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Jan 11th, 2014
Becky asked The Guru for the following Physiotherapy Advice:
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 Guru Responded:
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
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
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…..
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