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

Jan 10th, 2014

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 Guru Responded:

Hi Luke
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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.
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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).
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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
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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 [sports physios] who can……

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