I’m at a loss, and starting to get worried. My knee started hurting the day after an easy 7 mile run last week. (My training up 'till now has been very responsible, low intesity, slow-building, early-season base work.) The pain feels like it’s over the top of my kneecap (not above or below it, but rather right on top - like where it might hurt if you bumped your knee into the coffee table when standing up), and it hurts when I do things like ride the bike, stand up, walk (basically, everything). The pain isn’t excruciating, rather it’s just irritating. It’s not painful to touch, and moving my knee cap around doesn’t cause any pain beneath it (initially I thought chondomalasia). Anti-inflams don’t help, and it’s not improved since last Wednesday. WTF did I do? I’ve got a training camp in 3 weeks and I’m beginning to fear I may need to pull out.
I’d drop a bag of ice over it several times a day and wear long pants or tights while running and cycling (if it’s still cold where you live).
Tried icing it for 3-4 days without any improvement. I always wear tights (2 pair actually) when I ride. However, it did start hurting the day after I ran in just loose-fitting running tights (my legs were pretty cold when I was finished running - i usually wear tight fleece running tights which are much warmer). So, my question is this: Should I just try to train through it?
Sounds like a knee cap tracking problem. Might stem from your high saddle height. Anyway, consult a physical therapist and he/she can teach you to bandage the area in order for the knee cap to track properly. Or you can use the cho-pat (?) band, I don’t know if that stuff still sells.
Personally, I’d give it a bit longer if it were not for your training camp soon. So, wiith that said, I wiould see if you can get in to see an orthopedist. Having been through similar problems, it sound like chondromalacia but I am not a doctor and don’t even get to play on on TV. Try stretching before your next run and then stretch again after the run. Paticularly the hamstrings and quads. Such pain can be cause by the outter quads becoming stronger than the inner quads which results in the patella (kneecap) tracking improperly.
Again, my thoughts are to see your doctor…
Ryan
Actually, it may not be a tracking problem, plica. In that case, taping ( kineso or otherwise ) may not help. That would entail something more medially. A good PT will be able to nail it on the head. Best of luck!
Plica sounds like a pretty reasonable internet diagnosis (everything I read on its symptoms is exactly what I have). Does Plica take a long time to heal? Will continuing to exercise increase its healing time (I’ll take the pain so long as I don’t prolong the condition)?
Thanks
jhendric
i don’t post often but since i had first hand experience with this issue i figured i’d chime in. i dealt with plica issues all of last year. i strongly suggest you go to a good sports pt as soon as you can. i found sports pt’s can usually spend more time w/you for initial evaluation purposes as opposed to orthos. if diagnosed right away plica can respond to pt, etc but if you let it go (like i did for 2 months doing the ice thing) it can get passed the point of no return. i waited too long and as a result had both of my plicas removed last year. also plica pain can vary widely from the internet descriptions (as mine did) so be careful with the internet diagnosis. the good news is the recovery time is extremely short but it is still surgery, which i would rather avoid. good luck.
Plica is an overuse injury. Training through it will in fact result in bad things on the recovery front. Ice will help but does not relieve the underlying cause, reducing inflammation of the synovium and thickening of the plicae. The recommended regiment includes ice, ibuprofen, pt and rest followed by cortisone and surgery if required.
Unlike other parties, I would go see an ortho because knee diagnosis can be tricky. Generally speaking, I don’t screw around with knees, you wreck one and your racing career can be over. The guy I would recommend in Salt Lake is Lonnie Paulos.
Not a Doc, but I agree with others that it may be a patella tracking issue.
I have this on and off to. It is set off by:
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Big jumps in big or run miles
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Sitting for long periods of time with no leg movement( long plane flights)
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Training with cold knees(not wearing proper clothing for the conditions)
What solves the propblem almost instantly for me is a couple of intensive sets of knee extentions (with light weights)working ONLY the last 20 degrees to horizontal. Note that - if you work the whole range you will make the pateller pain worse!!
Good luck.
jhendric
Disclaimer: I don’t know- that said
I had the exact type pain. One day I had pain on the top of my knee, then it continued to get worse ( it felt like someone was driving a nail through my patella. I went to an ortho. Basic exam said nothing-possible overtraining. Went back got an mri- my knee was “hot” diagnosis was broken knee cap. The doc immediately said my kneecap was not broken. I believed him, I didn’t do anything to break it. He said I was having some tracking problems. Sent me to PT for medial side exercises and other. For 8 months I tried to strengthen it and had to stop running. For 2002 I couldn’t run. Finally in Oct 2002 had a lateral release surgery. He cut lateral side (loosened) and stitched medial side (tightened) and drilled couple of holes in knee (to release “hot” pressure on knee cap) After surgery he said I would be running in 6 weeks. Went back to PT for more exercises. I couldn’t run for a year without pain. It was better but not much. I have just started getting to 6 to 10 miles running distance with little or no pain. Sometimes it hurts alot. Sometimes it doesn’t hurt at all when biking or running, but when i am done i walk with a severe limp, then an hour later it doesn’t hurt.
All that said i think this is the exception to the rule. Go see ortho, they will probably prescribe specific PT then you will be fine. I liked my doc alot. Unfortunately he could not give me a magic pill. I would encourage you to go to a sports ortho doc.
Dude. You’re f*cking saint! I took your advice and did the exercises you described on Tuesday. Pain on medial side of kneecap was all but gone on Wednesday. Absolutely no pain whatsoever today. I’ve a little soreness beneath my kneecap (not under - rather between my patella and patellar attachement point) on that knee, but it doesn’t feel like an injury, as my other pain did. It could easily be from all the walking I’ve been doing in dress shoes around Chicago.
Thanks a million, Fleck.