Monday, June 29, 2009

How to Fix Runner's Knee aka Patellofemoral Syndrome

(Medical / knee school handouts are below)
A few months ago my knee started hurting worse than it ever had before. Then one day I woke up and tried to go down the stairs, but with a leg locked straight and a good amount of stabbing pain, it just wasn't happening.
I tried to R-I-C-E my way through it for a few weeks, figuring my joints were just getting rusty, as I am no longer in my teens. Ok, or twenties.
And then I got on a plane.
About an hour after takeoff, I started feeling this burning sensation that built up until I thought my knee might explode. I drank and fidgeted and massaged my way through the flight, then hobbled through the Houston airport to get to the nearest bar to wait for my connection, crying over the fact that I had to get on *another* plane and have my knee try to explode again.
I was seconds away from getting on the disabled and fat people cart for a pain free ride to the gate, but my pride held on strong.

So when I got home, I decided it was time to seek official medical attention. I knew I hadn't ripped anything, or I wouldn't be able to walk, right? So I did what any rational person would do. I logged onto WebMD and self diagnosed myself. I came up with no less than 7 potential conditions, 5 of which require surgery. But when I saw a real live doctor, he knew right away...Runner's Knee.
I still get a kick out of this because it implies that I am some sort of athlete. Occasional Jogger's Knee might be more appropriate.
It's nothing super serious. It just basically means you have a muscle imbalance around your knee, and they push and pull and give you pain and popping. In most runner's cases, the quads get too strong, so you need to build up the hamstrings, and inner and outer thigh muscles.
I've spent a small fortune on physical therapy (aka knee school) over the past few months, and decided it might be nice to share the exercises and save you some cash. Most of them are just basic stretches, but if you do them everyday, the pain does subside, and you can get to using small ankle weights in a few weeks.
I still haven't run again yet. It's been about 3 months. I'm now up to "brisk walk", but I am seeing the light at the end of the tunnel.

Anyhow, if you are having knee pain, go see a sports medicine doctor. I claim no responsibility for any injury you had, have , or may have as a result of these exercises. You need to get your strength tested to figure out which muscles you need to strengthen and which to lay off.

In general - avoid squats, especially with a weight bar, and stay away from that seated quad leg extension machine. I was warned to stay away from the elliptical and bikes as well. So I tried them both. You *should* probably stay off the elliptical. Very rough on the quads. Bike riding has been hit or miss, but a 15 minute ride, then a rest, then a ride home seems to be having no negative effects, as long as I don't start with pain.

For the exercises - start with the stretches on page 1 below. Do 3 sets of each, holding 30 seconds. If you feel pain, STOP!
Then move onto the laying down leg lifts. For the first week or two, don't use any weights. Just do the reps very slowly and focus on form. As you feel your legs getting stronger, add 1 then 3 pound ankle weights.

If you have access to a Pilates Reformer type machine (aka The Shuttle at knee school), you should be able to do Leg Lowering, Leg Circles (both ways), and Leg presses after about 2 weeks. Highly recommended. Those machines rock, and got my abs in better shape as well.

I'm very excited that you can actually fix this thing with a few simple stretches. Had no idea how much I'd actually miss running. And the exercises are simple enough that you can just lay on the floor and do them while watching tv. The other good news is that after about 3 weeks of these stretches, your legs really start to look pretty fantastic. It's a good well rounded warm-up that you'd better get used to, because to prevent runner's knee from coming back again, you're going to need to keep up with these exercises.
Happy Healing!

(Click blurry stretching man page below, print, then click back to this blog and repeat for page 2. Additional 4 page handout from the MD is below)

Also - Ice is your friend. It makes me squirm and I'm not a fan of how my knee feels immediately afterward (even the frozen food section at the grocery store makes my knee hurt), but the medical people keep insisting I ice it when done with stretches or exercise. I think it does help. I'm just a baby that doesn't like cold.

You & Your Runner's Knee - The Medical Handout

Did this help?! Comments and other tips welcome!...


blahblahblah said...

I don't know how old this post is, but I have a runner's knee on my left knee. You don't know how much I miss running. I can only run about 10 minutes before pain starts to kick in. It sucks really bad. I have been looking for cure, and I stumbled across your blog!! Thanx!!

rd said...

hope i could help, blahblahblah! and that you get back to your typical running self soon.
i'm up to between 4 & 5 mph on the treadmill comfortably. I turn it up to 5.3 or 5.6 to test myself but pain/ clicking starts after a minute or so.

Anonymous said...

glad to read this, as a survivor of chondromalacia, it took 8 months for me to realize that I just had to suck it up and rest for 2 months straight, no cycling, no eliptical, no swimming, no stairs... just walking, and sitting on my butt. After two months of this, continued on a gradual return to running over a month with a brace and viola! back in the game. REST 2 months, no drinking, no dancing, no cycling, no eliptical, no "exercises", just LIGHT stretching, walking, and rest

rd said...

i see a lot of people are reading this, and am hoping the info is helpful.

i'm going to do a follow up post, as i'm still dealing with this fun issue.
Am curious to anyone reading now...any tips on favorite types of braces?
I've tried the simple under the knee band and an open kneecap circle brace / sleeve. Not a big fan of either...

pink gixer said...

Thank you for posting this! I have been having problems with runners knee for a few months now and im miserable and terribly depressed from missing running so much. My body is freaking out from the lack of excercise and I think I'm starting to go insane, and I am terrified of the thought of surgery. <3 thank you for the information, thank you again for sharing.

pink gixer said...

RD- McConnell taping helps a lot with everyday pain. Sitting too long or walking too much starts hurting me and I was using RICE for a while, then found these instructional videos after weeks of looking for something or anything that could help me. I had also told my family Dr about it, he prescribed an anti inflammatory(Indomethacin) and MRI next month. I suppose the Indomethacin helped but it only helps as much as ibuprofen, and ibuprofen doesn't have the disturbing side effects. (I also tried knee braces, and ace wraps, the ace wraps helped with the compression aspect, but the McConnell taping has worked the best).

*You can find the McConnell taping instructional videos on YouTube. I use the video by probalance pt, but there are a few you can choose from, I felt immediate relief, but still can do too much activity. I bought about 5 different tapes looking for a strong one that wouldn't come off after 10 minutes. I use a clear medical tape I got from Walgreens in a double pack($4.00) it's really strong! Also, the first layer of the protective tape is important, I thought I could tape it without it(because I couldn't find a good one) and it hurt getting off! For protective tape, I landed up with an athletic tape from Sports Authority, called KT elastic athletic tape($12). Im sure people can find a cheaper one because it will go pretty fast with everyday use, and that can get a little pricey.

Good luck to you in your recovery, best wishes. I hope that you(and everyone suffering from runners knee, including myself) can get well soon. :)

Anonymous said...

I realized I had something going on in Nov. 2009 when my knee started popping going up and down the stairs. I was diagnosed and given similar info I still proceeded to train and complete a half tri. the fall of 2010. That was the last activity I proformed. Since then I have seen a Sport Dr.; 2 Physical Therapist; and a Chiropractor. I not only have pain in my right knee but now also the left. I feel like this is a nightmare that I will never wake up from. I can only wear shoes w/ inserts and I have to wear them ALL the time or my pain increases alot and no running around having fun w/ the kids. I miss that way more than running in general, but also miss running. I am glad to see and read all the posts. Helps me feel more normal. I am giving it till the end of this month then will try Cortizone shot but really didn't want to.
Also I love Kinesio tape as well. Very great stuff. About the only thing that can relieve it for much time at all. Best wishes to all other suffers.

Anonymous said...

Thanks for the great post and putting up those handouts. I have had runners knee for a month with not much sign of improvement even with exercises, shoe inserts and a knee strap. I have cut down the runs as i have pain after about 3k Still walking over 20k per week. The thought of resting is terrifying because weight will pile back on and i am awful if i dont run or walk. I had dreams of doing another half marathon and several 10k races this year, not looking promising!!

Anonymous said...

I have been looking everywhere for exercises! I went to therapy when I was just a freshman in high school. Its been 5 years. My knee has been acting up a lot lately. I can not wait to try these to see it they work.
Thank you

blah ger! said...

i DT massage it myself in the tub using a crowbar. i put a towel over my leg while doing it. chisel at it and also plunger it back and forth flexing it far. that will get all the pressure out. works great.

here's an inside trikc, while you do that, turn your neck to the sides as you massag it, you will hear pops and clicks. this will release pressure. don't ask me how it works but it is necessary to fix your knee. try it out.

i use eliptical with knee braces on and swim for exercise. if you jog or run or even walk for long times, it can make it worse and become chronic. its a battle, takes work.

blah ger! said...

yah, so i got this knunner knee shit after running for an hour daily for about 3 weeks every day. so dumb. That trick with the neck to the sides is Key!! its like channelling the pressure through your spine up to yoru neck and releasing it. it is a perfect method cuz it lets you know how much presh you released or even if you released any. But the crowbar digs deep!! thats the best part, no massage therapist can dig that deep or spend an hour or more and put as much force as the crowbar!! yah, crowbars fuckin rule!

blah ger! said...

also, use a hammer and pound at your knee on the top and sides, not super hard, but it releases alot of pressure, especially on the bone. it might bruise up at first, but after a couple times, it won't bruise, its releasing pressure its good. don't beat it too hard, proceed with cuation and risk. also, do stretches, yoga is good!

blah ger! said...

all i can say is that this trick works for me. its quick and efficient, but its really painful at first, cuz i had so much pressure and knots in my knee it was so tender. wow! but now its getting way better. i hope to rebound all the way and prevent it from ahppenin int eh future .

blah ger! said...

ok, so i wanted to clarify, i created the whole crowbar rehab system on my own, i did not read about it online. I almost wanted to just keep the info to myself, but if i can help others out I will.

Here are other tips:
1. HOT TUB Jets! those are great. the longer the better. at first it hurts, but you'll notice the pain goes away after a couple minutes.

2. Do eliptical backwards. since runner knee is caused by going forward, doing the eliptical backwards or in reverse motion will help counter balance your knee.

3. That neck trick takes practice to do. You lean your head to the side and sort of flex it to get "pops/clicks/presh out". its not dangerous, i can do it for hours with no problems, but i've practiced it for years.
this whole rehab trick is an artform, and takes practice, its not easy, but gets results. Do this before you go to bed, cuz your leg will be sore after rehabbing it.

4. I'm planning to put out a full video explainin these techniques on youtube so you can learn from the master. When I do, i'll post the link, but g/l

Anonymous said...

my last tip before the vid is sumthin i'm tryin out, but it is using teeter hang ups or other methods of pulling your leg out to create traction. i just started that. i'm thinking of doing some stuff at the gym using pulleys and weights. i'll keep your updated.

blah ger! said...

got one more, i actually use a chisel and a hammer. this works great in the center of the knee below the cap. find the tedner spots and tap on them to release pressure, all teh tricks work for me and help me rehab.

Anonymous said...

as for braces. i use this futuro knee brace and underneath I wear a McDavid sleeve. it gives you two levels, so you can put the futuro strap on brace over the sleeve brace. its the most comfortable brace i could find. got it online.

Anonymous said...

im back. youtube search runners kne solutions they dont want you to know about.

i finally posted a legit vid

Jason Strong said...

My right knee has been bugging me for the last few months and it seems to not be getting any better. I'm an active guy and am trying to find ways that I can stabilize my knee so that it doesn't get in the way of me doing what I'm doing. Does anyone have suggestions on what kind of brace would be needed for extreme activities? Any insights would be very much appreciated.

Annie Lima said...

I have been suffering from knee pain for a long time . Now I am using knee braces I feel comfort now . Thank you.

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