1st, can anyone recommend a good orthopaedic doctor who specialises in knees, preferably with a sport knowledge, in NYC or northern NJ?
2nd, anyone have any clues what this pain is caused by and how to fix it…
I’m currently marathon training, about 45-50 miles per week. Began to get some mild tightness and and knee pain in the side of my knee, towards the back of the joint when running. The exact location is just behind the point on the side of the knee you would point to if pointing at the pivot point of the joint. The pain begins to come after a few miles, and is pretty painful by the time I get 6-8 miles into a run. It is fine when I walk, even a few minutes after stopping running. I have been foam rollering my ITB regularly, thinking maybe it is tight, but a therapist said it’s not tight.
I assume it’s some kind of over-use injury or inflammation. It doesn’t seem to be anything that has ‘snapped’ because it’s not painful when walking or when I begin my runs. My plan is to take 5 days off and do water running over that time to try to maintain fitness, but if that doesn’t help I will go to a knee specialist. Marathon is in 2 months and I’m shooting for an aggressive time (for me), so I need to get this sorted asap!
Dr. Sergai Delamora
159 East 74th Street
2nd Floor
New York, New York 10021
Location Phone: (212) 737-3301
Additional Location Phone: Billing: (646) 619-8950
Location Fax: (212) 439-1695
He is an Ironman and knows how to get his athletes back in action.
I had Dr Scuderi at the ISK Institute (in Lennox Hill hospital…really good place). He did my ACL reconstruction and I was back playing football/soccer by 5.5 months (don’t tell him) and skiing off cliffs again (how I did it in the first place) by 9 months with no braces or anything. I also did my first race (duathlon) at 10 weeks and placed and tri at 12 weeks. The dude specialises in sports knee injuries and is a super chill dude, easy to talk to…i.e. he listens (he wanted to do a patellar autograft, I wanted an Achilles allograft. After discussing it, we went with the allograft). My knee is 100% perfect now, full range of motion and strength and no stiffness, etc, after exercise. He has all those awards as well (America’s top 10 Superdoctors, etc…they have their plaques outside their secretaries cubicles at the ISK).
I think pretty much anyone at the ISK or Hospital for Special Surgery will be fine. Just make sure they are sports injury specialists (there’s a lot at both). My insurance didn’t cover the couple of docs my friends have used at HSS, but my surgery went as well if not better at the ISK in terms of my recovery (of course that’s a personal variable as well). Also, Dr Scott is at ISK and he was the Dream Team doc and a whole host of other pro teams (e.g. Knicks for 27 years).
Dr Anthony Milea
Village Sports Medicine
212-675-5814
229 West 11th
I have been to Dr Milea for various ailments and injuries over the years including twice for knees. He has been great at explaining the problems and seems to view surgery as a last resort. Last year I went in with runner’s knee two weeks out from my A race, and he got the fact that skipping the race was not an option. With some rehab/PT I made it through the race and was ok by the end of the season.
based off of the limited information and just because it is fun to guess. I would go with Lateral Meniscus tear vs ITB leaning more towards early stage IT band. IT band is not truly a friction syndrome as some basic informational article will promote. Some higher level studies show it as a compression syndrome with compression and inflammation of the fat pad in that lateral area of the knee with some superficial nerve involvement.
Thks for the speculation. But wouldn’t a tear hurt when I walk or begin running? So if it’s IT band am I treating it the right way? Ice only? Ice and heat alternating? Massage in the inflammed spot or might that aggravate it? I’m in Cozumel this week so can’t get to a DR or PT earlier and hence need to self-treat for now.
If you have a meniscus tear it won’t neccesarily hurt all the time, but certain things may aggravate it. (For me sometimes groin stretches and some yoga poses cause it to flare up.)
I’m not sure if I missed it in the original post, but is the pain in the inner our outer portion of your knee? If it’s the inner, I’d say meniscus, if it’s the outer, ITB.
In my experience, for a meniscus problem, if the tear is mild, a period of rest and ice should help. After that, I found that a shorter stride helped (and as stated above, avoiding things like deep lunges.) It still hurts occasionally but I was told that I wasn’t going to cause more damage by running on it.
If it is the ITB, the foam roller is part of the solution, but stretching quads, hip flexors and hamstrings will help too.
I started having IT band issues after stopped cycling in September and ramped up my running mileage, probably too quickly. I noticed my glute on that side was more sore then usual and probably had weakened some after not cycling for a while. I started this routine every few days and have seen improvement in very short period of time. Ran 21 miles on Sunday and while IT band ached some by the end, it wasn’t bad.
Thanks - those routines look helpful. I was diagnosed yesterday with IT band inflammation and will have my fisrt PT appointment tomorrow. Will look to incorporate these strength exercises into my week around the PT sessions.
I am in the same boat as you. Moved from tri training to marathon training in Sept and ramped up the running volume from 15-25mpw gradually to 45-50mpw. But I was also playing with the kids in the park alot at weekends and I think this may have been the key factor.
My question would be how long did it take before you could run pain free again? I rested for a week 2 weeks ago and then tried to run gently. After 3 miles the discomfort came back, so I rested another 3 days. Then I could run a gentle 5 miles before I began to feel discomfort. I rode 90 mins Sunday on the trainer and felt no discomfort, but then when I tried to run Monday the pain started even quicker (after 2.5m). I always stop at the first sign of discomfort. The guy in the article/video talks about not being able to run for 6 months. I really hope it wont take this long for me to rehab and I was thinking more like a few weeks. So I would be interested in your experience here, and anyone elses - how long was your complete rehab process for IT band inflammation?
I haven’t really taken any time off as I’m headed into a marathon this weekend. I wasn’t really having issues until I hit around the 8 mile mark. So by adding this routine a couple times per week and a yoga routine that focused a lot on hips/glutes I managed it.
The discomfort hasn’t totally gone away and probably won’t until after this weekend and I take a few weeks off. Right now it’s more of a dull ache when it flares up and no longer shooting pain. I can now actually run through it to some extent, sort of like a mild cramp that you work through while still running. Probably means I wasn’t as extreme as some folks when this happens.
OK that’s good to know - thks. I only got to the sharp, shooting pain in the side of the outside of my knee once when I got to 11 miles a few weeks ago. Prior to that it was just the dull ache and since then I’ve always stopped when the ache begins. So hopefully I’m only a little worse than where you are and within a few more weeks of rest/rehab I can be back to normal.
Time to focus on these rehab exercises, core work and swimming…
Alot of good posts above. You mentioned foam rolling. But what about strength training for your hip flexors and glutes? Any stretching going on?
Icing?
thanks, yes, I’ve been icing and stretching and some strength work, but will begin the routine posted in #10 above. PT begins tomorrow too, so will see what the therapist says re stuff to do on my own. the big unknown I have is when it’s safe to try running again. so far the times I’ve tried to run have resulted in the pain beginning to come back, so clearly I need to take more time off running. the doctor was not very specific but did say I should drop my 3-hour marathon target (accepted that already!) and said switching to the half marathon option was more realistic (race is Jan 20). this implies I could be back to running in a few weeks, but the last thing I want to do is jeopardise my 2013 tri season by trying to run too soon.
Also, what experiences do others have re cycling with IT band inflammation? the doc said this could be problematic too, but when rode 90 mins Sunday I had no pain, although that’s not to say I didn’t make it worse.
That’s a really good program in #10 indeed! Don’t forget to also strengthen the muscles on insides of your thighs. As we cycle, we develop the outer quad muscles but forget about developing the inner quad (don’t know name sorry). That may also be a cause of your pain… minor muscular imbalance.