Runners Knee, but no injury. Is it really obvious?

Jan 26, 2012

• Luke Partridge asked The Guru for the following Physiotherapy Advice:

  Hi, I have been running 20-30 miles a week (around 5-8miles each session) for nearly 3 years. In mid-december i noticed a pain on my left knee, the morning after a run. the pain is not agonising and doesnt hurt to walk but it does feel 'weaker', like its more likely to twist or give way if i lost balance. the pain is on the inside of my left knee, below the kneecap. It is more painful if i move my left foot outwards from the knee away from my body (like the movement you do when doing breaststroke swimming). I stopped runing but after 4 weeks went for a steady 3-mile run to test it out, but it still hurts and its now been 6 weeks and doesn't appear to be improving. Any help would be greatly appreciated. Thanks!

• The Six Physio Guru responded:

  Hi Luke
  .
  Sounds like you've been doing a good distance, for a good amount of
  time. This therefore knocks out some of the obvious things such as
  training protocols and obvious dodgy techniques.
  .
  It could be one of two things. The first is a tracking issue with your
  kneecap. The pain you feel a day later maybe due to an irritation of
  the sub chondral bone behind the keecap, which takes a while to build
  up and feel rather than immediately (it's the cartilage behind the
  kneecap that gets bashed, but it has no blood or nerve supply hence no
  sensation - the bone does though, and sits below the cartilage).
  .
  The other maybe a grumbling medial meniscus (not the same as a torn
  mensicus), which has the same sub chondral bone issues - but is a
  repetative overloading.
  .
  The one things the two have in common are shoes. Are they broken? Worn
  too much? I think if you've rested and still feel the same, then look
  long and hard at the obvious. If you think your shoes are good, it
  maybe work a trip to see someone who can......