Oh woe is knee!

15 messages
20/08/2002 at 07:44
Over the last weeks / months I have digested everying I could about knee injuries - causes, prevention, cure, exercises etc. At the same time I've been to see doctors and specialists - admitedly not that many (!) but I would have thought a reasonable stab at a dianosis might be in order.

Anyway, as a result of my reading and elimination of things that it wasn't by doctors, I believe I've arrive at the correct diagnosis - Patella Tendonitis (or jumpers knee as its commonly known). I've come to this conclusion based on the symptoms, the fact that there are things I can do to alleviate the pain, and the fact that, now that I know what it is and can avoid the aggravating factors, its not getting any worse.

Anyway, I thought I would share my thoughts on the forum as it might help others.

Causes

The injury apparently arises as a result of an increase in running stress (i.e. increasing training or significant alterations in training regime). In my case, I'm certain its due to the rapid return to racing I made this year and the amount of downhill running I do (uphill running is fine - but what goes up etc...).

What does it feel like?

If you relax your leg with the knee slightly bent then just at the bottom of the kneecap there is a tendon which when pressed or masaged is sore to the touch.

The pain isn't under the kneecap, nor is it at the side (which has helped me eliminate runners knee and ITB).

The other thing is that the tendon is a little stiff - this means starting my runs at a gentle jog to warm up after which the pain subsides.

What to do about it?

Essentially rest is the only long term cure, however unlike some other running injuries, the wisdom seems to be that running on it is possible. With a marathon debut now 7 weeks away I am anxious to avoid total rest if I can.

Secondly, avoid the things which inflame the injury, in my case this means.
1. Avoiding agressive downhill running (it seems to be OK if I take it easy).
2. Avoid speed training (Not ideal, but mileage is what matter now in my marathon build up - I can do marathon paced runs which will help).

How to avoid it happening in the future?

1. First of all rest to clear it up.
2. Strengthen , stretch and cross train to become a more balanced athlete.
3. Proper bio-mechanics - I will go and see a podiatrist to get properly match my shoe to my posture but I definitely now believe more than ever that you should buy the best shoes you can afford.

Anyway, for now I will keep on running with the intention of reaching the marathon and then taking a longish rest. I am working on the cross training and stretching and my avoidance of aggravating events means I am in less pain now than at any time over the last 2-3 months...........of course I could be completely wrong and have a one-way ticket to a wheelchair.
Mij
20/08/2002 at 10:11
I hope you have it right - good luck.

Only question is - have any of the professionals shared your view, or been negative to your view?
20/08/2002 at 11:12
I haven't been back to the professionals to share my view - all I can say is that they all seemed remarkably unconcerned.

Generally I think that the medical profession do an extremely good job with limited resources and huge pressure - its just that whenever I go they seem to assume I'm mad and that it is all phantom!
20/08/2002 at 11:29
Sounds very much like tendonitis - I have similar symptoms with my achilles....

Have you tried ice and anti-inflammatories - this will certainly help the acute symptoms, but really the only chronic solution is long term rest and/or cutting back on the intensity/duration of your training....

Also I have tried a chiropractor in the past and they can often help if there is a problem caused by alignment of the spine/hip - a diagnosis is well worth it...
20/08/2002 at 12:18
Thanks Strider

I haven't tried anti-inflamatories yet as (and this may sound stupid) I want to know when its getting worse / better and am concerned that the anti-inflamatories might give me a false sense of security.

I'm also not sure about the alignment theory as I've run on and off for many years and never had any "mechanical" problems as such so it seems odd that they might suddenly manifest (although I am getting old and possibly lack of flexibility has become an issue).

Ultimately, I know rest is the only cure........"you've only yourself to blame" as MrsH so helpfully suggests
20/08/2002 at 12:27
Like Strider I am now having similar symptoms with my achilles. I am off to an acupuntucurist this afternoon will let you know if it helps. Good luck with your marathon, and I am keeping my fingers crossed I can complete my Half Marathon in 3 weeks time.
20/08/2002 at 12:27
Sorry I can't spell.
20/08/2002 at 16:05
Hope you are right with your diagnosis Martin and you are able to do enough to make that marathon. I'm sure you will!

Agree fully with your sentiments about the professionals doing a good job etc. But also agree that unless you are ill through your injuries they arn't that bothered in finding the true answer. Unless your willing to pay for your treatment!
20/08/2002 at 16:26
I hope so too hilly.

Since I reduced my running and introduced cross training I've actually increased my total training time so provided I can avoid breakdown I'm hopeful I'll make it to the marathon start.
20/08/2002 at 18:51
Glad to hear you've got a diagnosis - apart from needing to know what it is to treat it, I think it makes you feel much better just to at least know what it is.

Can the rest of us tap into your new found knowledge? Mine's a sore left knee after some long runs - shooting type pain when I put my foot down, at about 7 o'clock as you look at my knee cap (i.e. bottom inside part). Followed up with general soreness and horrible clicking noises. Sorry - that's a bit self, self, self isn't it!
20/08/2002 at 21:45
Doobs, unlike Martin you probably do have a runner's knee! The initial treatment is quite similar - reduce your mileage by about a third, ice, and anti-inflammatories if you need them to do your normal activities (but not to allow you to train!)

Then get yourself off for a biomechanical assessment. You may need orthotics and/or specific exercises to strengthen your vastus medialis (inner thigh) muscles so that your knee-cap moves vertically in the groove designed for it when you run instead of being pulled sidewards by the stronger lateral quads.

Martin, absolutely right not to take anti-inflammatories. Each to his own, and your approach is completely sensible.

And you've got the wrong end of the stick, Tim. GPs spend so much time seeing people whingeing about conditions that will get better without medical intervention that we positively drool at the thought of getting our fangs into an unusual condition. Problem is, your condition wasn't unusual. You're Tim and you're very special, of course, but to your GP you weren't "special", you were just another neurotic academic fussing about a bit of postural backache. And you HAVE got better with exercise, haven't you :-)

Cheers, V-rap.
20/08/2002 at 22:11
Thanks V-rap! I have been using ice and ibuprofen, so nice to know I've been doing things right. I've also got some exercises from Shattered which I must start doing more regularly - I've only done them twice in two weeks. At the moment it's been ok though, maybe because I missed a run last week.

Hope your knee improves Martin.
20/08/2002 at 22:52
I'd thoroughly endorse Shattered's exercises, Doobs - she ought to copyright them quickly before I print them out and start distributing them to people who are waiting for a physio appointment.

Cheers, V-rap.
21/08/2002 at 10:49
Re GPs: I have been brilliantly lucky, and for almost all my life in this country my GP has also been a runner. Indeed first GP was the woman who started me running! Therefore they are very sympathetic to running problems. Almost worth shopping round for one such.

Sorry, now hi-jacking the thread for personal issues.

re anti-inflammatories. I worry about them.

I take them (celebrex) pretty routinely, as they appear for reasons nobody pretends to understand, to be very effective against neurologoical symptoms, and I don't just mean being able to walk. Fits, visual effects, psychological effects and details like being able to find my nose with my eyes closed all seem to improve, and life becomes very much like normal.

So far, I last about 10 days without a-i's before things begin going pear-shaped. Clearly I run while on them. I try to minimize their pain-masking effect by not taking the morning dose til after I run.

Any good suggestions as how to monitor muscles, joints and bone problems beyond the obvious (which I do) "drying out" sessions, when I see how long I can go without taking the stuff?

Not entirely convinced that the drying out sessions are 100% good idea either - do I lose muscles/connective tissue strength every time the inflammation gets the upper hand?

Anybody else with experience?

Thanks. Marj



21/08/2002 at 16:42
Hey all,

I twisted my medial ligament in my left knee about 5 years ago (playing netball) and I've never really recoverd. I don't get any pain when I run, but I am aware that the ligament is there, I suppose you could call it a niggle.

Stopping running made not a blind bit of difference, but what does help is a daily does of high strength codliver oil, a good pair of shoes for training in and staying off the concrete as much as possible.

I'd also reccomend yoga to all runners as a form of cross training.It helps correct muscle imbalences and increase/maintain flexability, it's also great for strengthening and lubricating those joints!

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