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VLM just around the corner

Jan 10th, 2014

Hannah asked The Guru for the following Physiotherapy Advice:

I’m currently training for the London Marathon in 7 weeks time. I started training at the start of October, having not run much for the llast 3 years.

About 7 weeks ago I did 2 one hour tap classes having not tapped for about 6 years…Perhaps a foolish venture, but I didn’t expect it to have such an effect on my knee. It was aching, and as I ended up walking around a lot over the next day or so I wasn’t able to rest it. I strapped it up and stopped running for a week and a half. When I restarted my knee was ok, a little bit achy, but actually more comfortable running than everyday activities. After a half marathon training run it was a little sore again, so I iced it and wore the support again, but it seemed ok, so I continued with my training plan.Today I was out running a steady long run and felt great, when I reached 8.5 miles something happened in my knee and I had small fairly sharp pains which forced me to slow right down to a slow jog and head for home (2.5 miles away). The pain is located at the top of my knee cap towards the inside leg, as you look at the knee from the front it is in the top right quarter. It is slightly swollen and painful when bending the knee.

When I was a teenager I had a history of chondromalacia patella in both knees – perhaps related to growing pains.What do you think I might have done? I plan on seeing a physio asap (maybe tomorrow) but am really worried as I don’t want to have to drop out of the marathon at this point, tho I know I may need to reduce my training considerably…

The Guru Responded:

Hi Hannah

The body likes things just so, a bit like Goldilocks. Not too sweet, not too salty, but just right. The body doesn’t suddenly like doing something (tap) straight out of the blue. There is no time for adaptation and so it reacts. Most likely with swelling, which gives you knee pain – related to your kneecap.

In the meantime youve got the VLM to run, so continue with your training….and eventually your knee says enough. But all is not lost.

Going back 7 weeks or so, you’ll have adapted by slightly increasing the amount you pronate or letting you hip and knee roll in – loading up the back surface of your kneecap, where you had problem with your CMP (which I doubt you’ve got or had).

Make sure you see someone who can, and they need to have a good hard ,long look at your patella tracking, foot posture, hip and glut control – if they can do this trough gait annalysis, great. If they can tape your kneecap then they should.

I’d put running on hold until the pain settles, but I wouldn’t think about dropping out yet….

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