Some more injury help

[Pheidippides]

I mentioned that I had some pretty good pain in my knee at the end of my long run (18 miles) last week.

I tried to run on it on Monday, but shut it down after a mile. Same on Tuesday, and then I took the rest of the week off.

This morning I started off again - beginning of a rest week, so only six miles. No pain until about mile .75, and then it hurt again, so I cut the run short and went home.

Originally I thought this was ITBS. Maybe it is, but I'm not so sure. Seems that the pain is more internal to the knee than it is on the outside, and it's almost like a grinding sensation. I initially had pain when I would go up and down stairs - but for the past few days I haven't felt any pain at all during normal activities. Mild stiffness in the mornings, and not even that for the past couple of days.

I'm going to see a doctor this week about it, but wanted to see if anybody had any thoughts on what it might be. Also, any recommendations on kind of doctor to see - an orthopedist? General Practitioner?

[Mr Incredible]

I mentioned that I had some pretty good pain in my knee at the end of my long run (18 miles) last week.

I tried to run on it on Monday, but shut it down after a mile. Same on Tuesday, and then I took the rest of the week off.

This morning I started off again - beginning of a rest week, so only six miles. No pain until about mile .75, and then it hurt again, so I cut the run short and went home.

Originally I thought this was ITBS. Maybe it is, but I'm not so sure. Seems that the pain is more internal to the knee than it is on the outside, and it's almost like a grinding sensation. I initially had pain when I would go up and down stairs - but for the past few days I haven't felt any pain at all during normal activities. Mild stiffness in the mornings, and not even that for the past couple of days.

I'm going to see a doctor this week about it, but wanted to see if anybody had any thoughts on what it might be. Also, any recommendations on kind of doctor to see - an orthopedist? General Practitioner?

I've had a similar sort of thing. It took me about 6 months to get over it and is still flares up occasionally. I haven't been to a doctor so I am interested in what your doctor says.

[SteelBlue]

Nik, sounds like it could be a patellar tendonitis. The grinding description also makes me think of chondromalacia.

[Solon]

Nik, sounds like it could be a patellar tendonitis. The grinding description also makes me think of chondromalacia.

I don't know what it is, but get new shoes and rest, rest, rest.

[cowboy]

Nik, sounds like it could be a patellar tendonitis. The grinding description also makes me think of chondromalacia.

PT was my first thought as well. Is the pain in front, just below the kneecap, and is it tender when you apply pressure there?

[PaloAltoCougar]

I think I've picked up a mild case of patellar tendonitis, following yesterday's four-mile run (wimpy by most standards here, but the longest I've run in a decade), after which I played the hilliest golf course in the Bay Area. I don't feel any discomfort when sitting or lying down, but with movement there's mild pain, kind of a burning sensation, just below kneecap and at the very top of the shin (right around the patellar tendon).

I'm following RICE, taking Aleve, and not doing a long bike ride today. I'll rest tomorrow as well but I'll try running again Monday. I may also buy a patellar strap as I've read that can help (perhaps that's the C in RICE). Any other suggestions would be welcome. Sorry to intrude into your exam room Niku...

[cowboy]

I think I've picked up a mild case of patellar tendonitis, following yesterday's four-mile run (wimpy by most standards here, but the longest I've run in a decade), after which I played the hilliest golf course in the Bay Area. I don't feel any discomfort when sitting or lying down, but with movement there's mild pain, kind of a burning sensation, just below kneecap and at the very top of the shin (right around the patellar tendon).

I'm following RICE, taking Aleve, and not doing a long bike ride today. I'll rest tomorrow as well but I'll try running again Monday. I may also buy a patellar strap as I've read that can help (perhaps that's the C in RICE). Any other suggestions would be welcome. Sorry to intrude into your exam room Niku...

I have chronic PT, for some reason. My knees always grind, and my patellar tendon is always tender. I just take ibuprofen and run through it. Interestingly, my PT disappears during marathon training after about the 3rd week. I think it's probably because I run slower when I'm training. If you can take the pain, PAC, I don't think you'll do any damage.

[Fiyero]

Niku, how long were your knees inactive before your diet this spring?

[marsupial]

Don't go to an orthopedist--they just tell you that running is bad for you and you should stop. I went to one yesterday because I have been having some issues as well. He told me to stop running and try aqua-jogging. Yeah right.

I hate that something I love is so bad (and good) for me. I wanted to cry when I left.

I hope your knees heal quickly and you can hit the pavement soon.

[Pheidippides]

PT was my first thought as well. Is the pain in front, just below the kneecap, and is it tender when you apply pressure there?

Kind of to the side. It's hard to tell, actually, but I definitely think it is on the outside. And I did some playing around after I had some time to rest and there was some swelling (by feel - not noticeable by sight) right on the IT band, so I think I may be just frustrated that I didn't get better after nothing more than a week.

Niku, how long were your knees inactive before your diet this spring?

I'd been playing basketball every Tuesday for about a year by that point, and football every saturday for about eight months. And I was running a mile here or there (about one a week on average). So it wasn't completely inactive.

Don't go to an orthopedist--they just tell you that running is bad for you and you should stop. I went to one yesterday because I have been having some issues as well. He told me to stop running and try aqua-jogging. Yeah right.

I hate that something I love is so bad (and good) for me. I wanted to cry when I left.

I hope your knees heal quickly and you can hit the pavement soon.

Yeah, I'm going to stop when hell freezes over (meaning permanently stop). I haven't run all week (over a mile that is, which doesn't even make me sweat anymore) and it is driving me crazy.

If I have to take some time off, so be it. As long as I can do the 20 miler after Christmas, I'm still running that marathon. Until then, I'd better start working on my swimming stroke.

[bluegoose]

Without having looked at your knees, I would agree with Steel and cowboy in that it sounds a lot like Chondromalacia Patella or Patellofemoral Pain Syndrome. Its often found in conjunction with Patellar Tendonitis. More often that not, my treatment for one of those diagnoses will typically include treatment for both.

As to who to see, a good GP with a decent ortho background can often diagnosis your condition with a fair amount of confidence and offer you some good advice as to your options.

I'm a little biased here, but if it does turn out to be one of those diagnoses and you want to be a little more aggressive than just RICE, consider finding a good PT (phys therapist, not personal trainer - one of my pet peeves) in your area who sees a number of running injuries.

[ERCougar]

Don't go to an orthopedist--they just tell you that running is bad for you and you should stop. I went to one yesterday because I have been having some issues as well. He told me to stop running and try aqua-jogging. Yeah right.

I hate that something I love is so bad (and good) for me. I wanted to cry when I left.

I hope your knees heal quickly and you can hit the pavement soon.

This irritates me. There are a lot of doctors out there who simply follow the conventional wisdom on this because they're too lazy to investigate it and/or too proud to admit they don't know. This is NOT a settled issue. There are good sports medicine doctors on both sides of the debate.

Regarding physician choices, sports medicine issues are very dependent on the personal interest level of the doctor--how much he/she has taken a personal interest in learning about it. It's really not the core of either specialty, although it falls a little closer to orthopedic surgery, so your chances are a little higher of finding someone who knows what they're talking about among orthopedic surgeons. Your best bet, however, is to find a sports medicine clinic--I'm sure you'll have several in Houston. If you can't find that, look for someone who is fellowship-trained in sports medicine. If you can't find that, you're not looking hard enough, but try to find a doctor who runs.

Actually, I think the best resource is to find a physical therapist. They're not technically supposed to diagnose things, but the ones I know would give you some advice off the record, and anatomy is what they do, all day, every day. The only risk you run is if your pain is due to a non-anatomical problem (infection, gout, etc), but if you're relatively sure it's related to running, they're a pretty good bet.