Pain under Knee cap

Question
Hello john,

I am 31 years old, and I am in my 4th year of running. I have run many 5k's, 10k's in that time, and I have run 4 marathons in the last couple years. My recent marathon was June 18th, I ran a 3:47 which was 5 minutes faster than the year before. After My legs were sore like normal, but I also had a pain under my left knee cap when I would bend it. I figured it would heal up eventually, and it was not really that horrible of a pain. I did my first run 5 days after the marathon, a light jog because my knee was feeling ok, but after about a quarter mile I started feeling the pain again. I rested the next day and it was feeling fine again so I ran a 5k the next day, and I felt pain during the run, but it was not that bad so I ran through it. Later my knee hurt again for the night, but felt ok again the next morning. After a few days of rest I ran two runs of 2 miles each. Both I started feeling the pain again after about a quarter mile, and then the knee felt ok the next day. I ran another 5k the following weekend, getting the same pain. I then took 10 days off of any activity, and then ran a couple miles yesterday and right around a quarter mile the pain is back. I also ran a 5k this morning, and it was only slight pain during the run, but now its later in the day and the pain is there every time the knee bends. I have been icing it daily the last few weeks, and looking for causes on the Internet. What I have come up with is that it is what they call runners knee, maybe chondromalacia patella, or Iliotibial band Syndrome. I was wondering what you think, and if you think it may be one of these? Also what the effects of continuing to run on it would be? I have a marathon planned on October 2nd, and I really would like to be in training for it, but I also do not want to mess my knee up. I can run through the pain, but is this advised? Will my knee still eventually heal if I do, or should I take some time off? I have not come across anything like this before so I am not sure of what to do for fixing it. Any help you can give would be awesome and greatly appreciated. Thanks for your time, Harry

Answer
Hi Harry
You have developed some tracking and alignment issues and possibly a slight case of chondromalacia.I have  had it myself years ago and it won't go away by it self.I would not run on it till you can correct it since it will only get worst.I have helped 100's of these cases with individuals around the world.The number one best course of treatment is up right stationary bike workouts for 45 min to 1hr 30 as often as you can at med tension increasing it as you become stronger at 65 to 85 rpm.You don't want to do anything else or take any meds so you can focus and observe the changes along the way.This is 100% correctable,but you have to have a great great deal of patience.You can set up a marathon training schedule for the bike by just using time as apposed to miles.If you were going to do a ten mile run at 9min pace then you would bike for 1hr 30 and the same for other runs even a 20 miler and tempo's and speed work.If you have any questions just get in touch and if you want to call me here in Albuquerque NM any time your more than  welcome at no charge.Just go to my web site for contact info.

All the best to ya

John