New Knee Pain While Running

It sounds like it could be one of two things:  IT Band Syndrome or Runner's Knee.  Personally it sounds more like an IT band problem to me than the latter.  Initially it may not appear to be ITBS, since you said the pain is mostly right below your knee cap - if you straighten your leg you can feel a circular, bumpy bone on the lower outside of the kneecap.  Every time you extend your leg to plant, your IT band slides over this boney knob, and is very easily aggravated.  Pain in this area sometimes gives the impression of a knee problem, not an IT problem, but it's all related/interconnected.

I dealt with this on a pretty significant level last fall/winter.  Have been a runner for the last 8-10 years, got cocky/busy and decided that I could run once a week and go out and blow out a sub-1:50 Half Marathon.  In hindsight, that's not a smart thing to do.  Ran the half marathon portion of the North Face Endurance Challenge (trail half marathon) in early December, and could hardly walk for over a month.  I say all of this to warn you - IT band problems will not just go away on their own.  Better to take a week or two of rest now and remedy the problem (i'll get to that below) than to keep pushing it and have it linger as you get closer to your races.

IT band problems are caused by a number of things:  overuse (i.e. ramping up mileage too quickly), lots of downhill running/running on uneven trails when your legs aren't conditioned for it, riding a bike that isn't properly fitted, wearing shoes that are worn out.  Sounds like you may have been affected by several of these things, and even though you've corrected them now, if the IT band is already inflamed, it won't just go away on its own.  How much mileage are you running each week, and what distance is your long run?  As a general rule, you want to avoid having your long run be any more than 50% of your total weekly mileage.  So if you are only running 20 miles per week, but your long runs are 12 miles, that can very quickly cause major problems.

So that's the bad news.

Here's the good news:  It's a relatively easy/cheap fix, although you should be disciplined in taking care of it.  Take a couple of weeks off from running (it won't kill your training at this point for a May half mary) and riding on an ill-fitting bike.  Depending on the severity of the pain, you may want to try a week or so of no running or cycling, and then for the second week slowly bring back in the cycling.  Get a Foam Roller of Death.  They are uncomfortable, painful, and a myriad of other, less appropriate words - BUT THEY WORK.  Roll out both your IT band and hamstrings on a daily basis.  Make stretching a big priority every day as well, in particular with your hamstrings.  You can look up some specific stretches that will help your IT band as well.  Pilates bands are also a great, inexpensive tool to help strengthen both your glutes and hip flexors (a critical part of the knee stabilization that takes the pressure off of your IT band).  ICE, ICE, ICE. 

After a couple of weeks of rest, stretching, rolling, and strengthening, bring your running back in slowly. It's probably not a great idea to just jump right back into the mileage that you were doing before you started having pain.  Another thing I have found to help significantly is to ice after all of your runs initially, and then after your long runs going forward, at least for a couple of months.  Icing helps keep any lingering inflammation of the knee/IT band down.

As I mentioned above, the other problem could be "Runner's Knee", which is a patella (kneecap) tracking problem.  Commonly caused by the stabilizing muscles surrounding the knee (the lower inside quads) and the glutes/hamstrings not being strong enough.  The "good thing" about this problem is that the remedy is roughly the exact same as IT Band Syndrom:  rest, stretch, strengthen, ice.

Don't expect this issue to go away overnight, but it is a very easily treatable problem.  There's always a chance that this your pain is due to something else, but IT band problems are extremely common in runners.  They also are typically the cheapest and easiest fix, so it's not a bad idea to start with the remedies for ITBS, and hopefully the pain goes away.  If not, then you can look into seeing a doctor, etc.  Best of luck!

P.S. - SORRY FOR THE NOVEL!

Thanks for the info!  My current mileage is about 15-20 mpw.  I'm ramping up to my HM, which will go to about 25-30 mpw.  My logs are up to date.  Do you think I should take time off BOTH biking and running?  I'm really worried about how far back this will set me...

definately not the IT band...it is either patellar tendonitis or patella femoral stress/tracking disorder.....the IT band pain would be on the lateral/outside of the knee...definately not just below the patella, like your pain is.

quick answer: quad and hip stretching...heat before the run ice afterwards.  Women are more susceptible due to the Q-angle (angle formed from knee cap and hips) and could be due to increasing your mileage too fast....in an office setting there are other things that can be done.

sorry I am very brief with my response but I have to run (figuratively, but I saw your post and wanted to chime in...I can share more later or you can PM me...good luck

Go to a sports med doc and get a real diagnosis instead of a possible guess from the internet.

If you knee hurts running stop running and find out why before you injury yourself more.

I am going to copy and paste my answer here too.. for others to read beyond where I answered this before...

I am no expert on this. But I am currently in PT for this right now. I will say this... go see a PT or someone professional and FIGURE IT OUT NOW. I am in week three of no running and Physio.

That area is the Patellar Tendon. Turns out my MCL was weak from an old injury and I had bad Core and bad VSO, Tight Quads that ruined my range of motion and eventually the Patellar took all the abuse it could and Rendered me useless right now. Not sure what your root cause of this is. But that is def the Patellra tendon area not the IT if it is below your knee cap.

I am 3 weeks in. Had to scrap my HM for spring and I have no sign of when I am allowed to run again. I am finally allowed to spin with some resistance as of TODAY..

I have been allowed to swim. Which I can only do two days a week due to pools and work.

Not trying to be overbearing.. But I skipped that little issue and pushed on for one more run in the snow and it Totalled me.

but that is Def The Patellar Tendon area. It may only take some Pre-Wrap to help it. But then again It may be a sore spot stemming from other issues.

I am working hard to improve my Core, more stretching, More Core,,, some Core.. some ultrasounds, Tens Machine Core... and did I mention Core oh and a massage that helped greatly for my tight quads.

Just my 2 cents from someone that is going completely Stir Crazy not running with my new running group we started here.

Im with the guy that said go get a real diagnosis.  Sports Medicine docs are good but I have found that Active Release Technique docs are better.  They spend time separating the scaring from damaged tissue and finding root causes rather than just telling you to decrease miles, ice, braces etc because all of those things are just keeping swelling down.  Worst cause you have a meniscus problem and you will risk ripping it up more if you continue to train on it.  If you need more info on Active Release I would go to www.Activerelease.com or to this site that has great info on the therapy with actual specifics to running conditions www.P3sportscare.com

good luck and be smart man... get some real help before you are down for longer