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Jan 12th, 2014
Sophie asked The Guru for the following Physiotherapy Advice:
I’ve been having some knee pain since i’ve been running more regularly and for longer distances in the last month or so. I went skiing for the first time a couple of years ago and first experienced this pain which is in my left knee. I might he twisted it slightly whilst skiing but I don’t remember anything specific. In the last couple of years it rarely bothers me except when i’m running lots or running long distances usually when training for a half marathons. I do lots of other cardio and have no problems with it.
It’s a twingy kind of pain in the left side of the knee and normnally starts about twenty minutes into the run and then is noticeably worse on downhills. Over the last couple of weeks its still been achy the next day, especially going down steps. I’ve had it very opccasionally before and it helps if I strap the knee but I can still feel it a bit. I’d normally just strap it but I am currently training for an intense half marathon in three months which will have lots in inclines/declines and steps so I want to try to take preventative measures to resolve the problem rather than just treating it when I feel it. I have no idea what it might be or how to help it other than maybe doing some muscle strengtbening exercises but I don’t know if that will help or not. It does feel better after a few days rest but I need to be training regularly without causing any damage.
Any advice greatly appreciated.
The Guru Responded:
Is that on the South Downs?
Good news is that if you can strap your knee and it helps then if you teach your muscles to improve the quality of their work you won’t need to tape it.
Strength has no part to play in this – but control of the strength is key.
It sounds as if this is an issue with the way your kneecap moves in front of your knee – it sits to the outside of your knee and doesn’t like moving to the inside.
To have adequate movement and control of that movement you need to have a stable and neutral lumbar spine. Gluts (med) especially that switch on and off when you tell ’em to (single knee squats, lunges with fantastic form and no cheating is foot points out, knee rolls in, opposite hip drops down). Good, controllable foot position (so trainers are super important).
You knee is the victim of what doesn’t (but should) happen above or below it.
Foam rolling your ITB before and after running will be super sore BUT should really help your knee pain.
Thanks for your reply, it was very helpful. It’s not South Downs half I’m doing but the Great Wall of China half, so I need to do lots of hill training!
I have a couple more questions I was hoping you could answer.
What’s ITB? Also, is it worth seeing a physio to check my running shoes/style and see if there’s anything wrong there?
The Guru Replied:
ITB = iliotibial band. It runs down the outside of your thigh. Every runner should have a foam roller to roll away bumps ands nibbles.
I thinking seeing a Physio would be a great idea – this shouldn’t be a big issue.
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