You don't kneed this

Jun 11, 2012

• Becky asked The Guru for the following Physiotherapy Advice:

  Hi there,
  
  I ran my first marathon two months ago and have had knee discomfort from two days after the run. The soreness was quite painful for the first few days, so I rested and applied deep heat etc. Since then I have been left with slight soreness when I press on the top inside of the knee, just as it meet the thigh and often a noticeable dull ache when I walk. I am concentrating on strengthening excerises in the gym as I know I have weak hips and glutes (have suffered shin splints in the past because of that) and have been able to workout fine with no pain on the knee. It's really day to day life when I feel it - especially when I first wake up each morning, it becomes very stiff and uncomfortable.
  
  I have decided not to run until it feels ok again - would love to hear your thoughts!
  
  

• The Six Physio Guru responded:

  Hi Becky
  .
  Muchos congrats on running your first marathon - what you're
  complaining of is far more common than you think...
  .
  As you know that you've already got poor(ish) gluts (in control, not
  strength) you'll also have less control of how much your thigh rolls
  in. When you run 26m every step you thigh and foot will roll in. Your
  knee is the victim in the middle.
  .
  Your kneecap sits in front of your thigh, and when you bend or
  straighten your knee is sits in a groove (on the front of your thigh)
  and tracks. If you've lost control of how much your thigh and foot
  roll in, then your ITB will pull your kneecap to the outside of the
  groove.....
  .
  Here lies the problem. You will have massively overloaded the under
  surface of your kneecap. Until you can get the load off, it's a bit
  like kicking a bruise.
  .
  I wouldn't run, I wouldn't do anything that aggravates your pain . I'd
  concentrate on rolling your ITB and doing stability NOT strength work
  for your glut med and tib post (balance, SKS etc). Go for form and
  control.
  .
  If you were to see a physio you'd need your patella mobilised and
  taped, to decrease the pain - even showing you how to do it.
  .
  This is really pain, no gain.....
  
  
  

2 Comments

• Becky Responded:

  Jun 14, 2012

  Many thanks - what specific exercises would you recommend? By the way, the soreness is on the inside of my knee and that knee does roll in when I walk and run.

• The Six Physio Guru Responded:

  Jun 14, 2012

  The soreness on the inside is the retinacular tissue being stretched because your kneecap is being pulled towards the outside of your leg.
  .
  Specificity is all in the doing - and not the explaining....it's very tricky to describe what needs to be done properly, that'll make a true change rather than just doing some form of exercise that resembles specific rehab....
  .
  You need to feel the burn in your bum, glut med to be more specific (at the top of your butt) in lunging, squatting and any functional, weightbearing activity. Your tib post needs to control your foot function and allow your push off to be more stable and prevent the dreaded rolling in of your foot and knee.
  .
  Use mirrors, bare foot and controlled.