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I have a friend who has an upper inner knee pain. It hurts when she pulls up while riding and when she lands on the balls of her feet while running. It doesn't hurt if she lands on her heels and then rolls to her toes while running.
If you're looking at your own knee from a sitting position, it is the left knee, on the inside part just outside of the knee cap. If the knee cap was a clock, and 12 was at the very bottom (again looking from a seated position), it hurts at about 4:30-5:00.
If you have any help, I'll pass it on.
if the pain is in the cap at all....i say chondramalacia(sp) softening of the bone....its an overuse injury that only rest can cure...if its not the bone, perhaps the cap isnt tracking properly from a muscle imbalance. My two cents, see ya at white lake.
First off, an internet forum is not your best bet on knee pain advice. Get it professionally diagnosed by a therapist/ortho who is an athlete and knows running and cycling. Depending on where you live that may be a project to find.
HAving said that, has there been a big "ramp up" in mileage over the last four weeks? WE are getting into "knee pain" season right now, when everybody starts hittng it really hard and their body starts complaining.
The Tri Shop.com
My internet guessnosis would be chondramalacia patella. This is more commonly seen in females because of a bigger Q angle. By that I mean an angle drawn from hip-knee-ankle. It's larger in females because of a wider pelvis.
I've treated a number of these cases and have also sometimes found pelvic unlevelling, short leg and/or dropped foot arch on one side.
There are a number of different approaches but I've found that electrotherapy on the knee for a few visits with perscription orthotics works in many cases.
I'll put in an unashamed plug for my occupation and suggest that she finds a chiropractor familiar with running problems.
From the inside location I would guess either a problem with synovial plica, or there is a medial tendon (in around 70% of the population) - which I can't remember the name of - that causes pain at a very specific point on the upper inside edge of the kneecap.
pronation, supination problems should be ruled out for most any knee problem. For the medial tendon one odd cause I remember from Andy Pruitt's book was tight ITB. And generally strengthening the VMO to stabilize the patella is always a good idea.
i've a similar thing with my right knee; although the symptoms are somewhat similar to CP, it's not quite that advanced and doesn't involve tendon-cap grating... yet!
keeping knees and joints warm helps tremendously. stretching the back of the knee helps too. remembering not to sit in an office chair with one leg folded under my bum is also very very important!
on the bike, try to use a narrow Q-factor crank - i'm particularly sensitive to that. I use a Q of 140mm, any more than that and it's bad. (even 5mm is noticeable). If your friend's legs aren't that long, could be even more noticeable, although women tend to have wider hips and can typically tolerate wider Q's than men. I can't ride anything wider than 145 without pain, and also pay attention to cleat position and type of pedals.
also look into different running shoes. I have some New Balances with a kind of roll-bar close to the heel, which effected the type of heel-to-forefoot roll while running that you talk about.
finally, shape of the foot-bed can make a huge difference. many people say that proper orthotics saved their knees and running/cycling careers, in the case of some pros. highly recommend looking into professional help on that bit, maybe starting with Petersen PowerBed soles (<$30 and they mold to your feet with use); i use Carnac insoles in my cycling shoes and sometimes other athletic shoes - it helps with pronation and arch support.
try searching "knee pain" on the following website:
her problem could be muscle-related and could be treated w/ a tennis ball.
btw, i'd strongly recommend the _pain free triathlete_book on the julstro website; it's "cured" a lot of running and swimming injuries that i've had.