Knee Pain/Training

Question
QUESTION: Hello,

For the last six months I've begun training for the 400m again after about a
two year break due to severe shin splints. Everything was going smoothly
until I began to encounter some slight knee pain about three months into
training. This knee pain has continued somewhat consistently for the past
three months. I would have stopped training altogether but the knee pain is
very strange. My right knee only hurts when I first start my warm up jog.
After about half a lap around the track the knee pain is practically gone and
the rest of my workout goes smoothly as if it never happened. I've done my
best to diagnose the pain so hopefully some of this information helps. I can't
find any swelling or inflammation. I also can't find any spots that are sore or
tender, which worries me because I thought maybe it was something deeper
into the joint or surrounding muscles. It also only hurts on impact. If I'm just
stretching, bending it or cycling it doesn't hurt unless weight is put on it. It is
sort of hard to pinpoint the pain exactly but it seems to be just under the
knee cap and on the outer side. I was wondering if these symptoms were
familiar to you because I have no clue what is wrong. The only thing that
sounded reasonable was the suggestion (by a friend) that my knee might be
misaligned slightly and the running/cycling motion helps correct the joint. I
don't know if that is possible though. I was also worried about low knee cartilage but I thought the pain would increase with activity, as would
ligament and joint problems. One other thing to note, after a few rest days
the pain decreases. As the training week goes on the pain is sharper but
always disappears.

Just for reference, I'm 21 years old, five foot eleven inches and about 170
pounds. I do some long distance running (very little) and lots of sprints and
fast paced runs. I haven't done much weights or plyometrics since this
occurred but the same goes for those exercises: once I'm warmed up and run
a little, the knee pain is gone. I do train pretty intensely as I'm trying to get
my 400m time back below 50 seconds once again.

I hope this information was helpful. I'm anxious to hear your opinion about
my knee.

Joe

ANSWER: Hi Joseph
Thanks for the great description it makes my job so much easier.You have a clear description of a slight case of chondromalacia.It is primarily a tracking and alignment situation which is quite common in runners.I was my first client with this years ago and out 8 months.The best course of action to rehab this is a up right stationary bike workouts for 45 minutes to 1hr as often as you can.7 days is fine.You want medium tension increasing it as you become stronger with high rpm 65 to 90 but controlled smooth ride.I have helped 100's of people all over the world with this situation.I would also advise to stop your regular training till this is corrected to insure it doesn't get worse or create other problems in the area.If you would like to call me here in albuquerque NM to get more clarity and info on this your more than welcome any time.Go to web site for contact page.


All the best

John

---------- FOLLOW-UP ----------

QUESTION: Hi John,

Thank you so much for that fast response! And I'm glad it does not appear to
be something worse. I do have a few follow up questions though. First of all,
and I know this is difficult to gauge without having seen me in person and
diagnosed the injury yourself, do you know how long something like this can
take to heal on average? I mostly ask because I would hate to be out of
training for too long since my training has come a long way in six months.
Secondly, are there any other exercises or rehabilitation techniques that I
could use? Like icing? Heating? Stretching? Strength exercises? I want to
tackle this problem aggressively and make sure it heals. Thirdly, what usually
creates this condition? Is there something wrong with my running form or my
training or is it just from over use? I just want to make sure I can prevent this
problem from reoccurring.

Sorry for asking so many questions, but thank you for all the help!

Joseph

Answer
Hi Joseph
There is no way to tell how long it takes to recover fully except with a verbal explanation with the rehab process.The situation is based on many things that you do or don't do with follow through and consistency.Out of training and getting back soon question.You got your self into this situation and blew off the problem early on and did nothing about it thinking it would go away.No symptoms go away they just get worst.It is not totally your fault since you don't have the knowledge or back ground to make a quality serious decision in regards to sports injuries and symptoms and how to proceed with correcting the problem.I can tell you from 30years of experience and a very accomplished athlete and coach of some of the best in the world that the doctors don't no either,not all but most don't have a clue how to treat this and many other situations.They just want your money and milk you as long as you let them.Additional exercises....Your muscular skeleton is i'm sure quite strong from past work you have done so i would stick with the biking which will in time take care of your tracking and alignment situation.Your last question in regards to your form,over training or what creates that condition i can only answer that verbally over the phone do to the complex information i need to convey in a way you understand with clarity with the ability to implement consistently.You have to treat your running career like a business.Will explain if i talk to you.

All the best

John