Dealing with Runner’s Knee

9 May

runLast night, I had a very anticipated and successful trip to the Physical Therapist (PT).  Last week my visit to the Sports Med doc landed me with a prescription and diagnosis of Patellofemoral pain syndrome (aka Runner’s knee).  This is a very common overuse injury, and my appointment last night armed me with even more information and most importantly, a plan. 

What’s the problem?

Just a recap (Get it?  Knee cap? Ok – that pun was intended and bad).  Runner’s knee is a phrase used to describe a couple conditions that all cause pain around the front of the knee.  Mine is most likely Patellofemoral malalignment – essentially my knee isn’t ‘tracking’ appropriately. Tracking is referring to the bending motion and how the patella (knee cap) should slide easily in the femoral groove.  Because the knee is very sensitive and pretty complex, it is a likely joint to experience endurance pain. (How many CLs do we have? ACL, MCL?)  In my case I experience knee pain while I run, but also when I’m just relaxing at home.  My knees feel most at ease when they are extended and not in a bent position.  

What is the cause?

There are myriad causes of Runner’s knee – one of the biggest reasons it’s the most common running injury.  These are the most common causes found in the paperwork from my PT:

  • Malalignment of the kneecap (due to biomechanics)
  • Complete or partial dislocation
  • Injury or trauma
  • Weakness of thigh muscles
  • Flat feet
  • Excessive training or overuse
  • Tight or weak leg muscles

During the appointment my PT did a number of tests by having me push or pull against her in various ways.  She had me walk and evaluated my gait.  At my next appointment she’s going to put me on the treadmill to watch my running gait.  Because there are many possible causes, she had to go through several little tests to rule out possibilities.

What’s the word?

The end result?  I have weakness in my hips that is causing my knees to pull slightly out of alignment.  While walking and running short distances, this isn’t noticeable, but once I get up in miles, it is essentially hours of my knee bone rubbing against my thigh bone – yikes.  That’s exactly how my knees feel! 

What’s next?

The great news is this can be fixed!  My PT was very optimistic about my situation and felt like it could be resolved.  She assigned me 4 exercises to complete at minimum once a day.  These exercises are all aimed at strengthening my outer hip muscles (yeah…never really thought about bulking up those muscles!). Additionally I have a few other appointments scheduled where she will continue to work with me to get me back up to speed.  She’s a little against my upcoming half-marathon, but said she’ll help in any way to get me to run it as safely as possible.  Next week we’ll talk about specific taping techniques to help my knees.

Long-term

After my next half-marathon I will be taking 2 weeks off of any knee stressing exercises.  This includes running, legs lifting, or Insanity.  I think both physically and mentally this might be a nice break.  I know my knees will certainly appreciate the chance to let the inflammation go down.   I’ll probably fill my time with walking, yoga, and some of the lower impact P90X videos.  Once I get the clearance from her to pick up the pace I will start introducing low-mileage runs and hopefully Insanity during the first few weeks of June. She doesn’t feel that this injury will permanently or long-term side line me from running.  This is amazing news.

How am I feeling?

Thrilled!  I have exercises, a plan, and an awesome PT to help get me to the next finish line.  My biggest priority at this point is to deliberately do my exercises every day – I know that’s incredibly important to my recovery.  Feel free to casually harass me about my knee exercise progress.  (Hey Kelly great recipe post…you better be doing your exercises!) I have appointed almost-Dr. Adam (he graduates from med school this weekend!) to be a key reminder in my exercises as well.  I’m also going to continue to ice and rest my knees as much as possible.

Prevention

If you want to stay happy and injury-free, follow these tips!

  • Warm-up and stretch appropriately.  This one is such common sense, but it’s amazing how easy it is to skip.  Find a couple stretches to do every time and get in the habit of doing those same stretches.  Warming up sufficiently is also key.
  • Increase the intensity of workouts slowly. This one always seems to get me every time.  The typical rule is don’t increase distance more than 10% in a week.  This means following a quality training program (check out Runner’s World for some good ones) and sticking to it.  Just because you have a great run one week doesn’t mean you can up the speed or distance by a crazy amount. (I’m talking to myself here!)
  • Keep yourself in good shape.  Make sure your body is strong!  Incorporate weight training and core work to make sure your whole body is strong.  Consider adding legs/hip exercises to strengthen your whole leg.

Worried about Runner’s Knee?

The first step would be to talk to a medical professional.  I saw a sports med doc and he was wonderful in guiding my diagnosis.  Just because you experience knee pain doesn’t mean it’s Runner’s Knee.  A doctor or PT can help you determine your exact cause of pain.  Until I see a professional, I always use the RICE formula: Rest, Ice, Compress, and Elevate. 

A hopeful summer of running and fitness

The other great news is that this means I can move forward in planning.  If you’ve been around here for a couple posts you probably have gathered that I like planning and organization.  Now that the mini is over I have been looking ahead to fall races and potentially spring stuff.  I have been going back and forth on marathon vs. half-marathon and my diagnosis has affirmed that I want to continue with the half-marathon distance for at least a little while.  This summer I have deemed “The Summer of Speed!”  (don’t worry – I’m not turning to drugs ;)).  Because the pain comes from many miles, I will stick to shorter distances and work on running in the 7’s as I so desperately needed during the mini.  Perhaps in the spring or fall next year I will look at getting back at the full marathon distance.  At this point I’m thrilled to continue to train for a distance that I really enjoy.  I feel like I still have some time to shave off – bring it on fall 13.1!  I’m excited to start picking out races :)

-Kelly

Have you ever experienced Runner’s Knee?  How do you recover from injuries?

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4 Responses to “Dealing with Runner’s Knee”

Trackbacks/Pingbacks

  1. Life Changes and Excitement! | Races, Reps, and Ramblings - May 16, 2013

    […] the start of short runs again (I’ve essentially stopped running normally/regularly due to my knees).  I’m really excited to start chronicling my thoughts of Insanity and doing a post-P90X […]

  2. The Decision Not to Get Knee Replacements at Age 46 | Races, Reps, and Ramblings - June 3, 2013

    […] at home.  My Physical Therapist is wonderful and tells me I have been making great strides with my Runner’s Knee.  I would agree because my knees no longer ache at rest.  I’ve been feeling good and she even […]

  3. The Benefits of Not Running | Races, Reps, and Ramblings - July 12, 2013

    […] You can check out my experiences with Runner’s Knee here: The Dreaded Runner’s Knee, Dealing with Runner’s Knee, and When Running Hurts, okay…so maybe I talk a lot about my inability to really run.  But what […]

  4. Once I Can Run Again | Races, Reps, and Ramblings - October 21, 2013

    […] it does happen.  My knees are still giving me pain even after a visit to the Doctor and Physical Therapy last May.  I know, I know… I need to go back and get it figured out.  More tests = more time, […]

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