Jane is a 32-year-old who entered her first ½ marathon in Vancouver this year. She is a comfortable runner who regularly runs 6 km’s a few times each week. In March she started following an online guide to increase her running in order to compete in August’s race.
She had never previously experienced knee problems but as she started to reach 10 km runs she noticed a growing pain in the outside of her left knee. At first the ache did not seem severe enough to stop her running and would usually settle within a few hours after the run. However, as the training progressed she was experiencing a worsening pain that did not resolve unless she took an ant-inflammatory and rested a few days. Eventually the pain started almost as soon as she started running.
When she was examined she appeared fairly normal, her alignment, gait and body composition looked within normal parameters.
She described the pain as being on the outside of the knee around the lateral bony prominence. Testing revealed no abnormal internal knee pathology. Hips and ankles were normal for range of motion. Back movements were ok though she did have tight hip flexors and her lower thoracic spine was tight.
So where was the source of her problem and what was it?
In this case she had irritation over the lateral side of her knee (lateral femoral condyle) probably due to poor hips stability, an inflexible mid back and a tightly bound kneecap.
(This shows poor stability in the hip musculature- there really should be better alignment)
Focusing on Jane’s hip/core strength, mobilizing the tightness in her kneecap and loosening her back through mobilizations and exercise allowed the ilio-tibial band to ease away from its “rubbing” point on the outside of the knee. Concurrently she was able to keep running through taping the kneecap and lateral glut muscles. This is an artificial means of “unloading” stressed areas for the duration of exercise.
In the end Jane was able to compete and complete her first ½ marathon with little problem.
There are of course many other diagnoses and solutions for the painful knee of a runner and it is always worth having early intervention. Identifying the what and the why with the help of your therapist can keep your goals in good shape!