This almost sounds like what is sidelining me. In my case I am almost certain that it is ITBS - dull pain around hip (where IT starts) and sharp pain in certain area of knee where IT. I am headed for a second opinion Monday. The knee kills me too on the downhills, but uphills are fine. How is the area up around your hip of the leg effected?

Hmmm inside knee joint?

I had a case of pes anserine tendonitis that caused this for me last year.

Solved by deep massage/rolling with lacrosse ball up the inside of my thigh along the pes anserine tendon then strengthening it with some bizarre angle leg lifts

Just one possibility for you to google.

Good luck

Please answer these questions and i'll try to help you more!

• When did the pain start and how?
• How was your training leading up to injury?
• Did you change anything leading up to injury? Not only training wise.
• Please grab a pic from google and show us where the pain is.
• Can you do leg extensions? In other words, work the knee extension without hip extension.
• Are you tender on palpation? Any swelling, redness, hotness?
• What previous injuries have you had? How did you manage them?

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Endurance coach | Physiotherapist (primary care) | Bikefitter | Swede

I have got these exact same symptoms right now and also struggling for a diagnosis...

I got my injury 2 weeks before ironman new zealand. Stopped running before ironman new zealand. Raced without pain as long as i concentrated very hard on running gait. Knee locked in finish shute and then blew up like nothing else.

Had mri which shows structurally the knee is fine but swelling inside the knee with no explanation.

Now 6 weeks post race its still very tight and i cant ride or run. My pain now starts in my calf outside front of calf and radiates up into the front of my knee.

It wasnt this bad before the race so i wouldnt suggest trying a 42.2km run off a 180k ride to see how it feels...

I have mri results if anyone here can help let me know i can send them to you to look at. Im clutching at straws at the moment cause none of the people i am seeing seem to know what it might be and i am not getting relief from massage or needling.

I think whatever i am suffering from is the sameas the original poster so i really hope you guys can figure it out for both of us 😊

Ahh sorry I just re read and realised it said medial. My bad mine is outside of knee. Damn all your other symptoms match mine for when it comes on and movements you can do that do not stress it.

This doesn't sound like a "strength" issue in the traditional sense, but more controlled and coordinated motion.

Common for many during run stride is to transition from initial foot contact to midstance with increased speed at the knee joint (visually this can look like the affected leg "collapses"). In other words, if your right side is relaxing too soon in the gait cycle (many reasons this can occur), the knee may be in a precarious position when it should still be relatively stable.

The fact it increases during downhill movements is more in line with the above motion and inability to decelerate at initial contact.

Some basic parts of the run that can increase this are "crowned" run routes, sitting back in your stride, continuous hip flexion (common for many that believe they are "leaning" into their run- they only do it at the waist), and significant alterations to foot contact without changes to other joint kinematics. This last point is common for many who started trying to run with a midfoot strike 8-12mo prior and still land with a relatively straight knee.

On a side note- the barbell squat and DL's- stop them. The very nature of the movement done by many (which is debatable if right v. wrong) instills in people to "never put the knee past the toe." The reason they never hurt is because you're performing a movement pattern that doesn't get to the root cause and emphasizes using coordinated motion that has little transfer to the run. Although I am a fan of strength training for runners, it should also be complementary, and in your case squats and dl's are not.

Hate to say it, especially since it has become a "shin-splint" garbage term of late, but this might be as simple as right medius issue. Full range of motion lunges, eccentric single leg squats, and when safe running with the flow of traffic are your friends in this instance. Faster contact time can assist as well (note- this is not the same as steps/min).

Good luck- good news is that it sounds like you're catching this sooner than opposed to later.

Rob

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http://www.reathcon.com

Good question about the hip--my right hip joint has been curiously tight. I've been assuming they're somehow related but unsure

Yep, I'll give that a try. Thank you!

When did the pain start and how?
It first came on during a run last fall. I took a month off hoping it would go away but no luck.
How was your training leading up to injury?
Good
Did you change anything leading up to injury? Not only training wise.
One change: I work at a standing desk. Left heel pad grew thin, uncomfortable, causing asymmetrical lean into right hip until I noticed and started working in Altra sunning shoes
Please grab a pic from google and show us where the pain is.
Can you do leg extensions? In other words, work the knee extension without hip extension.
Yes absolutely
Are you tender on palpation? Any swelling, redness, hotness?
None of the above
What previous injuries have you had?
Patella femoral syndrome (yoga, strength training) Achilles tendonopathy (rest; eccentric raises) How did you manage them?

Hey thank you for this--it does sound relevant. I switched to forefoot stride about tenyears ago, then to a more mid foot strike maybe one year back. I've never had great core control and while coping with this injury I have noticed that if I make my ground strike quick and firm it is less likely to hurt. I've also noticed that deliberately activating glute medius seems to help. Question now is how to make that stable enough to train hard again

You have an injured knee and you are doing heavy squats?
Take a month or two off, see how it goes, let it heal. I know resting can be a difficult solution if you like and need to run. But its often the best one.
Also, what kind of surface are you running on? A sloped or unstable surface my affect this.
Another thing to consider is forefoot instability. Is your big toe shorter than your second toe? If so a little wedge under the first toe in the sockliner of your shoe might help.

Hi,

I'm having a similar issue as the OP that started last July. I think you're right about it being a lack of coordinated motion control, but I can't figure out how to get the muscles to fire when they need to. One PT said that my glute wasn't working and assigned exercises. I've been doing them, and I feel that I can engage the muscles when standing straight or isolating them in a fixed position, but not when running. I also feel that my front quad (rectus femoris?) kicks in and is overworked to compensate for the glute medius not working. My TFL used to kick in to compensate, but the exercises I've been doing have somehow stopped it.

Do you have any suggestions other than lunges and single leg squats? I've tried those, and they both aggravate the knee. Or, should I just push through the pain initially and stop only if it doesn't go away after n tries?

Thanks!

hmmm. maybe its some form of degeneration of the muscle... or something? You might find this helpful. I hope you get it sorted soon! All the best of luck!

So, I've been having this for a long time. Long story about when it started and why only recently did I get an MRI, etc. Suffice to say our last 1.5 years have been really busy. I had tried about everything, seen about everyone. All of the manual tests for knee issues (meniscus tests, ACL/PCL/MCL tests, etc.) were negative. So, since there was still pain that no one could solve, I went to get an MRI. It wasn't getting any worse, it just wasn't getting much better. It was annoying.

I've had an MRI and have a small meniscus tear (with no inflammation anywhere) in a completely different location. Three Docs have reviewed the MRI, done all of the manual tests (negative) and are all surprised there's an issue there. And, their advice was to keep doing what I'm doing to try to kick it. 1 PT, 1 chiro, 1 Orhtopedic Dr. who has moved away from some surgeries and more towards biologic treatments.

That's not to scare you, but it is a very brief history.

Google is not a diagnosis nor a doctor. You might look for saphenous nerve entrapment.I think that I had a pes anserine bursitis long ago, started compensating, and have the issue now. There have been some pretty good write ups about it.

The things that have worked best for me have been some nerve glide stretches, you'll find them if you find saphenous nerve. Dry needling helped. Chiro and ART also helped a bit. Again, I didn't really get on top of it for a really long time, so getting work on it early might kick it quicker. Those treatments have been more recent. I've also been doing some of the mobility suggestions that Kelly Starrett (Supple Leopard) has for hip/adductor/quads. Again, it has been a really really slow process, but it has been incrementally improving.

Also. As you mentioned, weights do not cause an issue for me. Traditional squats and deadlifts. But, I've stepped back from doing them. I've moved more towards (as previously suggested) some single leg exercises. I've been really focusing more on the movement aspect of things. Single leg squats with the back foot elevated seem to put the muscle/nerve in tension and that is the only way I've been able to duplicate the pain, but that seems to stretch and loosen things up. Really focusing on hip stability seems to help. A reverse step down and up also has really helped a bit. Again stable movement seems to help. Single leg squat down towards a pistol position (but not all the way). Exercises like that.

MRI sometimes stands for 'might result in injury' to be a cynic. In my case, it showed an issue that the Drs I've seen aren't keen on fixing right away. I'm pretty well retired, so I want to be active and fit. I ran 5 miles this AM for the 3rd run this week with no real issues. Again, not a Dr and not providing a diagnosis, but giving my experience.

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Brandon Marsh - Website | @BrandonMarshTX | RokaSports | 1stEndurance | ATC Bikeshop |

Hey Brandon, thank you so much for this. I appreciate it. Daunting, of course--all those years of multiple therapies. But it helps a lot to have ways of thinking about these things. I suspect that an MRI would go much the same way, for me: confirmation of some little tear somewhere, just because I've been living hard for a long time, negative for the condition in question. I say that because, as I said, I can do endless squats and lunges--and even rotational meniscus-tear tests--and feel no pain. And now I'm realizing that I have a whole suite of related/compensatory issues in that leg: tight hip-joint capsule, shortened hamstring, etc ... So it does seem like some movement/mobility disfunction that got hard-wired over too many years of neglect. Anyway, thanks.
LS