Rehab for Runner’s Knee

Hi there! For the past month, I’ve been knee deep (haha) in knee drama. After trying to do it on my own with consulting collegues and friends about my pain, I finally went to see a sports medicine doctor last week. After x-rays and a physical assessment, I was diagnosed with patellofemoral syndrom aka runner’s knee. So what does that mean?

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Ready for your anatomy of the knee lesson? In basic terms, it means inflammation of the patella femoral joint, where the kneecap hits the thigh bone. When you contract your quadriceps, the patella moves into the femoral groove. If there is an abnormality such as structural alignment, poor flexibility and ROM (range of motion), and lastly weak VMO (vastus medialis oblique) and hips you are more likely to have patellofemoral syndrome. Women, knock-kneed or flat footed runners and those with an unusual shaped patella are those mostly with the diagnosis.

Emily, my PT, lead me through different tests to determine what abnormalities I had. Thankfully, she did not do a mental test. We already know I’m abnormal. 😉

Structural alignment – FAIL. Knew that was a given since I pronate and my knee caps track out rather than forward. Although after watching me run, Emily didn’t think my alignment is all that bad.

Poor flexibility and ROM – PASS. That is definitely not a problem although the day of my eval my legs were super tight from my preview of CrossFit at HLS.

Weak VMO and hips – FAIL/PASS. I knew going in that my VMO is not the strongest. My hips however are very strong.

So what’s the plan? Emily showed me two new taping techniques to try. This is the first one with Kinesio Tape.

This actually worked out well. I ran 3.2 miles with it and no knee discomfort. Emily suggested I try this one first. The other technique is more aggressive in that you physically pull the knee cap over and tape it in place.

Yesterday I had a visit with Emily. She started off by using ultrasound to break up tight muscle fibers with heat. She then brought out the torture devices. First up was the Graston Technique. The first words out of my mouth? “HOLY MOLY!” I really wanted to say, “FUDGE!” 😉 I thought the foam roller was painful but good God that was not fun. After what seemed like an eternity, the torture continued with a Tiger Tail. I asked which is better, foam roller or Tiger Tail. Emily believes the foam roller is much better when you are using it on yourself since body weight helps really get in deep to release the muscle fibers.

My legs do feel much less stiff now but I’ve got bruises everywhere. Some from my treatment and others from the kiddos jumping on me while I’m foam rolling at home. They are so helpful. I also now have orthotics in my Mizuno’s for the first time. I’ve heard good and bad things about orthotics so we’ll see how I tolerate them.

Oh and remember this lovely piece of hardware?

I ran with it a few times but it felt really cumbersome and seemed to throw my gait off. Emily suggested not to wear it. Ever. Except if I get a major tear in my MCL. Good to know. Hope I never have to use it again. 😉

So I’m feeling optimistic about my knee. This isn’t anything career ending. I’ve got some strengthening to do of my VMO (more on that soon) as well as stretching the crap out of my IT band, quads and hammies. My feet and knee anatomy aren’t the greatest but I can make it work and get back to running. I’ve got work to do since I’ll be running this 1/2 marathon on September 30th. And since I know I’ll be back in running shape by November, I registered for this too. I felt the pressure to register for it last week after seeing that it was nearly full. That’s my race so I have to do it even if it means walking. I haven’t given up on the full marathon yet either. There just may be one in me before the end of the 2012!

30 comments on “Rehab for Runner’s Knee

  1. Good luck Anglela,
    I also have Patellofemoral Syndrom. I am no longer running but am able to work out every day doing kickboxing / bootcamp type videos. I do have to modify the workouts to protect my knees (I dont’ do lunges). I found the taping helpful and I really like the orthotics. I didn’t have good luck at all with prescription orthotics. The ones that work for me are the Spencos sold in sporting goods stores.

    1. Thanks Elyse! Everyone is different so it’s hard to say what will work for some and not for others. The important thing is that you are pain free and are able to still workout.

  2. I had Graston when I had my bad ITB pain plus 4 sessions of Active Release Technique. I was good as new (along with hip strengthening work) in about 4 weeks. Those crazy things they do work miracles somehow! Hope you’re 100% soon!

  3. I had my first run in with runners knee just about a year ago before my first half marathon. For me it is something that has never really gone away but I have learned how to minimize flare ups and recognize when a flare up is about to happen. I do inner thigh workouts every day that I exercise because my innner thigh muscles are waaaay weaker than my outer. If I skip these exercises my runners knee flares up. When I do get a flare up I turn to KT Tape, ice and resting until it goes away. It’s a frustrating injury but you will get through it!
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    1. I’ve learned from others that runner’s knee isn’t something that will be gone for good once I’m “cured.” I’m glad you have been smart by listening to your body to control flare ups.

    1. Thanks! It was really hard to put aside my own professional “hat” and let someone else tell me what to do. But Emily is a great therapist and really knows her knees. I’m glad I did it even though I have a crazy co-pay!

    1. I’ve had that happen to me a couple of really humid mornings too. I make sure I don’t have any lotions on and I kind of “rough up” the area around my knee so the tape sticks better. Sometimes it works, sometimes it doesn’t.

  4. So glad you could connect with someone knowledgeable and get a more compete exam. It always makes me feel better just knowing someone else is on my side in figuring out those aches and pains, and she sounds awesome. I’m never tried Graston but heard that it’s really painful and really effective, as you seem to have found! Yay for feeling encouraged!
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    1. I’ve had a lot of varying opinions about what’s going on with my knee. I think everyone is stumped why I’m not getting pain with anything else and not until 3 miles. I’m hoping things continue to be positive.

  5. I’ve never had knee problems but I dealt with an IT band injury back in college. Addressing any pain you have upfront is really key so you don’t end up in months of rehab having to sit out a big chunk of your training. Good luck with your half-marathon! Will it be your first? I did one a couple years ago- it was a great feeling completing it and I average 6min miles even after I felt like I didn’t get in enough training.

  6. Hi,

    I am a long time (10 years +) sufferer of patella femoral pain. One thing to watch for is a reducing ‘envelope of activity’. This is where progressively less intense activity causes the pain to occur. If this starts happening to you (despite doing remedial activity) be very careful. After 10 years I can no longer run at all, and get pain from low intensity cycling with my children.

    An alternative theory to patella tracking is that ongoing activity (even walking) prevents the knee from getting a chance to heal. Total rest – of the knees – for an extended period (1 month) is suggested.

    Does anybody know of a site where long term patella femoral pain sufferers share information / support?

    Fred

  7. That is interesting about how your kneecaps ‘track’ outward. Mine are the opposite, inward. I haven’t had any knee issues yet (knock on wood) but my share of hip/IT band drama. I always wonder if/when knee problems will arise since my knees don’t align perfectly forward either. Curious! Hope you start getting on the mend with this soon. The taping in your next post seemed to be a great solution! My sports chiro has taped me before in the knee area when we were dealing with the IT issues and it really helped. I was amazed!
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