Aching knee.

Question
I read all the questions that were previously asked but none sounded 'exactly' like my problem.

I've been running Marathons for 10 year and in that time between training, I always make sure I run twice a week. I do a fast 4 mile speed run on the treadmill and the second run of the week is a slow 90 minutes run where I take my time but do about 8-10 miles.

I don't ever get pain when I'm running and in fact I usually don't even get sore the days after a run.

I don't own a car and ride my bike everywhere and in the last year or so I've been noticing a dull ache in my knees. Right behind the knee cap.

In the day or so after a run I don't get the aching, but two or three days after a run they start to ache. Like when I'm sitting at my desk at work.. they just ache.

Then when I go and run again, the next day they're fine again.
When I start my run, for the first mile or so they're a little stiff but then when I'm into my run, my knees feel great.. and even immediately afterwards...

It's just two days after the run the aching starts again.

About 6 weeks ago I did a trail Marathon with lots of hills.. I trained really hard doing lots of hills but since this Marathon, the aching has gotten worse. About two weeks after this marathon I was biking home from work and I got a sharp pain in my knee and I had to get off the bike and walk.. I couldn't bend my leg for about 5 minutes.. then the pain went away and I was able to ride home again... it's not happened again, but I still get aches in the knees.

I wouldn't mind taking a break from running and biking but I don't want to give up running as I love it and I don't want to give up my biking as I would hate to have to buy a car.

Please advise.

Thanks in advance.  

Answer
Hi Jon
You definitely have chondromalacia and need to correct it before it gets worse.The biking your doing is fine ,but i would add stationary biking for the the rehabbing and give up the the running for a while till you can eliminate the situation.I have put together some case histories and testimonials and prescription for your consideration.I' don't know if you have seen these exact ones.

All the best

John

Hi Pettina
Just what i thought.I have copied a recent case history on the problem and a prescription on how to take care of it with some follow up testimonials from scott lowell and another youn lady.Pettina,the most important thing is patience,consistincy.Everybody heels at different rates depending on the severity of the situation.My self it took 8 months.If you have any questions just get in touch,and keep me posted on your progress like scott did.Also start taking 500mg of vit c with your three meals a day.This is like gold for active people and athletes and yoga instructors.

To a successfull rehap

John



Subject: Knee recovery

Question:
Hi John,
Its Scott Lovell here again.  Thought I would give you an update on the
knee.  I am into the full swing of refereeing and now doing up to 4x90
min games per week.  Great newsw is I have absolutely no problems at
all.  Am back to normal - jogging, running and sprinting.  Thanks again
for all your advice.  I feel well and truly back on track and actually
feel fitter than ever.  Absolutely no soreness at all now, so you can
imagine I am really happy about it.  I obviously keep up the bike riding
during the week, to ensure no reoccurance

Cheers,
Scott

Subject: runner's knee

Question:
Dear John,

Your program is working like a charm, I felt such a huge noticeable  
difference when walking up stairs. Thanx. My question is how much running
is a little running? I ran 1.5 m 2x on my on and with the running class
I ran 3m. This is in a one week span. I also did 5 spin cycle classes
this week. I tried the kickboxing but it messed me up. So I won't be
doing that any time soon. I'm trying hard not to gain weight while I
rehabilitate. I have quite a bit of a metabolism problem. What do you think?
-------------------------

Followup To

Question -
Dear John,
 I suspect that I have runner's knee. I've been stepping 2 to 3 times
a week for the past three years. I would sometimes have pain around the
knee especially if the next day after class I would wear heels. I
didn't think much of it until recently. Two months ago, I started running. I
loved it so much I was running 6 miles 2x a wk and then 1/2hr with my
running class.  The day after one of my runs I had excruciating pain
about 2 inches under the knee between the knee and the ankle.  It stop me
in my tracks for a few minutes and I had to walk very slowly. The next
day the pain was gone. I done some digging, it looks like I could do
some spinning and I need to do some quad strengthening. My question is
how do I do it? Take a spin class first then do my quad work or in the
reverse? When is it ok for me to go back to running? Do you think my case
is severe? I also found out that my pronation is off and my feet do not
rotate enough. Are there special running sneakers to help me? I run in
reebox speed runners for men because they are so comfortable. Do you
think these are good enough for me?

Answer -
Hi Revel
Pain 2 inches below the knee would be pantella tendonitis.Your case is
no severe and you will be fine and you can continue to run a little as
you work on my prescription for rehap.as explained in the attached
letter from a privious client.Your running shoes are just fine.Don't
change.Start adding 500mg vit.c to your 3 meals a day to assist recovery and
don't ever stop the C.Follow my program and keep me posted how it is
going.You will be is good as new in no time.The key is patience and focus
and consistency Revel.I would lay off the steping for a few weeks till
you get well into my program.Let me know if you have any questions.

To a successfull rehap.

John


Scott Lovell Asks in Category Jogging & Running ...

Subject:  Knee soreness
Private:  no

Question:  Hi,
I am 30 years old and have never really had any knee problems.  I am
very annoyed because I feel I have brought this on myself.  I run about 3
times a week, usually on a treadmill.  2 weeks ago I was doing some
lunges with hand weights at the gym.  Admittingly I strained a little and
had probaly used weights too heavy.  3 days later I had a run at the
gym and after 20 mins my knee was really painful.  I iced it up that
night and the following day and then it felt fine.  I have no soreness
walking and none on a very hard workout on the stepper.  2 weeks later I
had a light 5 min run and suffered no pain, then did a 30 min step with
no pain and no sorenes the next day.  2 days later I did a fitness test,
running 3.2km in 12 mins, then 2x100 meter sprints after it.  During
this I felt no pain, but an hourr later I could feel the pain and its
pretty sore again.  2 days since that, my k nee is feeling fine again.  
Does it sound serious?  Have I just pushed it too quickly?  I'm seeing a
physio in 3 days to be cautious.  The pain feels around my knee cap
really - never suffered this before?

Answer:  Hi scott
Great discription of your situation.Thanks for that.Sure makes my job
easier.You  have a slight case of chondro malacia.It isa disintegration
of the patella and femoral cartilage surfaces,resulting in uneven rough
gliding motion between these structures.Any disruption of the normal
smooth gliding motion of this structure will result in cartilage
damage.This is why your feeling where you do.Bottom line not serious but could
be if you don't adress it now.Your knee tracks like a train on the
railrod tracks,and it got out of the groves,jumped track do to some of
those exercises you just did.
To fix this there are 2 things you need to do.First start riding an
exercise bike for 30 to 40 min.3 to 4 times a week.Not a regular bike
except for rec purposes.You want a med to high spin with med to hard
tension.This will retrack the knee and also sand down the back of the knee
cap and smooth it out and also strengthen quads.Second start doing leg
extensions,curls,adductor,abdductor work.Thats it scott,cancel your
physio save $$$.Your situation does sound miner since it goes away quickly
so you should respond rapidly.I would continue with this routine as a
way to stay ahead of the curve as they say.To stay active you have to
incorporate prevention consistently or things will catch up with you,and
that is a promise.Hope this gives you a plan to work with.Let me know
how it is progressing and if you have any other questions.

To your success

John







Only those who risk going to far can
possibly find out how far one can go





Jogging & Running - knee pain

Follow-Ups to Answer from Expert John DeHart

steve writes on 2008-12-21 20:14:27
I followed your advise and it has all but eliminated the pain. In total it took about 14 months, but I am playing every week without pain. The extra leg exercises and patience worked for me. I will continue to do the exercise routines 4 times a week, and play on Saturdays. very, very, happy and grateful for the good advise

thanks

steve