"Sudden Alien Right Leg Syndrome" (SARLS)

Tight muscles on long run, now ongoing knee problem

7 messages
01/04/2004 at 14:10
Hello everyone. Having been a member for well over a year this is my first post (sorry its's quite a long one!) Any help and advice would be very welcome. Thanks.

In short, after a recent bout of mild shin splints which upset my training for the FLM (see background below for more details), I was building up mileage fairly slowly and avoiding roads until mid-Feb. On my second long run I went from 1hr15 to 1hr45 and the hamstring and calf tired much more quickly than ever before. About a week later I developed pain in the outside of the right knee and a stiff hip. The hamstring had stayed tight for days. I have been given exercises by my physio (focusing on glutes and hamstring) which have helped the hamstring and got rid of any symptoms in the hip, but the knee is getting no better. (The physio thought everything relating to glutes, hip, hamstring & knee was inter-connected, hence no specific diagnosis of the knee problem or specific exercises for it). Also, I had new orthotics fitted this month which I am using for everyday wear as well as sport. They really felt natural v quickly and I am pretty sure the knee problem does not relate to these.

I know lots of you are probably thinking this is ITBS, but I am not sure. It is not brought on by running, though I have done no more than 4 miles at once since the problem run. When applying pressure it hurts most when straight rather than at 30 degrees. The pain is localised, on the extreme outside of the knee, between what I think (based on reading) would be the ITB and LCL. Most worryingly it seems to affect the motion of the right leg when walking: after about 2 miles walking the knee is stiff, and in general it doesn't move freely, almost as if I've suddenly got someone else's right leg (hence punning thread title). This is just incredibly weird to me as I have always been the sort of person who walks everywhere and my legs have always done everything I've asked of them. There is also, when walking, a sort of 'pinching' sensation in the back of the knee, and the top of the calf sometimes feels a bit stretched as well. There are absolutely no symptoms in my left leg.

Some background which may save time by setting the problem in context:

Age 31, 6'3", took up running in 1999, on and off (2 GNRs) until being accepted for 2002 FLM when it became more serious. Was over-pronator and used suitable shoes, changed them regularly etc. Did 2002 FLM in 3:45, Robin Hood half 2002 in 1:38, was improving all the time and totally in love with running. No injuries. During training for FLM 2003 developed severe shin splints in LEFT leg which forced me to withdraw and kept me out for 3 months. In the meantime had full biomechanical assessment, physio, rehab exercises. High-arched left foot, 'flat' right. Prescribed orthotics which worked fine, did GNR 2003 after gradual buildup, slower than before injury. Began training for (deferred) 2004 FLM in Nov 03, developed mild shin splints in right leg which upset training, this was due to not keeping up with rehab exercises since Sep. So I did exercises religiously, avoided road running and built up much more gradually than usual schedule.

I am all but resigned to withdrawing from the FLM for the second year in a row: in rueful mood I think it must be the fates getting me back because I was lucky enough to apply twice and get in both times...

Anyway, if anyone has experienced something similar or has more insight into whether it could be ITBS (or can just cheer me up!), I'd be very grateful. Cheers.
01/04/2004 at 16:04
Poor You

Dont give up yet - can you cross train to keep your fitness ?

I had my knee bursa - caused by extreme alance from extra long runs preF LM - wrongly diagnosed as ITBS by a sports physio who worked at the Commonwealth Games - they're often wrong it seems!

Must admit - from what you've posted - I'd try another physio.....

excellent stretches are on

but if its an imbalance - it needs correcting - and could be OK within 10 days - you could just make it but must see someone who knows what they are doing fast!

Look at the best of injury & health (top left) and see if anything there seems a possible as well

Good Luck
01/04/2004 at 16:04
meant to say

caused by extreme quad imbalance
01/04/2004 at 16:06
Arron, I had a problem with the "popliteus" muscle at one point which helps to prevent the kneecaps lateral rotation from quads pulling it. This had the pinching sensation behind the knee cap and left the whole area feeling distinctly odd (possibly similar to your alien feeling?). However no pain on the outside apart from an odd snapping sensation when walking occasionally.

Anyway a couple of days icing behind the knee with the leg elevated when watching telly or reading did the trick. Ice for 8 minutes, then wrap in warm towel for 10, then repeat 2/3 times every morning and evening if possible.

Might be worth doing a lookup on "Popliteus Tendinitis" anyway...
06/04/2004 at 11:25
Thanks for the responses.


I had a look at 'popliteus tendonitis' and although some of the symptoms sounded similar I wasn't totally convinced, as the pain on the outside of the knee is predominant at all times (the 'pinching' is intermittent and most associated with wearing harder work shoes as opposed to casual or trainers). I will ask the physio about it though.

Shattered shins

I have been crosstraining but really have to be honest with myself: only 5 miles running per week since the start of March will not be good enough. The received wisdom is 15 miles comfortably by the date 3 weeks prior, and the most I've got is 11, which led to this tightness/knee problem. I wouldn't even fancy walking 26.2 miles to be frank.

The imbalance you mention ought, surely, to have been picked up by the biomechanical asessment nearly a year ago. It leads me to ask what made you say I should try another physio. Is it because she really should have looked more closely at the knee in isolation and not just elsewhere? Or is it because I shouldn't still be getitng problems after all the treatment and assessments and orthotics I've had over the last 6-12 months? Needless to say the latter would worry me more.

I had already looked at 'best of' injury and health and the closest thing was admittedly someone who suffered hip and knee problems at the same time and was asked to work on glutes especially. So this would suggest that the physio was on the right lines. It's just the fact that the knee never feels right no matter what I do. Can't see the physio till 14th April: will insist she looks at the knee as a priority and see what develops from there.
06/04/2004 at 14:15

Are you certain this isn't an ITB related problem as it sounds very, very similar to what I have at the moment.

Basically, a so-called specialist running shop sold me completely the wrong type of running shoe i.e they told me I pronate - I actually supinate. This has caused bio mechanical problems. My right knee has started to turn inwards leading to pain in the ITB, stiffness in the hip and a stiff lower back. My knee generally feels stiff and uncomfortable but not sore particularly except for on the extreme outside (across the nobbly bit!).

Basically, I think the message is that a problem in one part of the leg can easily cause biomechanical problems almost anywhere else in the leg. Personally, I would be a bit worried if you are still having problems after all this time and it might well be worth getting another opinion.

Hope you get it sorted soon.
06/04/2004 at 16:57

I am not certain of anything, that's part of the problem! The main reason I doubted ITB was because it doesn't come on when running and then ease, it is there all the time and if anything walking is worse. Running seems to make me forget the problem, perhaps due to endorphins. But I don't know whether it will make it worse in the long run, which is why I'm not doing anything over 4 miles at the moment.

One difference between us is that I know I pronate: I have a running shop, an NHS sports injury specialist and a podiatrist giving me independent views on that. But the soreness is definitely on the extreme outside as well as (particularly today) when pushing the finger in on the back part of the leg behind the knee.

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