Front of knee pain

[albarker]

Hi all

I'm new to this board and hope someone can give me some advice on what my knee problem is and the best ways to treat it. Bear with me on the detail

Until June this year I would class myself as a intermediate runner. For the last 5/6 years I have normally run 6k-12k a week in 2/3 runs and occasionally taken part in 10k races (circa 50mins). However since leaving work in April in the period until June I was running about 30k-40k a week. This might sound like a big uplift but ive had injuries in the past and think I know when my body is telling me "enough" and compensated my running style for any little niggles I had. Up until the time of my injury all was ok.

Then..... one day I decided to stretch prior to the run.... not something I normally do, and amongst other things I pulled each leg back so my foot touched my buttocks, then went for a run. After the run of 45 mins the front of my right knee started just below the cap to ache and this got worse over the next few days to the extent it hurt every time I bent my knee over a certain angle/ kneeled/ walked stairs/ etc. This has persisted but has gradually improved over time to the extent that now I can run gently (not bending my right knee too much) for up to 45mins but can still feel minor knee pain. Walking is fine too. I can only feel discernable pain when I bend my knee too much.

Now I have a theory as to how it was caused. Regularly when I am in a seated position at a desk my right leg is in a normal position but then I place my left leg underneath it horizontally so that my left ankle sits under the right knee. This will be stretching the knee cartlidge. However I never do it in the opposite way (bending my right knee) as it feels unbalanced and lopsided so my right knee is never getting stretched in the same way. When I did the stretching exercises I must have pulled something in my right knee; the ACL?

Has anyone any ideas of what it could be? and how best to treat it? I did not run for 4/5 months at all while I gave it time to recover and although it is improving it is a long process.

The doctor suggested it could be due to weak knee muscles but I have discounted this. My legs are very strong after years of running and having to carry around my 85kilo/ 190lb weight.

Any views/ advice much appreciated.

[Heidi]

Hi

Thanks for your post.

I'm afraid I don't completely agree with everything you have said. Sitting in the position you describe would not stretch the cartilage. Cartilage doesn't stretch - which is why tears are so common. I also think an ACL injury is unlikely from how the pain started. Usually with an ACL injury (even just a strain rather than a rupture) there would be a sudden point of pain where you twisted your knee or something. They don't tend to come on after activity and the pain tends to feel like its either deep in the joint, or all around it.

My personal feeling is that it is more likely to be a patella tendon problem:
http://www.sportsinjuryclinic.net/cybertherapist/front/knee/indexjumpersknee.html

Although it may not be a typical 'jumpers knee', the symptoms you describe of pain on stairs and when bending your knee fully fit in, and of course also where the pain is.

Patella tendon injuries can be caused by a number of things and to make it fully go away you would need to discover what caused yours....
Muscle imbalances can definately be a cause and I'm guessing that's what your Doctor was getting at.

[My Aching Knee]

I agree with Heidi it does not sound like a ligament problem and she is right cartilage does not stretch. You probably are suffering from patellofemoral dysfunction (sometimes called runner's knee). It is when your patella does not track correctly in the trochlear grove of your knee. If you run I agree it probably is not a strength issue, but may be a muscle imbalance. There are a number of factors that can lead to your patella maltracking. A website of interest for you to look at is www.myachingknee.com. You need to find a treatment method that will align your patella back in the grove, along with physical therapy to address the cause of why the patella is not tracking correctly.