Knee Issue

I'm right with you.  Last month I started to get a pain on the outer, lower knee after running for a while.  Feels like someone stuck a knife there.  Started at mile marker 4 but now it starts at mile 2.  If I stop runnign it goes away.  From everything I have been reading it is IT Band Syndrome.  Look at the main site here and there is a pretty good article on injuries and it covers ITBS with some stretches to use.  Good luck.  After a month I think it is time I see the doc.  It really put a cramp in trying to improve my running thtis off season.  Plus, now I will not sign up for IM Florida 2005 tomorrow and will hope to get over this and sign up for IM Arizona 2006.

http://www.beginnertriathlete.com/cms/article-detail.asp?articleid=316

Edited by PGoldberger 2004-11-06 8:15 PM

When you say you upped your mileage, how much are you talking? The reason I ask is that I think I also have been struggling with ITBS, and I'm sure it was from going from essentially no running to diving into a marathon training program at the beginning of August and within a few weeks going from 6 to 12 to 16 to 20 miles as long runs. At the end of the 20 miler, I noticed the same kind of pain that you describe, but it didn't bother me any other times except some tightness/slight pain if lying on my left side and moving my right leg. I took a day off, then did an easy 4 miles two days later, with only a little tightness during the run. I went out for 5 miles the next morning, and it actually hurt, but I finished the run. At this point I was 2 1/2 weeks away from the marathon, and essentially did nothing more than a 3-4 miler every few days, with about five days of rest before the marathon.

The first few miles of the marathon were fine, but by mile 4 it was getting tight, and by mile 10 it was definitely hurting. I managed to finish, but walked about half of the time during the last 6 miles. By that night I could not extend my leg without major pain on the outside of the knee, plus I was hearing various strange noises coming from that area. Still no major heat though, and no swelling.

It has now been three weeks since the marathon. It was about five days before I could walk normally. I ran about five miles on a treadmill a week ago, and it was still tight. I ran 1 mile last night, with some tightness, but no pain, so I am hopeful. I am going to very gradually build back up, mainly running on the treadmill (since everything I have read says that hills definitely make it worse, and hills are all I've got around here).

All that to say that it sounds like you are dealing with a similar problem. From what I've been told (and what I learned), you can't run through it, and you need to do some rest, with gradual buildup and stretching. The shoes could be a problem as well. Also consider what kind of surfaces you've been running on (most of the roads where I was training have a very steep camber at the edge, and are very hilly to boot). Very frustrating, but, at least for me, I've been able to swim and do some spinning in the meantime. Good luck!

-Rob

I had problems with ITBS and found stretching, a new pair of shoes and also what really seemed to clear it up was arch support inserts, I have been considering going to a pediotrist but the cheap inserts that I used seemed to work

Sounds like the right spot for IT band problems, but the "clicking" concerns me a bit.  Try the new shoe idea, stretch the IT band after running, and if you aren't getting better, get it checked out.  Sometimes clicking/popping can be a bigger problem, like a meniscus issue.  Hopefully not though!

What if, instead of being on the outside of the knee, the soreness is on the inside (side) of the knee, right above where that big tendon connects to the lower portion of the knee joint?

If the pain is consistently there after running for 1/2 hr or so but not before and seems to recover by the next day. It is highly likely that a strength/balance training program combined with increasing your flexibility/stretching will take care of the problem.
A paraphrase for what I believe what is happening is that when you start running and your muscles are fresh no problems but somewhere one of your supporting muscles is compensating for other tight muscles or bad form and as those supporting muscles get tired things start not lining up...pain begins to insue.
Good luck

Thanks everybody! I really do not think I have the IT band problem but am going to have a running specialist Dr. look at it this afternoon. I will keep everyone updated.
Rob, my mileage increase was NOWHERE near yours. The most I have run at once so far is 8 miles and that was a trail run. At that time I was 15-18 miles per week. However, I was getting ready for a 10K when I did that and the 10K was very hilly. If you search the site there are some articles and threads where folks have had problems after hilly races. I have noticed it since the race but also during the 8 mile practice run. After years of weights I dropped that totally for tri's and probably do have some over-compensation in my legs as well as a slightly shorter left leg (makes a slight pigeon toed). Once again, THANK YOU to everyone. You guys make this site excellent.

Fred

Doctor Update:

After meeting with a sports Doctor yesterday afternnon it appears the prize for correct diagnosis goes to pjsuperhawk. She said it could and probably is some form of IT band issue but is not severe for me. I do not have the "knife in the knee" pain . I also do not have the pain after running or any swelling or discomfort later. She showed me some good exercises and IT band stretches to start using and said keep the runs to 30 minutes or below for a while. One thing to point out - I did not have the problem until my tri season was over and had all but stoppped riding my bike. I immediately uppped the run mileage to get ready for a 10K race. The doctor said the bike was helping to keep my legs in balance with the quad workout. Something to think about.

Fred

Karl (Motivated), sounds like we need to chat.

All- My knee pain is just below the knee cap and I believe it's "jumper's knee" or patellar tendonitis. Anyone haveexperience with this one? It hurts mostly when I am sitting or not active for a while and I can 'pop' it a lot. Good during the run or when its warmed up but painful during long rides. It actually causes me to kick my leg out during the swim too.

Any advise with the patella tendon?

Tony

pjsuperhawk,

this interest me as this is the same pain I have it starts to hurt in runs that last about an hour or more within a half hour of stopping its a very sharp pain that lasts up to a day later and then subsides just long enough for me to hit another long run in my schedule. The pain started about two weeks ago. However I'm in the MS phase of strength training that I've been in for about 3 weeks and I've been getting pretty good balanced leg workouts doing quads and hamstrings and very little lower legs. I bought new shoes (same as my old ones that I had about 500 miles on) and did my last run 30 mins on a treadmill to limit the impact and didnt have any pain today but this was a relatively light run in which any suggestion of discomfort and I started walking. Im trigger shy to up the pace. Any suggestions for stretches other strength exercises etc would be really handy as Im in Base phase and this is killing my run workouts its stressing me out.

In my research on ITBS, I read that most sufferers of ITBS have weak abductor muscles (outer thigh/hip/butt cheek).  Neither biking nor running really exercise these muscles.  So, if you're at the gym, hit the inside/outside thigh machine.  Otherwise, incorporate leg lifts.  Hit the inner thigh (adductor) too in the interest of balance. 

From http://www.physsportsmed.com/issues/2000/02_00/fredericson.htm:
Hip abductor weakness. Researchers at our institution (14) recently compared 24 distance runners (14 women, 10 men) who had ITBS with noninjured controls and found that runners with ITBS had significant weakness in the hip abductors of their affected limb. After 6 weeks of rehabilitation directed at strengthening the gluteus medius, 92% of the runners were pain free.

Edited by Whit 2004-12-02 9:16 AM

Update: My Dr said I have patellar tendonitis and possibly chondromalacia. The pain is just below the knee cap and is worse when I sit for an extended period. My knee cap still 'pops' very frequently too.

NO running but can do light cycling. He prescribed leg extensions with light weights, leg lifts, and a few other minimal impact exercises. I will be starting over next year with my training it seems...................

Tony

Everything you have stated is just as if I wrote it my self. I have been fairly pain free all year until a 8.5 trail run I did last September that had hills beyond what a sane person should run. Feeling that I just came off of 4 tris and a few 10 mile and 1/2 marathon runs I thought this run would be a breeze. About 7 miles into the run my knee started to feel a bit stiff and sore. I finished the race but couldn't bend it at all later that night and into the next day.

Anyway, I saw a doc and he said my knee is fine and it is probably due to overuse. Overuse? I've been training for a long time with proper build up and periodization. I have shoes that are in shape, foot orthotics, and I wasn't really pushing myself. What I concluded was a mixture of two things happened. I finished my tri season about a month prior to the trail run and I haven't focused on hills at all this summer. I think the biking and swimming kept my knee in check and balanced out my running and once I took a break from those two my knee didn't have the strength to support the ITB issue. And hills just suck!!!!
Long story short - Good shoes are critical! Replace them just before you think they need to be - trust me. Finally, strength train your legs but avoid heavy weights. Bodyweight exercises are key.
Hope this helps as your comment about biking and helping your knees help me think this is what happened to me.

tri-wolf, so how long did you take off from running? I am nervous b/c I took 6 weeks off from all 3 sports and started doing light running/cycling a few weeks ago and it has not improved. I will continue strenght training but probably not run for a while. I can deal with pain but this is crazy. Maybe I need more time off?

Thanks,

Tony

I actually just started running again a couple of weeks ago. I ran a small local 5K and it was pretty much pain free. The big mistake I made was running as part of a relay team in a marathon right after I first injured my knee. I felt preasured to run and I kept a strong pace over 7 miles. My knee about buckled a few times and I could hardly walk for about a week without pain. So whatever you do don't rush yourself.

I have taken it very slow in returning to the run and besides this is the off season! I didn't run at all for a month. Don't laugh, but I also have been cross training with more of a race walk. I have found that my knee doesn't bother me at all and it is really a challenge. My knee feels stronger with the increased strength I'm getting not only in my quads but my shins as well. I'm being very careful because everything I've read and have been told is that an ITB injury is very difficult to heal if you don't take your time. I can now run at a pretty good pace and as soon as I feel tight I shut it down, stretch and Ice. Each time I run, I find that I can go a bit further and come January I'm going to try to increase my mileage following the 10% rule.

Tribesman,
I just read an earlier posting from you where your doctor prescribed light exercises including squats. Be careful pushing/throwing weights around. If you want a great lower body weight exercise in squats do a search on Hindu Squats. I've done a lot of research on these and they are controversial but I actually feel a lot stronger as a result of these. I also believe that mixed with my walking program it has helped my knee get closer to running form. Just a thought for ya.

Hi Tony... I'm sorry to hear this... with any tendonitis, rest usually is a good cure. Not what any of us wants to hear. Once you're better, have someone check out your mechanics while riding and running.... it could be that you may be favoring something more thus increasing an overuse injury such as tendonitis.

Also, I would have a second opinion on your chondromalacia diagnosis... 1). this is not something that should be guessed on [too serious of a diagnosis]... and 2) I've been told by my med friends that this is a popular 'diagnosis' when DR's really don't know what the root of the problem is.

Good luck with this and keep us posted on the progress.

-Milly

Milly,

Thanks for the message. I am considering seeing another Orthopaedic Surgeon as I kinda feel like he blew me off. He gave me a couple of shots and some exercises and said see you in 6 weeks. He did order an MRI but did not see much he said.

I am nervous b/c I took 6 weeks off from training and it did not feel better. Now that I am doing light stationary cycling, leg exercises, and fast walking, it seems to feel a little better.

Thanks again,
Tony