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Knee Pain!?!
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Just wondering if any of you suffer from a similar problem?

I ran my last Oly Distance Tri last Sept., and experienced a dull ache on the outside of my right knee with about 5km left to go on the bike. Went through transition and the knee felt OK until about 3km into the run. The dull ache started to come back, and got progresssively worse. By the end of the run I was in alot of pain....but finished. :) The knee was sore for about a week. But....ever since then I cannot run more than 1/2hr or bike more than an hour berfore I feel the pain coming back. I saw a Doc in December about this. X-rays came back negative for any structural damage, and diagnosed it as a tight IT band. I have been stretching my IT band nearly every day since then, but it doesn't seem to be getting any better.

This is getting really frustrating.....
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Re: Knee Pain!?! [Krugsey] [ In reply to ]
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Uh ohhhh... Seriously. The X-rays don't shoe connective tissue very well but the alignment of the bones (or minor misalignment) can reveal a soft tissue problem to a trained and experienced eye. I am pleased to say I know nothing about this ITB syndrome thing- and hope I never learn. The right ortho guy can use the appropriate diagnostic tools to determine the correct course of therapy/treatment/surgery. One thing for sure- deal with it proactively. Don't just keep trying to run on it hoping it will cure itself. Make some calls, get some appointments, do the work. Don't push the injury in traing. Do the work to proactively get it treated and follow the treatment instructions.

Tom Demerly
The Tri Shop.com
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Re: Knee Pain!?! [Krugsey] [ In reply to ]
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May want to get a second opinion on the IT band diagnosis, try reading up on it on the internet and also looking for other problems associated with knees. If it is IT band, which it very well could be, you may have a muscle spasm. Go to www.julstro.com and look at their discussion forum, there are techniques you can use to work out the spasm. Stretching alone won't get rid of the spasm. You may also need physical therapy as well if you have developed some muscle imbalances, which are straining your knee alignment.

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"What the mind can conceive and believe, the mind and body can achieve; and those who stay will be champions."
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Re: Knee Pain!?! [jjmc27] [ In reply to ]
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Thanks for the advice...

Talked to my doc today, and he's going to get me an MRI appoint next week. Maybe then I'll have a better idea of what I'm up against for rehab.

One thing I did find on the net that have helped alot of people with knee problems are leg extensions & curls. This is something I'm going to add to my weight training program.
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Re: Knee Pain!?! [Krugsey] [ In reply to ]
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Krugsey wrote: One thing I did find on the net that have helped alot of people with knee problems are leg extensions and curls.

This makes me nervous. Your biomechanics are NOT best designed for extensors to do an isolated leg extension. Your leg is designed to use extensors when under the load of your body weight. Be VERY careful not to do too much weight on leg extensions...and don't straighten the knee all the way...leave maybe a 15 degree bend in it at the top of the lift. You can cause some nasty problems getting carried away with leg extensions.

Properly done lunges and squats are better...the flexors are helping to stabilize the knee while the extensors work...that's how the joint was designed to function the best. Unless you have a specific imbalance that needs to be corrected, use compound joints in compound motions, not isolated motions.

In rehab, light leg extensions are fine and dandy. Leg extensions have their place, but, it's a limited place.



Quid quid latine dictum sit altum videtur
(That which is said in Latin sounds profound)
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Re: Knee Pain!?! [Krugsey] [ In reply to ]
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I'm not a doctor, or physical therapist. My only experience with knee problems is from having them the last year from starting out too fast and hard in getting back in shape. I freaked out when I had pain in my knees thinking it was serious. Turns out it was ITB, which is pretty common and not much more than a real nusance. Anyways, I've read and been told by several physical therapists NOT to do leg extensions as this actually hurts the knees. I'm not sure who is right, but I thought you should know that there are conflicting viewpoints before you incorporate this into your rehab. Personally, I have been prescribed by my PT to do leg press. I do these twice a week, and I perform self massage on each leg with a tennis ball using the techniques from www.julstro .com, when I get a flare up.

The MRI is good, can't be too careful about your future.

Good luck getting healthy.

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"What the mind can conceive and believe, the mind and body can achieve; and those who stay will be champions."
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Re: Knee Pain!?! [Krugsey] [ In reply to ]
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Eeeek!!!

I just wanted also to advise against doing leg extensions and curls if you have knee problems! Not only are machine-assisted leg extensions a bad idea from anatomical/biomechanical perspective even if you have NO injuries, they are a horrid idea if you have an ITB problem! (or anything other knee pathology)

It is a good idea to strenghten your knee flexors and extensors though. However, Id recommend something that uses the entire lower-leg kinetic chain, foot, calf, quads, hamstrings, hip flexors, gluteal region etc. ITB problems arise from an imbalance between those muscle groups, IMO, and you can never achieve balance on a machine which more likely than not, will cause further biomechanical problems. Id recommend gentle low-weight free-weight squats, focusing on techinique, as well as calisthenic exercises-- pilates/core/yoga whathaveyou that work the hamstrings/calf/back muscle chain. (ie, superman type stuff).

Also, aside from stretching the ITB in isolation, what I find helps me the most when mine flares up, is focusing on regular, consistent and thorough stretching of all the muscles that act through the hip in any way: spine stabilizers, upper back, lower back, iliopsoas, all leg muscles. Working the small hip/glut muscles (piriformis gemelli etc) by loosening the hips with 'balletstyle' turnout exercises also really helped.

Oh, and reduce run mileage and check bike fit. Maybe you need a different angle on your cleats? worked for me...

Ziva
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