Kneecap

Is it pain with movement only, and if so, which movements?  Or just a solid pain even when at rest?

I've had a variety of kneecap issues so I may be able to give you some suggestions if your symptoms are similar to mine.

Very little pain at rest, but painful to the touch. Hurts more after being idle. Pain is mostly during the expansion of the knee/leg under load (walking up steps hurts more than walking down)... if any of that makes sense.

Sounds like inflammation of the cartilage under the knee cap.  Had you banged it against something, I would say it's acute and should heal on its own.  Since you didn't, it may be the start of a chronic problem due to how your kneecap is tracking.

I started having kneecap inflammation, i.e. chondromalacia last year after years of my knee not tracking properly during exercise and I just never realized it.  An MRI with the ortho can't hurt just to be sure it's not tendon related but it sounds like chondromalacia from what you've described.  The up the stairs pain is a big indicator. Tendon or joint issues you would feel more deeply into the knee, the sides, maybe the back.

Definitely ice until you get a chance to see the doc.  I continued to run and bike on mine as those two motions didn't cause pain.  The knee is definitely more inflamed after though so I ice right away.

If he says it's chondromalacia I can tell you in more detail what I've been doing to correct mine.

My problem, a very common problem that is the main cause of chondromalacia: quad dominance.  Your quad muscle over fires while the glut under fires.  This causes pulling and stress on the kneecap.

The exercises I do are primary to make that glut fire again.  PM me and I can give you the details...there are about 10 different exercises I do and all require a bit of explanation!

Finally got a diagnosis after x-rays, MRI, and physical exam:

patellofemoral pain syndrome

Basically inflammation between the patella and the femoral groove where the kneecap tracks. Looks to be caused by too fast a build of mileage and running in a pretty hilly area. Can't do much about the hills but I can keep an eye on my volume. I definitely cranked it up relatively quickly in the past several weeks.

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Sounds like the same problem I am having. It is killing my squats and deadlifts. I am fine under warm up wight but any time I add any real weight to the bar I am toast after about 5 reps then I can't even do an unweighted squat. The going up stairs is an issue as well. Last tie it happened at the gym one of the chiros I know was working out at the same time and he did some manipulation of my knee and it was way better! I was back to running up the stairs into work the next day.

Most people with patellofemoral problems have a weak VMO..........the part of your quad to the inside of your knee, resulting in the patella sliding laterally.  This is what I advise for my pts (and a LOT of people have this problem)

1-Do the PT.  It will take 6-8 weeks for the exercises to kick in but it will help
2-Avoid knee extension machines.  They transfer 3-5 times your body weight to your patellofemoral joint which is already pissed off
3-Its OK to do squats, leg press BUT listen to your body.  NEVER go beyond 90 degrees of flexion (I don't care what a "crossfit perfect squat" is I am trying to protect the long term health of your knees)  If it hurts at 90 then try 60 degrees and work up to 90.  The point is to strengthen without pain and without getting your knees more irritated.  Do both legs together AND each leg independently.  It will not feel like one is stringer than the other when you do both legs together but you sore leg will be weaker
4-Leg curls, 4 way hip and toe raises are all fine
5-Work on your balance as well.  We guard a sore limb and your balance will be off
6-Consider bracing until you are stronger and not sore.  I like this brace http://www.betterbraces.com/donjoy-tru-pull-lite?utm_source=msn&utm_medium=cpc&utm_campaign=[roi]+donjoy+products&utm_content=tru-pull+lite+-+$118.99&utm_term=+tru%20+pull&utm_creative=p  a lot.  THey do run ridiculously small so be careful with the sizing.  If you can get a script for it then your insurance should pay for it. Feel free to PM me if you have other questions

Yes, a fancy way to say your kneecap is rubbing.  I can send a list of exercises to help correct the imbalance that's causing this if you'd like.  They have helped me tremendously.

I am going to try these exercises and stretches.  http://www.nismat.org/patients/injury-evaluation-treatment/lower-body/patellofemoral-pain-syndrome

Am I totally hard-headed to keep running while working through this?  

No problem.  The idea here is to neuorologically retrain your brain to do the correct movement and muscle firing patterns instead of the incorrect ones that are causing the imbalance and thus kneecap pain.  I do these six days per week and it takes about 20-25 minutes.  Here's a list of the easiest to explain exercises:

1) The first set of I do for 30 feet, 6 times (so 3 times there and back):

High knee march -- kick each knee up high, forward and away from you and drive down through the heel, kind of like an over exagerated march

Side step -- facing side, step the lead foot as wide open as you can, then use that same glut to just step together, kind of like a vaulting motion.  Don't bend forward and make it a squat, keep the posture upright

Lunges -- unlike the usual walking lunge, this one focuses on two things: 1. taking as big a step as you possibly can keeping the knee way back behind the toe as you lunge forward and 2. making absolutely sure that lead foot is totally straight and not turning (this was a major thing for me; I didn't realize that each time I lunged my foot was a little crooked, thereby torquing the knee); step together to sort of reset between lunges instead of flowing directly into the next with no pause

2.) To open the hips -- leg swings.  One leg at a time, I swing 25 times front and back just letting it fly in a big movement.  Hold onto something at chest level with the hand of the non-swinging foot.  After doing that on both sides, face that fixed object and swing 25 times side to side, leg crossing in front of you, with each leg.

3.) Single leg squats on one leg.  Stand next to a wall for a balance spot in case you need it and come onto the leg closest to the wall while to other is off the floor in a comfy position.  On just the single leg, reach down for the floor in as much of a squatting motion as you can without pain.  Be VERY sure to keep that knee directly over the ankle which is not easy.  Kneecap pain sufferers have to avoid letting that knee push forward toward the toe.  Keeping balance the best you can, do 15 reaches for the ground coming all the way up in between.  Switch legs and flip around--you want the supporting leg closest to the wall; the idea is that if you lose your balance instead of dropping the non-working foot you can keep it in the air and use the wall thereby keeping that one glut activated.  Two sets on each side.

4.) 15 squats x 2 sets.  The key is to keep the feet wider than hip width, just by a little and again, KEEP those knees right over the ankle.  Don't let them travel forward.  Allow your chest to bend forward as much as you need to complete each motion and touch the floor.  It's tough at first to keep the knees from moving forward but you'll feel those gluts firing instead of making the quads/flexors be the primary movers.

I have more, PM if you'd like.  They are a little harder to explain but I'll do my best.  Good luck! 

It's baaaaaaaack.

Got sick right after initial diagnoses and was out of commission for 4 weeks. Got back to running in April and felt fine, little no knee pain. Figured all I needed was the rest. Slowly ramped back up and was feeling really good until the past few weeks. As my mileage has built with marathon training so has the pain.

Did I mention that I didn't do any of the PT? I am now, that's for sure. Taking a few days off, doing PT, ice, and back to the ortho. Am considering a cortisone injection to get through the marathon 11/17 then a retooling of my training over the winter. I think my lack of strength training since my shoulder injury is a major contributing factor so plan to get back to that (of course, I could have still been doing lower body...). The older I get the more I feel like I need a more wholistic fitness regime, plus maybe the longer distance stuff just isn't a goof lifestyle fit anymore. And here I was considering a push to KQ when I move up to 55-59 in 2015

One week without running and it still hurts under certain conditions, sometimes pretty severely. Walking down stairs can be rough, and sometimes just bending the knee after sitting still for a while.Tried running on a treadmill today with a nifty new knee brace as recommended by Socks. Walked for 1/2 mile, felt ok, ran for a mile, felt ok, started to feel pain in the next 1/2 mile so I decided to shut it down. Marathon is less than 3 weeks away and I am really conflicted about what to do.

There this Type A, get it done, overcome limitations, rah, rah, rah side of me that wants to soldier on. Then there's the more rational side of me that thinks it's better to identify root causes, embark on a solid recovery plan, and live to fight another day (and keep my knee intact). If an injection dulls the pain I could race, but the root cause is still there and I could maybe do more harm. I just hate having to DNS.... I've had way too many in the past year or so, ever since I crashed on my bike and broke my collar bone. Injury, sickness, car crash; all have led to a DNS and now I'm staring at another. I feel so mortal...

Dude....I'm no doctor, but your symptoms sound EXACTLY like mine.  I took the same attitude prior to IMLT.  I figured I was either going to line up or blow it out.....and I ended up sprawled out on the path I was running, and it took me an hour to do the mile back to my truck.  My money says torn meniscus......be careful....or not.

Dude....I'm no doctor, but your symptoms sound EXACTLY like mine.  I took the same attitude prior to IMLT.  I figured I was either going to line up or blow it out.....and I ended up sprawled out on the path I was running, and it took me an hour to do the mile back to my truck.  My money says torn meniscus......be careful....or not.

Yo LB, did you have to write it twice?? I've had a torn meniscus, I don't want another. Had x-rays and MRI in March when originally diagnosed so unless the tear is new or was too small to see back then and got worse I doubt that's what it is.