Hi,

Im just wondering if anyone can help me with some knee pain. Pain came on fairly suddenly and intesified over a couple of days. Walking is giving me problems, especially down stairs or downhill. The pain is on the lateral side of my knee. Even non-weight bearing things like straightening my leg are hurting. Any advice would be really appreciated.

Thanks

In case you need some acronyms:

R.I.C.E

Rest
Ice
Compression
Elevation

For me, I would take a couple days off of training, take a couple ibuprofen (assuming I'm not pregnant ;) ) and think about what could be causing the pain.

If I haven't changed my shoes in a while, I would go and get a new pair. If my training intensity is too high, I'd reduce it. And if my bike isn't fit right, I'd take it to a bike shop and get it fit to my body.

Then, once the pain had subsided, I'd go to the gym and do some leg-isolation exercises to strengthen the muscles supporting the knee. And I'd do that for as long as I needed to.

That's what I would do. :D


Good luck! and get feeling better!

If your knee injury pain is lateral (on the outside edge of a knee), then it's likely that you are suffering from one of the most common knee complaints - iliotibial band syndrome (ITBS). One on-line source says that about 60 percent of all runners are injured in an average year.
The role of the iliotibial band is to control side to side knee movement - about 90 times per minute per leg as you run and almost 22,000 times during a four-hour marathon! (Note: the ACL and PCL control forward and rearward knee movement). If you heard a "pop", experienced immediate pain, and or possibly subsequent swelling, then you probably experienced this "side of the knee" injury. (Happened to me once snow skiing).
Regarding the PAIN: Once it starts, the pain tends to be persistent if you keep going - and frequently gets worse during downhill running (and while walking down steps). It may subside after you stop running. You will have pain if you repeatedly straighten and then bend your leg due to the fact that the contact friction of this band will be quite painful if it is swollen and inflammed.
AS TraindeBrain said RICE is about all you can do, unless an xray shows that you actually
severed one of these bands and a repair surgery is necessary. I would have the knee looked at just to be safe, and do only swim workouts, with very light flutter-kicking for the next couple of weeks. Hope this helps. !

Here's another post on here with info about knee pain:
http://www.trifuel.com/forums/showthread.php?t=1123

Hey, to go along with that iliotibial band syndrome (ITBS) post by Thommy, if that is what it is. I read that it can be caused by running on uneven surfaces. I first experienced this when I decided a great place to run was down the median of the road because I didn't need to worry about traffic, then the pain started I got back onto a more even surface and poof before long pain was gone, and oh yea, stretch well too! :)

I am currently battling this as well (2nd time in two years). The prior advice to stay off it is very sound. It will only get worse if you keep at it. Get in a see a doctor - who will likely refer you to a physical therapist. Find a good one. It makes a huge difference. The first time I got this I was out for 2-3 months. This time, I think I will be out 2-3 weeks. In the mean time, you should be able to do some non-impact cross training once the inflammation has died down a bit. To speed that, do take an anti-inflammatory and perform a vigorous ice massage up and down the length of you ITB and a more gentle massage over the area that is in pain. I try to do 3 or more of these massages per day for 10 minutes each using a solid cup of ice (much better than a bag or ice pack). In the past, when I felt this coming on I have averted disaster by doing these ice massages. A regular sports massage is also very helpful, but not free. There are a number of good stretches that can help, but go easy. They can do more harm than good if you try too aggressively. Lastly, a foam roller can be very helpful. There are a couple of good sites with info on this condition.

http://www.nismat.org/ptcor/itb_stretch/index.html
http://www.csuchico.edu/phed/atc/Projects/ITband/ITBFS.html
http://www.time-to-run.com/injuries/thebig5/itb.htm
http://www.itbs.info/

Best of luck!

While we ae all talking knees has anyone ever gotten pain on the inside of your knees( like the inside hinge i guess the MCL)? I think i may have gotten over it althoug..., I was speaking to a exercise/sports physiologist and he said that it was probably caused by a muscle strength imbalance between my hamstrings, groin and thigh muscles. I have been strength training and stretching those muscles and so far haven't had a recurrence, but I fear that alot of it was from cycling. I am about to start getting back into cycling heavy soon! Anyone have any advice?

Thanks in advance,

Keep on tri-ing,
Eric

Does anyone have any idea what may have caused pain in the front on the knee, the tendon directly below the kneecap and slightly underneath it. Pain came on while doing a short run off the bike, after a long ride. I have been off for 3 weeks now and it is improving with RICE, but want to avoid a recurrance once I start training again ??

Pain on medial side of knee could be a tear to the MCL or it could be related to PFS. Cycling makes heavy use of the VMO muscle, which inserts on the medial side of the knee, so I would first investigate possible trigger points in that muscle (get the book "The Trigger Point Therapy Workbook" by Clare Davies for how to find/work trigger points. INVALUABLE book for anyone who works out a lot) before assuming it's the MCL. If it were your MCL your knee might either lock or buckle.

Pain under kneecap and below could be PFS or patellar tendonitis.

Lots of good websites accessible via Google to check which one it might be.

My Physio has identified it as Patella tendonitis, but is frustratingly vague on what might have caused it, or how to avoid it in future. Bike setup has been investgated and all seems fine.

Patellar tendonitis, PFS, ITBS, plantar fascitis are all symptoms of general "overuse" injuries. Overuse refers to overdoing something to the point where part of the body fails (becomes injured). Common causes:
- increasing volume too quickly for your current fitness level
- inadequate recovery time or nutrition
- increasing intensity too quickly for your current fitness level (intensity meaning either the HR or hill running or using too big a gear on the bike)
- biomechanical issues making you prone to the particular injury (i.e., you might need orthotics for running, your bike fit may be poor, or you have poor swim technique)
- worn out or inferior equipment (e.g., run shoes with too much mileage on them, a bike that needs tuning, running on cambered or tilted roads)
- poor flexibility/muscle imbalances

In some cases, it's possible to continue the training while addressing the underlying causal factors; in other cases not. For example, if your running shoes are worn out, and it's caught early enough, simply switching to a new pair might make whatever ache/pain you have disappear. When you have ITBS, though, you probably need to stop running at the point when you experience pain in order to prevent it from worsening.

The R.I.C.E. is used to address symptoms, not causes. So even if you have an overuse injury that you are able to get over with just R.I.C.E., it's always important to consider what may have caused it in the first place so that you don't have a recurrence. This is one reason why it's good to keep a training log...if you see that you nailed 2 really tough workouts in a row and then the next day you feel something not right, you are able to see what happened. IMHO, it's in determining the cause that the medical profession is of little to no help. Their concern is to make the pain go away, not necessarily to stop it from recurring. So know yourself, your body, and then it's OK to get medical help to alleviate symptoms, but it's your problem really to make sure it doesn't happen again.

Excellent - thanks for the info. Very helpful.

Now 3 months on from the original injury, the injury does not seem to have improved much. There is not longer pain, but what I can only describe as a continual 'discomfort' below the kneecap area. Recuperative measures to date have included protrated rest, as well as excercises to strengthen the VMO muscle, etc. Originally my physio proscribed that I do not do any exercise beyond the piont of any pain however later suggested that any pain might be as a result of scar tissue, and that exercising through an amount of pain might help break down the scar tissue. Has anybody heard of this before, and does it make sense to exercise through pain? How long can the effects of patellar tendonitis last?

Hey GC, This may sound like a stupid question but do you drink alot fo Soda pop? Cola and or carbonated drinks? Many different dialects in that, where I come from we call it POP!
Anyways, I have found a direct correlation with joint pain and the amount of soda i drink which changes like a roller coaster, anyways if so you might try giving it up or decreasing it, I know this isn't the cause but It could be prolonging the effect and or pain. Also I have tried Glucosamine Chondriotin (spelling?) mix and it seemed to help a bit!

Keep on tri-ing,
Eric

Thanks Eric. Have now been to see an orthopeadic surgeon, who has suggested that the damage to the knee, although an overuse injury is not in fact damage to the tendon but to the fat pad beneath the tendon. A shot of cortisone seems to have helped somewhat and unless further recovery takes place the knee will be in for an MRI scan to look for further damage and ways to resolve the issue. Finally feels like a step the right direction - lesson learned for me ... get a second opinion ... :)