Knee issues

[CelticCat]

I am 35 years old (female) and have been running seriously for the last 10 years. Last year I trained for and ran a half marathon (my second one) in May. Just before the race, I began to have some pain in my right knee. I ran anyway and the pain got worse. I went to my family doctor and she sent me for X-Rays. The result was that I had bursitis, but they didn't see anything else. I was told to take it easy and stop running. I did that for the summer, but the ache in my knee did not subside. I went and got orthopedic inserts for my shoes. I then went back to my doctor and she suggested I try a chiropractor and a physiotherapist. The chiropractor examined me and told me my problems were runners' knee and a tight IT band. She used the active release technique on me for 2 months. I didn't feel any better so I decided to try the physiotherapist. He gave me a few stretches to do and thought acupuncture would help. I tired that for two months and still things were not better.

The pain is all around my kneecap- it aches all of the time. The skin feels bruised. I get sharp pains under my knee cap and on each side 9all the way around). My IT band is still tender to the touch. I have been doing the exercises that I was given, as well as trying to do short (20 min) walks on a treadmill. I have always been an active person and not being able to be active is really getting to me. My knee creeks when it is bent- if you put your hand on it you can feel it. I try to ice my knee after activity. Even walking around the city for part of a day last week had my knee aching and feeling weak.

I am going back to my family doctor tomorrow to see what can be done. Any suggestions as to what tests might determine what can be done, specialists to request to see or any advice??

[Heidi]

Hi
It sounds to ma like a combination of two conditions which are both sometimes referred to as runners knee - patellofemoral pain and IT band syndrome.
http://www.sportsinjuryclinic.net/cybertherapist/front/knee/patellofemoral_pain_syndrome.php
http://www.sportsinjuryclinic.net/cybertherapist/front/knee/irunnersknee.html
Check out both of these pages.

You sau you have tried stretches, orthotics, acupuncture and active release techniques, but no mention of any strengthening work?

Both of these conditions can be caused at least in part by weak outer hip muscles and a tight ITB and other lateral structures. If the outer hip muscles are weak, this causes the knee to fall inwards on walking and running which can cause problems with the tracking of the patella and cause the creaking you describe.

I would recommend you get a full biomechanical assessment to determine if this, or anything else, is contributing to your problem. A podiatrist is the best person to see for this. Correct of any biomechanical factors alongside the therapeutic treatments you have recieved should be effective.