Member Case Study: Patello-Femoral Pain

author : AMSSM

comments : 0

It sounds like you have a very common condition that many runners and triathletes experience called patello-femoral pain syndrome. We have seen that runners with core weakness experience this.

Question from ryancrook

I've been having problems with my knees lately. It's never the same one, either. Last night I ran on the treadmill at 5.5mph for a half hour and towards the end I felt a sharp pain on the lower front part of my kneecap. This happened before a week ago to my right knee (which didn't bother me last night). I don't believe I'm overexerting myself and I'm not sure what I did to it or what I can do to prevent this from happening again. I'm training for a HIM in July and I have plenty of wind in me but my knees start to hurt when I go longer distances.

Answer from Margarita Sevilla, MD

Member AMSSM

Dear Ryan,
First of all congratulations in attempting a half ironman this summer, that is quite an accomplishment. Regarding your knee pain; it sounds like you have a very common
condition that many runners and triathletes experience called patello-femoral pain syndrome. In the past, we used to blame the alignment on the knee cap, or our lack of quadriceps strength. Now, we have seen that runners with core weakness experience this more often. You might say, "but I lift 2-3 times a week, how can I be weak?" Well these muscles need very specific exercises that we don't usually trigger when doing the usual lifting. The main muscles of the core are hip, glutes and certain abdominal muscles. If you start doing a routine triggering these muscles, you will see that the knee pain that you are experiencing is going to decrease a lot.

The other advantage of doing triathlons is that you are always cross-training, so this should also take away some of the pressure on your knees. Even though you have only had the pain while running, I would have your bike fitted again. Our body changes with training and sometimes if the seat is too low or the cleat alignment is not right you can experience knee pain.

To deal with the pain I would ice for 15 min before and then 15 min after your runs or bikes. If right now the pain is too much to run, do some water running or more swimming until the pain is tolerable to train. It will take at least 4-6 weeks to notice a difference, once you start your core strengthening.
Best of luck with your HIM training,

Margarita Sevilla, MD

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date: March 17, 2008