had a half at the end of April. I took a weekend off but It didn’t get much better and started PT. Made it to the half ... hurt first 3-4 miles, then pain essentially went away, but came roaring back as it stiffened up. Horrible for several days. Did PT exercises for glutes and hamstrings and no running for three weeks. Within one minutes on the treadmill and pain was back like I’ve done nothing to help it.
I was assuming it was actually patellofemoral pain, but now question that it is patella tendinitis? Any thoughts on what’s actually the source of pain and what I can do to help it?!? Thank you.... going crazy not running...
an amazing likeness
An "oldie but goodie" thread here on RA might have some insights...
I'm not a doctor (well, not a real doctor) but I'd say that's your problem right there. My guess is that you could fix this in a couple of weeks if you get strict but you need to do four things. 1. Immediately reduce the inflammation and then 2. Keep from irritating it again whilst you: 3. Build up strength/flexibility to prevent recurrence and 4. Eliminate any possible causative factors 1. Reduce immediate inflammation with ice/Ibuprofen and maybe rest for a day if it is bad. 2. Keep from irritating it for at least a week or so by: Keeping your runs short. After a day or two you can try doing a couple of runs with some rest, ice and stretch between. Avoid any speedwork. Avoid any downhills. Avoid corners - seriously, be VERY careful going around corners, slow to a practical stop if you have to make a right angle turn. Avoid roads with steep cambers. Avoid running tracks. You get the picture.... Also, make your short runs in the form of a circle around your house. That way if you feel the SLIGHTEST pain you can stop and slowly walk home. Never run on it when it is painful. If you stop the instant you feel irritation you can be back out tomorrow, possibly even later the same day. If you inflame it you'll be sidelined for another day Use ice and Ibuprofen after your run to reduce swelling even if you didn't get any pain. Don't use Ibuprofen before the run since it may mask the pain and lead to injury. 3. Build strength/flexibility with the various recommended stretches and exercises. Find ones that seem to work for you and do them ALL THE TIME. I like the stretch I mentioned earlier because you can do it anywhere without looking too daft. All you need is a chair, table, car, fence post, shelf, large dog or anything to steady yourself against. Every time you have a spare 30 seconds you should so this stretch. You can do it whilst you read at a table if you want. If you work at a desk, even if only part of the day, then do it whenever you get up to, or return to your desk. It will not hurt to look into combining the stretching with some strengthening exercises too. 4. If there is any suspicion that your shoes may be to blame then switch back to an old pair. Otherwise try to think what might be leading to the irritation. For me I suspect that too much downhill running is often the trigger. Even after you get your mileage back you may want to avoid possible triggers for a while - or at least approach them with extreme caution. If you are strict with yourself and don't try to do too much too soon you can get your mileage back up pretty quickly. Say that you can't get beyond 3 miles without pain kicking in then try something like: 0, 2, 3, 2+2, 3, 4, 3+3 which would give you practically a week of stretching before you tried exceeding 3. Then in one more week you could build up to 7 or 8 miles. Good luck. John
Well, since I started this back in early March...thought I'd report back. No expectations that anyone was waiting with bated breath to see how it work out.... Clearly, as can be seen throughout the thread as folks shared their personal experiences, there is no one solution -- everyone seems to work to find what works for them. For me, the ibuprofen and other otc medications were not a preferred approach as I try to avoid medications when reasonable. I did try a shoe change, but that didn't prove to be a factor for me -- I didn't expect it would as I hadn't made any sort of shoe change recently near the time I started to struggle. In early March, I started making sure to never run past the point of any pain. At any knee pain, I stopped and walked it in. I focused my stretching on the quads on the bad side. I stayed with the foam roller. I gave up some personal safety and was careful about managing my running line to avoid heavy road camber. I added an icing routine. Slowly things came around and I was able to start adding back mileage. Towards the end of April I experimented with longer runs. In May I was able to get back to more normal mileage levels and was actually able to log a tick over 200 miles with some runs over 10 miles. Just a twinge of knee pain towards the end of the month, so I back off a few days. For me, I don't think it is 'all better', I have to pay attention all the time, and each run still has a 'knee management' constant mental note in it, that's what I miss the most is just the carefree 'go for a run'. My thanks to everyone who shared their story and advice, you gave me some good insights that have helped.
Clearly, as can be seen throughout the thread as folks shared their personal experiences, there is no one solution -- everyone seems to work to find what works for them.
For me, the ibuprofen and other otc medications were not a preferred approach as I try to avoid medications when reasonable. I did try a shoe change, but that didn't prove to be a factor for me -- I didn't expect it would as I hadn't made any sort of shoe change recently near the time I started to struggle.
In early March, I started making sure to never run past the point of any pain. At any knee pain, I stopped and walked it in. I focused my stretching on the quads on the bad side. I stayed with the foam roller. I gave up some personal safety and was careful about managing my running line to avoid heavy road camber. I added an icing routine.
Slowly things came around and I was able to start adding back mileage. Towards the end of April I experimented with longer runs. In May I was able to get back to more normal mileage levels and was actually able to log a tick over 200 miles with some runs over 10 miles. Just a twinge of knee pain towards the end of the month, so I back off a few days.
For me, I don't think it is 'all better', I have to pay attention all the time, and each run still has a 'knee management' constant mental note in it, that's what I miss the most is just the carefree 'go for a run'.
My thanks to everyone who shared their story and advice, you gave me some good insights that have helped.
Acceptable at a dance, invaluable in a shipwreck.
It's hard to tell what may be causing it without seeing your doctor. i would suggest that first if you have pain that's keeping you from running for this long. If your doctor is able to provide a diagnosis, he/she can give you specific exercises to target the muscles you need to work/strengthen to heal and get back to running.
I do knee strengthening exercises, intense foam rolling, and targeted stretching 6-7 days a week. The strengthening exercises that help me the most are wall sits focused on targeting specific muscles, and weighted/flexed leg raises. Also, my heating pad is my knee's bff. I use it every day. The combination of these things seems to keep me running despite a patella-tracking disorder diagnosis. I avoid ibuprofen and cortisone like the plague. They may help short term, but in the long run they will do nothing but numb pain and allow me to further injure myself.
Good luck, I hope you're able to get some relief soon.
SMART Approach
Can I assume you had x-rays to rule out arthritis? Pain going up or down stairs? My recommendation is to see a good physio or manual therapist to analyze your feedback from shoulders to toe. Something off in upper body or pelvus area can wreak havoc down the chain. Sometimes these things resolve themselves but you need to stay active. Biking may provide some healthy quad work too.
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Thank you to the several responses! I went to the doc in early April, but thinking I may have to go back as it was deemed IT band issues and it seems like something else at this point. I did have X-rays at that April visit and nothing was mentioned of arthritis. I’ve been stretching, strengthening glute med, hamstrings plus squats, lunges, step ups, wall sits, etc. I have biked indoors the last 10 days. I tried running again today with my knee KT taped and was able to run 1 mile with manageable pain (2 out of 10) and no lingering pain. running as many of you can relate is my stress release and im desperate to get back to it regularly.
With the pain seemingly going away during the run it didn’t seem like patellafemoral pain... but I have no real clue... that’s why I got on here!
Just be very aware. If possible, run more on grass, dirt, trails, woods chips, rubber track, treadmill etc if possible to see if it feels better or as you ease back in. Also, get your knee real loose with warm up, dynamic movements, moist heat etc before your runs. If soft tissue related, it is very important to loosen up and warm these tissues before pounding.