A Physiotherapist with Runners Knee

10 weeks into my 16 week training schedule, 6 weeks until race day, my knee buckles and I can’t weight-bear without 7 out of 10 knee pain (10 is the worst pain you can think of). It all began two weeks previously on a hill training session – and only when running down the hills.  The training sessions to follow I mention nagging knee pain but really didn’t pay that much attention to it. Until that faithful week 10 run where I was 5 km into my run and had to stop and couldn’t continue. Of course my phone died, and I forgot Visa Card at home and couldn’t call a cab, oh and it was pouring down with rain. I had to walk 5 km back to my car, and by walk I mean shuffle in sloth mode and when walking downhill I had to side step down.
Devastated and fearful of not being able to race in May I set forward to figure out what was wrong with my knee.

My knee pain

• Sharp and even burning pain on the outside of my knee
• A bit swollen
• Pain when pressing on the outside of the knee (over the femoral epicondyle)
• Aggravated by downhill walking/running, going downstairs, a bit when bending

My injury

Iliotibial (ITB) Friction Syndrome, excessive stress/rubbing from the ITB over the outside of the knee called the lateral femoral epicondyle.

Causes for my knee pain

• Poor biomechanics: I’m an overpronator, I had orthotics but threw out a pair of old running shoes a while back and well my orthotics were in those shoes and I’ve been too lazy and too frugal to get a new pair
• Overuse, increasing the volume and intensities of my runs too suddenly
• Weak gluteus – specifically Gluteus Medius
• Weak inner quadriceps – VMO, Vastus Medialis Obliquus
  • This weakness lead to major imbalances of my muscle system and overtime with training is a primary reason for my knee pain
• Tight outer quadriceps (Vastus Lateralis), Tensor Fasciae Latae (TFL), outside gastrocnemius and peroneals

How I managed and treated my knee pain

• I stopped running but continued painfree cardio at the gym
• Ice, 15 minute every hour
• Foam rolled daily
• Taped my foot into neutral
• Was able to get fitted for custom made orthotics by Dr. Caolan Teasdale (Absolutes Physio care’s Chiropractor)
• Began my physio exercises immediately. Starting with low level glut and quad strengthening exercises and progressed when I felt less pain and felt stronger
• Trained my poor motor control/weakness of my inner quad muscles (VMO) with NMES (neuromuscular electrical stimulation), we have this in the clinic and it’s a great piece of equipment to aid in motor control training (see photo)
• Used surface EMG which is also a good training tool to help with motor control
• Had a sports massage by Gizelle Vowell (Absolute PhysioCare’s RMT)

Things I learnt

• Always run with your Visa Card and charge your phone before you leave the house
• If you have pain don’t ignore it and address it sooner then later
• Ice is your best friend when it comes to swelling and pain
• The foam roller should be done often
• When you lose your orthotics, get another pair. There’s a reason you had them in the first place!
• DO YOUR PHYSIO EXERCISES, and continue doing them. Always be aware of your muscle imbalances and aim to correct them

It’s looking hopeful for me and I’m on track to run in May! Wish me luck and happy running!

Related Posts on Running Injuries & Sports Rehab

• Common Running Injuries & Sports Physio

• Tips to Foam Rolling for Training & Running

• Injury Rates & Gender Differences in Runners

• 9 Common Running Injuries that Physiotherapy can Address

• Understanding Iliotibial Band Syndrome

For sports physiotherapy or for help with your running program and training plan, come in for an appointment. Please contact us at 604-558-CARE (2273) or get in touch with us online!
If you have any questions regarding your sports related injury, feel free to drop by and meet the sports therapy team, one our physiotherapists at Absolute PhysioCare & Sports Rehab in Burnaby B.C. can help you optimize your recovery and get you back to pre-injury state!

Happy running!

Christina Brownlow, Physiotherapist