The Dreaded Runner’s Knee

1 May

Well, I finally did it.  I went to the doctor about my knee pain.  As a long distance runner I’m very accustomed to over-use injuries.  Whether it’s stress fractures or sore joints or ankle pain – been there done that.  Normally the recipe for success and recovery is the same sad story: no running, rest, and ice.  When my knee pain started last September I did just that.  I dropped my half-marathon, I stopped running completely, and I let myself totally rest.  About 6 weeks later I began P90X and maybe a month after that I started running again – this time only short distances.  I am pretty “by the book” when it comes to treating injuries, so I really expected a quick recovery.  My body had something else in mind.  When I started training in February for the mini-marathon I experienced little knee pain and felt confident progressing.  About a month ago, however, I had to walk home because the pain was too much.  That was the final straw.  If weeks of rest, strength-training, and limited racing didn’t solve the problem, there had to be more to the story.

Today I found out that I have Patellofemoral syndrome aka ‘Runner’s Knee.’  This is the most common running injury and certainly nothing out of the ordinary.  It’s a relief that this is something pretty standard, but also a bummer that it is bad enough to be qualified as something.  My sports med doc was very thorough, and I left feeling a bit sad but confident about the next steps.  I had a resident in my appointment, which was fantastic because the doc ended up explaining verbally all of his testing and tweaking – which was great for me!  I loved hearing the explanation behind all of the pushing, pulling, and analyzing he did.  Based on my pain, symptoms, and physical exam he came to a swift conclusion that I have runner’s knee.  Yay – no MRI or x-rays needed!  But sad that the pain was real enough to lead to such an obvious diagnosis.

What is Runner’s Knee?

According to trusty Wikipedia, Runner’s Knee is caused by the prolonged repetitive compressive or shearing forces (running or jumping) on the Patellofemoral joint.  The result is the thinning and softening of the cartilage under the patella (hence the pain under my knee cap – makes sense!).  Essentially my kneecap is irritating the groove where my femur is resting.  It is very common, and is found twice as often in women due to wider hips (thanks Ma!).  It’s tough to say exactly what is causing it in my case, but it could be any of the following:

  • Overuse
  • Biomechanical problem – my body just might be more prone to it (something about Q angles?)
  • My quads are weak, specifically the inner quad
  • My hamstrings are tight
  • My gait isn’t aligned appropriately
  • Or a few other things

kneepain

So how do I fix it?

The bad news: no running.  This was to be expected.  I think this is a big reason I’ve been putting off this Dr. visit for so long.  I knew this was going to be the first order of business.  Though he did tell me, “I know you have your races coming up so go ahead and do those.  I’d tell you not to, but I know you wouldn’t listen anyways.”  I laughed and told him he was very correct.  He must be a runner :)

The good news: there is more to the story than just rest and ice.  Obviously rest and ice is the first step, but there are also exercises for strengthening the inner quad muscles.  Additionally I can tape my knee and wear a brace that might provide some support and relief.  The last step: Aleve twice a day for 2 weeks.  That’s a lot more anti-inflammatory medication than I’m used to taking, but he wanted to be aggressive in relieving the inflammation.  I have to admit that it felt pretty good walking out of there with a prescription and Physical Therapy referral, as opposed to just “rest and stop running.”

Hopefully I’ll get my first PT visit scheduled soon and I’ll be on the road to recovery.  I’m still looking forward to my upcoming races, but sad that I’ll have to take a break once they are done.  I’ll be sure to soak up the running happiness and really enjoy them.  Biking and swimming were the recommended replacement activities, but I’m still not sure what my next step will be exercise-wise.  I’m not sure how much this will affect my 2013 Fitness Goals.  Really I’m just trying to process the information.  Let’s see.  Essentially any bending motion irritates it more: so no Plyo, likely no Insanity, lunges, or squats for a few weeks, along with the running.  Sigh.  Should I start thinking more seriously about committing to biking and swimming?  Ugh.  Knees – you can get better!  I believe in you!

I’ll leave you with some old lady advice: take care of your bodies and be sure to stretch and rest appropriately! You don’t want to be sad and benched like me!

-Kelly

How do you handle periods of rest and recovery?  What’s your favorite ‘recovery’ exercise?

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14 Responses to “The Dreaded Runner’s Knee”

  1. atwostoreyhome May 1, 2013 at 10:47 pm #

    Ugh, that is such a bummer! I’m sorry you have to deal with that (and not run,) but like you said, at least you can do more than just rest and ice. I used to get injuries all the time–shin splints, stress fractures, knee pain–and I’ve found that by putting a rest/cross train day in between running days I can stay injury free. Not sure how often you were running before, but maybe that will help when you do start running again! And swimming is a great recovery exercise–no impact, but strengthens muscles that might be neglected by running!

    • racesrepsramblings May 2, 2013 at 9:17 am #

      Thanks for the sympathy! :) It’s a bummer, but I’m just hoping I won’t have to be out for toooo long. I’m only running 3 days a week now, but I’m doing P90X the other days – so it could just be overuse. Once I’m done with P90X and my races I’m thinking a few weeks off will help. And you’re so right about the swimming. I really need to find a local pool, because it would truly be the perfect cross-training activity. Thanks again for the support!

  2. boltingbutterfly May 2, 2013 at 9:17 am #

    That stinks about your knee! At least you know how to treat it now. This post is a really good reminder to me to stretch and not neglect my body so that I can avoid injury, I haven’t had too many issues yet (knock on wood). Swimming and biking can be awesome though. Maybe you should consider making a triathlon a new goal. I did my first one last summer and it was awesome!

    • racesrepsramblings May 2, 2013 at 10:12 am #

      Agreed – it’s nice knowing specifically what to do to get it better! I’m glad this is a helpful reminder for you – it’s so easy to get in the habit of not stretching or cross-training enough (clearly I’m guilty). Usually it takes an injury to remind me :P And it’s funny – you’re the second person to recommend a triathlon to me this week. Maybe I really should start considering it! Thanks for the sympathy and suggestion :)

  3. megbek May 2, 2013 at 12:47 pm #

    Glad you went and learned everything that you can do about your situation! Why is it, that as runners, we don’t like to be told we can’t run? It’s such a disappointment to hear those words and I’ve certainly experienced it too. At least you can do your races and work on improving your knee. Tough stuff, but in the mean time, you can focus on strength training or something else fun! :)

    • racesrepsramblings May 3, 2013 at 9:46 am #

      I know! It’s funny – many people would cheer if they were told they shouldn’t run. Not runners though! But you are right – I’m feeling good that though it’s a set back, it’s still almost a “best case scenario” of setbacks. I have a plan to get it resolved and I can still race. I’ll take it :) It has pushed me to think of other workout ideas, which is good too. Thanks for the encouragement!

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