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Lets discuss Bateluer's knee

Bateluer

Bateluer

Lifer
First noticed this back in March, prior to that, I had I no issues or problems in my knees to speak of. Its only the left knee as well. When I first start a run, I'll get some discomfort in the left knee. Wouldn't call it painful, but I definitely know something isn't right. It usually goes away after about 10 minutes, once I'm warmed up. After that, there's usually no problem for ~20+ miles.

Post run, though, if I keep that leg stationary, I'll get a dull throbbing ache in the knee. If I move the leg at the knee a couple times, I'll feel the knee joint crack and the ache disappears entirely. For a while.

I started doing the hot yoga recently, and on weeks where I'm able to attend 2 or 3 times in a row, it seems to be helping. But its lingering and hasn't completely gone away.

Thoughts?

Update 5 Sept 2012: Saw the orthopedic doctor today. He felt up my knees and tested the range of motion, etc, asking if I felt any pain as he did. There was nothing but some cracking as he did. They took X-rays, which he said looked fine. But to see the inside of the joint, he suggested an MRI. They offered Rx pain killers and anti-inflammatories, which I declined. They did suggest otc ibuprofen if needed.

I am uncertain if I want to go through an MRI for this . . . what are the odds there'd be something on the MRI that the x-ray wouldn't see any at all? Should I have inquired or pushed about a physical therapy Rx?

Given my race calendar, I'd rather not make a problem worse, but neither can I simple stop running.
 
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SilthDraeth said:
Have someone ride beside you with a camera mounted to a bike and record your running gait.

Analyze your gait.
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Won't work. 😛 I've no friends and run where a bike would have a lot of difficulty with that.

Don't think my gait has changed and this is a relatively recent thing.
 
Running 20 miles a day in rugged terrain. Of course you have no friends!

Well good luck finding out what is wrong. And damn, I am a bit envious that you can run like that.
 
Where on your knee does it hurt? Under the kneecap? At the knee joint itself? On the inside, outside, front, back? Need a lot more details to give you some ideas 🙂
 
SociallyChallenged said:
Where on your knee does it hurt? Under the kneecap? At the knee joint itself? On the inside, outside, front, back? Need a lot more details to give you some ideas 🙂
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I'll see if I can get you a better answer shortly. 😛 It really only causes me a bother when I'm at home, because I'm more likely to be sitting in the computer chair. At work, I'm moving around and the joint is exercised. If that makes sense.
 
That sounds odd Bateluer. My knee has been wonky lately, too. Oddly enough, my knee responds better to long, gnarly trail runs than to any length of road runs. How does it do for you when you aren't recovering from a long training run?

ps - how's your training for your fall ultras coming along?
 
Megatomic said:
That sounds odd Bateluer. My knee has been wonky lately, too. Oddly enough, my knee responds better to long, gnarly trail runs than to any length of road runs. How does it do for you when you aren't recovering from a long training run?
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So far, it hasn't really caused any degradation in how I function daily. :/

ps - how's your training for your fall ultras coming along?
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Somewhat badly. Phoenix summers, its about 90* when I start. And approaches 100 by the time I finish. Its a struggle to get the mileage in. I was up in the 60-75mpw range up until early July, then had to knock down to barely 50mpw. It'll rebound in the cooler months.
 
IT band? Sorry, that's the only problem I've had with my knees which sounds even remotely similar. If it is IT band, I'd recommend not running on it; I continued to run because it didn't hurt that much after I warmed up (similar to you, it would go away around 20 minutes into a run), but it got a LOT worse and I had to take a lot of time off mid-season. It got bad enough I couldn't walk around normally (due to inflammation I suppose).
 
Age, weight? Miles you are actually running?

take this as no advice, but strength training has done wonders for my knee over the past year.
 
IHateMyJob2004 said:
Age, weight? Miles you are actually running?

take this as no advice, but strength training has done wonders for my knee over the past year.
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29, ~155lbs. Mileage stepped down when the heat hit, was doing 9.5 M-Th, 19 or 20 on Sat&Sun. Had to drop it to 4.7 or 6.4 M-Th and 13 on Sat&Sun.
 
If it's not hurting going up and down stairs then it's likely not patella femoral.
If it's not hurting on the outside of the knee then it's likely not IT Band.

Definitely need to know location of pain better and more descriptions of when the pain presents. Extension of leg? Impact of foot strike?

Right now I'm going with the very vague, generic term of "Runners Knee".

😛
 
Bateluer said:
I'll see if I can get you a better answer shortly. 😛 It really only causes me a bother when I'm at home, because I'm more likely to be sitting in the computer chair. At work, I'm moving around and the joint is exercised. If that makes sense.
Click to expand...

Yeah, I can give you a little more info if you give me more on your symptoms and location.
 
SociallyChallenged said:
Yeah, I can give you a little more info if you give me more on your symptoms and location.
Click to expand...

I'd say lower middle of knee, if I had to be specific. Sometimes it seems that the entire knee hurts, though when immobile for a time. Both knees crack often when bending, and I do feel some soreness and creaking when going up stairs.

During a few of the bikram yoga courses, before it injured my foot (separate problem), I'd feel something in my kneed that I can best describe as scrapping a rubber band over a surface. Its not painful per se, but definitely feels abnormal.

Most runs start off with some knee pain until it warms up, then it virtually goes away, though it can rear up on longer runs.

I've been icing it after most runs now, which seems to be helping in the short term.

Edit - After North Country next weekend, I'm debating whether I should make an appt to have them looked at. Before I run them into the ground with a heavy racing season.
 
Bateluer said:
I'd say lower middle of knee, if I had to be specific. Sometimes it seems that the entire knee hurts, though when immobile for a time. Both knees crack often when bending, and I do feel some soreness and creaking when going up stairs.

During a few of the bikram yoga courses, before it injured my foot (separate problem), I'd feel something in my kneed that I can best describe as scrapping a rubber band over a surface. Its not painful per se, but definitely feels abnormal.

Most runs start off with some knee pain until it warms up, then it virtually goes away, though it can rear up on longer runs.

I've been icing it after most runs now, which seems to be helping in the short term.

Edit - After North Country next weekend, I'm debating whether I should make an appt to have them looked at. Before I run them into the ground with a heavy racing season.
Click to expand...

Sounds like some patellofemoral joint maltracking. A fancy way of saying your kneecap moves wrong because the stuff connected to it isn't mobile enough. The rubberband sensation is pretty common and that can be caused by the patellar fat pad getting squished and released or due to the plicae (connective tissue) connected to it rubbing. Either way, it's typically not a terribly difficult fix - just some soft tissue work, some joint mobilization, and maybe some motor planning re-training to fix some problems. I'd definitely say see a physical therapist, as it is something we see very frequently and successfully.
 
SociallyChallenged said:
Sounds like some patellofemoral joint maltracking. A fancy way of saying your kneecap moves wrong because the stuff connected to it isn't mobile enough. The rubberband sensation is pretty common and that can be caused by the patellar fat pad getting squished and released or due to the plicae (connective tissue) connected to it rubbing. Either way, it's typically not a terribly difficult fix - just some soft tissue work, some joint mobilization, and maybe some motor planning re-training to fix some problems. I'd definitely say see a physical therapist, as it is something we see very frequently and successfully.
Click to expand...

So, need to see a knee specialist first, get some x-rays and an Rx to a physical therapist? :/

Supe at work described similar pain to mine, but it was something called Plica syndrome. Which required some minor knee surgery. He recovered quickly, but if thats the case, I can kiss Javelina Night Run, Cave Creek Thriller 50K, and Javelina Jundred goodbye. 🙁
 
I don't know how your insurance works, but I don't believe you have to see a specialist. You can see a general practitioner and get a prescription if you ask for it. They may also prescribe you pain meds. Plica syndrome can be related, but is fairly rare compared to general patellofemoral maltracking. It's a genetic anomaly and I think only ~20% of people have the plica that causes trouble and even fewer have problems with it. Even plica syndrome can be treated via physical therapy. Many times, if you normalize the knee cap's range of motion, the plica will not experience abnormal stresses and thus you won't have pain. You don't even need x-rays if you specifically detail that you didn't have anything traumatic happen. Every time I've gotten a scrip for PT, I told them what hurts, when it hurts, the non-traumatic onset, and that I'd like to do PT for it. You can straight up ask for a prescription - they don't typically mind.
 
SociallyChallenged said:
I don't know how your insurance works, but I don't believe you have to see a specialist. You can see a general practitioner and get a prescription if you ask for it. They may also prescribe you pain meds. Plica syndrome can be related, but is fairly rare compared to general patellofemoral maltracking. It's a genetic anomaly and I think only ~20% of people have the plica that causes trouble and even fewer have problems with it. Even plica syndrome can be treated via physical therapy. Many times, if you normalize the knee cap's range of motion, the plica will not experience abnormal stresses and thus you won't have pain. You don't even need x-rays if you specifically detail that you didn't have anything traumatic happen. Every time I've gotten a scrip for PT, I told them what hurts, when it hurts, the non-traumatic onset, and that I'd like to do PT for it. You can straight up ask for a prescription - they don't typically mind.
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My insurance is pretty solid, but specialists are more common than general practioners. At least, around me. :/ I need to find one thats decent, get a physical done. Haven't had one since MEPS.

I scheduled an appt on 5 Sept, and cross my fingers that PT is the remedy.
 
Bateluer said:
My insurance is pretty solid, but specialists are more common than general practioners. At least, around me. :/ I need to find one thats decent, get a physical done. Haven't had one since MEPS.

I scheduled an appt on 5 Sept, and cross my fingers that PT is the remedy.
Click to expand...

You can see an orthopedic surgeon. They're fairly aware of patellofemoral joint dysfunction and very frequently prescribe conservative care (PT, NSAIDS). Hope that works out 🙂
 
Update in OP.

Update 5 Sept 2012: Saw the orthopedic doctor today. He felt up my knees and tested the range of motion, etc, asking if I felt any pain as he did. There was nothing but some cracking as he did. They took X-rays, which he said looked fine. But to see the inside of the joint, he suggested an MRI. They offered Rx pain killers and anti-inflammatories, which I declined. They did suggest otc ibuprofen if needed.

I am uncertain if I want to go through an MRI for this . . . what are the odds there'd be something on the MRI that the x-ray wouldn't see any at all? Should I have inquired or pushed about a physical therapy Rx?

Given my race calendar, I'd rather not make a problem worse, but neither can I simple stop running.
Click to expand...
 
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