My Knee Hurts....Help me fix it...Please

So I was training pretty good, biking lots running lots. Not upping too much too quickly and then all of a sudden I have knee pain and cannot run. There was no incident to incite this angst it just happened.

-Pain is the top of the knee cap slightly to the right
-hurst when climbing stairs, doing squats and real bad on leg extensions
-does not hurt walking

I thought it sounded like runners knee but then I cannot find a definitive answer on whether it is or not.

I am currently in Afghanistan and do not want to bother a doc unless absolutely necessary. I have tried icing, nsaids and muscle relaxers and no joy and it has been about 14 days.

any help is good help…thanks

It would help if you told us which knee hurts. If it’s your right knee, and the knee pain is on the outside/above your kneecap, you may be having IT band issues. My guess is you have weak glutes and need to do side leg raises (Suzanne Somers style) with a straight leg to strengthen your glut medius muscles. You also probably have a weak upper quad muscle (your IT band attaches on top of your quad and at your glut medius). If you do super light weight single leg extensions (I’m talking 10 pounds) and just work on the last couple inches of the extension you can help strengthen that quad muscle.

IT problems suck, we all get them eventually, and the only medicine is to do injury prevention type exercises.

Also, yoga is magic for this kind of stuff.

Edit: After rereading your post, it also sounds like you aren’t having ITB issues, maybe tendonitis at the knee cap? More ice!!!

I will also agree with IT band - my bet is patellar tendonitis caused by a tight IT band.

Stretch and strengthen your glutes; stretch your IT band. Any chance you have a foam roller? Or a rolling pin will do in a pinch to roll around on.

Are you riding a trainer or actually biking over there? I had a problem with my knee this winter, same symptoms and IT band stretches helped very little. I quit riding my trainer when I could ride outside and the problem disappeared.

Do you use cleats on the bike? If so you may benefit from more float, play on that side. Knee problems have reduced in cyclists as many have gone to cleats with more or variable flost. This allows each leg/knee to find its best position through the rotation cycle.
Speedplay pedals have completely free float settings which can be too much for some but have helped many cyclists (me included) with knee pain like yours.

Second the Yoga idea. It is great for core/lateral hip strength and stability.

Sorry bout that it is actually the left - it almost centred above the knee cap (although alomst on the cap) but slightly offset to the right
.

I am currently in Afghanistan and do not want to bother a doc unless absolutely necessary. I have tried icing, nsaids and muscle relaxers and no joy and it has been about 14 days.

any help is good help…thanks

Advice: bother a doc.

I have the same problem on the same knee…but mine stems from the fact that I dislocated that knee twice playing ultimate and in a Samurai battle (long story) and have had a meniscopy on it. It all stems from a tight IT band. All the ways described earlier are good and they should all be tried but see a doctor first. Don’t mess around with your knees, get them looked at and work from there. My knee sounds like a gravel mixer all the time now - that is also because of patelar tendonitis due to the tight IT band (and now a lack of a normal meniscus)…a myriad of knee stuff.

I use speedplay normally but am reduced to clip ins while here.

I will attempt more ice and morestretching if nothing changes in another few days I will see adoc.

Cheers

A “doc” here–You are describing quadriceps tendonitis. Treatment and presentation very similar to runner’s knee but pain above the patella, often with direct pressure right at the insertion.

Often no quick fix, but ice and relative rest help. Core, hip stability, terminal extensions, short arc leg presses (no flexion past 45 degrees or so), stretching is the long term treatment. There are other options. The other advice concerning float and IT band treatment is good, “bother a doc” is real good. It’s no bother, really. We like to help : )

Thanks very much…I had just found animage online highlighting in red exactly where the pain is and describing is as quad tendonitis also.

I will continue to ice and nsaids.

Any recommendations for hip stability and terminal extensions (no idea what that is)

thanks

Brian

Hip stability:

lay on your back, arms at sides, knees bent up. Now push up so your torso makes a plank. Lift one leg, put it down. Lift the other leg. Goal is to not drop hips.

Get on all fours and do sets of 10-20 leg raises in which you raise your leg like a dog would to pee on a fire hydrant. Good for glutes.

Abdominal work = also good

Leg raises - lay on one side, engage glutes to do straight leg raises

“monster walks” (google) - another good glute thing.

ST - the first thing you’d benefit from is reading the multiple tendonitis web sites as they relate to quadriceps tendonitis. This tendon takes the force of the 4 muscles in the front of the leg and attaches to the upper part of the knee cap. The tendon can rupture but this is frequently in “older” athletes so I doubt that would be your condition. You’ll learn the role of ice, anti-inflammatories, relative rest and even physical therapy if this continues and the potential for involving the medical team further. I’ll bet you can resolve this on your own with just a little education, rest, exercise, and activity modification.

Terminal extensions= leg extensions but starting with the knee flexed only 30 degrees or so, then going to full extension. Light weight, higher reps. More suitable for runner’s knee then quad tendonitis. It’s an open chain exercise so I wouldn’t focus on it. I use it as a warm-up and do the weak leg first and equal weight/reps with the stronger leg. More useful for maintenance/rehab. You’re still in the acute phase of tendonitis.
Good luck.

don’t use nsaid’s. they may take the pain away but they actually slow the healing process…

One other thing you may want to take a look at is the muscle Popliteus. This muscle is responsible for aiding in knee stabilization, it flexes and medially rotates the lower leg.
With many clients that I work with that have quadriceps tendinitis, there is typically an imbalance in the quad/hamstring/glutes just as the others are saying. From my experience the popliteus starts to work even harder; going up and down stairs, sitting on the trainer and the other movements you mentioned become even more painful because that muscle is creating a torque on the knee.

Cindy McGuire LMT, NCTMB
www.handsonsports.com