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Old 12-06-07, 06:59 PM   #1
Plainsman
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Let's play "Name that knee pain!"

Alright contestants, here is your question:

Our patient has pain only in his left knee, feels like it's at the base of the patella. He's only been running for a year, mostly 5 and 10ks (Sprints and Olympic). Never any knee pain until about 3 weeks ago. Two tidbits that may contribute?

1. Our patient has been running in the same pair of shoes for one year now.
(just bought some new ones yesterday - I know, way overdue)

2. Mileage is starting to increase (never more than 10% per week, 8 mile max run) in prep for a half IM.

On your mark, get set, diagnose!!!

Seriously, any help would be great. I've heard IT band and other stuff. I'll probably have a doc check it if it doesn't feel tons better. Right now I'm just walking for 30-45 minutes so at least I'm doing something. Have not run in about a week and a half. It feels a bit better now, but I'm not sure if I should try to run on it (it's not so excruciating that I couldn't) or wait for all pain to go away. I would love some advice.
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Old 12-06-07, 07:47 PM   #2
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Wait until it goes away...

I had the same knee pain last year when training for my first triathlon. Slowly worked my way up to 3 miles then suddenly one day it was there in my knee (i forget which side, probably right side) 2 months before the event. Took at least a month of not running (i walked a bit but mostly swam and cycled) before it went away.

I think shoes could have been one of the biggest factors (or crappy insoles, i ended up replacing them and used the same shoes for afew events after that before getting dedicated running shoes).

I also started doing ITB stretches regularly and trying to adjust my running technique. Additionally, i started doing light weight lifting (squats) to help develop my quads a tad (i hadn't started cycling yet) since i did read that unbalanced quads (inside vs. outside) could potentially pull the patella out of alignment.
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Old 12-06-07, 08:41 PM   #3
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Thanks. You are the second or third person to suggest ITB stretches. Do you know of a site that illustrates some good ones? Until a week ago, I did not even know what an IT band was. I did a spin class earlier in the week, and with the exception of a few standing sprints, I did not have any trouble. The more I hear the more I'm suspecting bad shoes, which I've since replaced and have sitting in a box just begging to be used. I've been cycling for a few years, and I strength train regularly so I thought my leg strength was okay (though I could be wrong), but I have jumped from the 4-5 mile run to a 7-8 in the past couple of months.

Also interesting that you had the same experience with just one leg being affected. I wonder why that is?
Here is a thought if anyone cares to weigh in - it's my left knee - and I always train on the road running against traffic, so this leg is always closest to the road's shoulder. Any connection?
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Old 12-06-07, 08:47 PM   #4
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(unprofessional opinion)
patellar tendonitis or tendinopathy
http://www.sportsinjuryclinic.net/cy...mpersknee.html
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Old 12-06-07, 08:52 PM   #5
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Quad muscle imbalance. Wall sits will help the inner quad get stronger and pull the patella back in line.

Just a guess. Also, go see a Dr.
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Old 12-08-07, 09:14 AM   #6
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I am going to say NO to it being ITB. Your IT band is on the outside of each knee. Probably more along the lines of what Cooker posted. Try some RICE, reduce mileage for a couple of weeks, break in the new shoes then resume.
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Old 12-08-07, 07:44 PM   #7
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Quote:
Originally Posted by Psydotek View Post
Wait until it goes away...

I had the same knee pain last year when training for my first triathlon. Slowly worked my way up to 3 miles then suddenly one day it was there in my knee (i forget which side, probably right side) 2 months before the event. Took at least a month of not running (i walked a bit but mostly swam and cycled) before it went away.

I think shoes could have been one of the biggest factors (or crappy insoles, i ended up replacing them and used the same shoes for afew events after that before getting dedicated running shoes).

I also started doing ITB stretches regularly and trying to adjust my running technique. Additionally, i started doing light weight lifting (squats) to help develop my quads a tad (i hadn't started cycling yet) since i did read that unbalanced quads (inside vs. outside) could potentially pull the patella out of alignment.
I wouldn't disagree with anything except for the insoles. They're meaningless unless you need orthotics.
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Old 12-09-07, 01:59 PM   #8
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when i started upping my distances i started having knee pain like your guy... i did research and found that it was my iliotibial band. i got a foam roller and in about a week of stretching it a lot the pain went away...

my pain was to the lower outside area of the patella..
http://www.howtostretch.com/iliotibi.htm this site helped alot for stretching..
http://www.youtube.com/watch?v=0ZIl0QxOgKc stretch itb with foam roller...

Last edited by WxGuesser; 12-09-07 at 02:05 PM.
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Old 12-09-07, 02:28 PM   #9
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Thanks for the link with ITB stretches. I made an appt. with the doc for this week, and wouldn't you know that as soon as I did the knee started to feel better. I have not really run on it for almost 2 weeks. Since I bought some new shoes, I think I'm going to take a short easy run this afternoon, and see if how it does. If I can run a couple of times before Friday with no real issues, I may just cancel the appt. Here goes!!!
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