Runners knee rehab suggestions

Neil_D

Neil_D

Chapter Presidents
Aug 30, 2010
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Adelaide, South Australia
minimalistrunning.blogspot.com.au
#1
Dear Docs,
I have what has turned into a long term knee irritation which I believe is runners knee that I am hoping you can suggest some self treatment suggestions.
I am pretty sure it is not a cartilage issue as I don't get any pain when walking around except if I climb a steep hill.
I caused the problem by not resting an injury on the right knee. That was caused by a twist on a loose pavement stone while avoiding a pedestrian.
That injury healed after a month but in that time my running must have been favoring the injured knee and caused an injury in the left knee that I have not managed to shift for over 6 months.
The pain is towards the lower inside edge of the knee, if feels like a tendon issue and only hurts when I run.
The pain is usually most acute when starting the run, if I can can get past 1km then it starts to ease off but is still there. Going down a slope, or a sudden jar can cause it to start up.
I think it may be a imbalance in the quad muscle that is causing the knee cap to go off track. What suggestions would you have for self treatment. I find knowledge of how to fix an injury is better than paying to see a physio who can only do what I can do for myself.

Regards

Neil
 
#2
Hi Neil,

I am no doc, but I had a similar issue. For me, foam rolling the inner muscles of the leg (adductors, gracilis, semintendinosus and semimembranosus) solved the issue. I used a black roll, slowly rolling over the muscles, staying at points of hurts, and contracting/relaxing the muscle during the pressure of the roll. It took only 2-3 sessions to get completely rid of the pain, which would not respond to my usual routine of massage and stretching. I guess the trick was in the way how the foam rolling was done - stay 60-90 seconds on spots that hurt, gently contracting/relaxing the muscle some times during the pressure. Maybe you will want to inform yourself about how to work with foam rolling / black roll or similar.

From my reasoning, your injury is clearly muscular, as it gets better with activity, and reacts with cramping to sudden high loads. So any type of trigger point massage or foam rolling / myofascial release should help. The pain at the tendon insertion is just a symptom of an overloaded, cramped muscle.

www.triggerpoints.net has a good overview of the anatomy of your problem under "anteromedial knee pain", see http://www.triggerpoints.net/symptom/anteromedial-knee-pain .

Good luck,

Christian
 
#3
Hi Christian,
I had the foam roller working on my legs today. I did notice that the quad muscle on the outer side felt more painful than that on the other leg, it may be that it is a lot tighter.
I have been trying to get down to the gym a few times a week to do a variety of leg exercises, extensions, curls, lunges, etc then followed by the roller.
I'll give it a few weeks to see if I have an improvement. It is very frustrating when you have an imbalance issue and you can't pinpoint it. Running is my real passion and being injured for this length of time not good for confidence.

Regards

Neil
 
#4
Neil,

You certainly make it sound like a muscle imbalance but from where? If you want I can reach out and see what help is around you. From clinicians to trainers that use exercise and teach you to help yourself instead of depending on them.

Let me know or look for yourself. Rehab2performance.com
 
#5
Hello Mike,
I'm doing some exercises that were recommended for patella tendon soreness that consist of eccentric knee bends on a sloping surface so that your heels are higher than your toes. I can see why they do this as it takes the loading off the calves and throws it onto the quads.
So, you start off by putting your weight on the bad leg, lowering yourself down as slow as possible until the knee is at 90 degrees. Transfer they weight onto the good leg then push back up, then repeat. Wow did that make my quads sore, they must have been weaker than I thought.
I got on the roller a couple of days later and ouch, the muscles were tender. I've been doing them for around 8 days now and it's feeling stronger and slightly better.

Regards

Neil
 
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#6
Sounds good. Remember the body works as a whole, not in parts. Don't focus on one and forget to integrate the whole
 
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