Runners Knee, but no injury. Is it really obvious?

January 10, 2014

Luke Partridge asked The Guru for the following Physiotherapy Advice:

Hi, I have been running 20-30 miles a week (around 5-8miles each session) for nearly 3 years. In mid-december i noticed a pain on my left knee, the morning after a run. the pain is not agonising and doesnt hurt to walk but it does feel ‘weaker’, like its more likely to twist or give way if i lost balance. the pain is on the inside of my left knee, below the kneecap. It is more painful if i move my left foot outwards from the knee away from my body (like the movement you do when doing breaststroke swimming). I stopped runing but after 4 weeks went for a steady 3-mile run to test it out, but it still hurts and its now been 6 weeks and doesn’t appear to be improving. Any help would be greatly appreciated. Thanks!

January 10, 2014

Hi Luke
Sounds like you’ve been doing a good distance, for a good amount of time. This therefore knocks out some of the obvious things such as training protocols and obvious dodgy techniques.
It could be one of two things. The first is a tracking issue with your kneecap. The pain you feel a day later maybe due to an irritation of the sub chondral bone behind the keecap, which takes a while to build up and feel rather than immediately (it’s the cartilage behind the kneecap that gets bashed, but it has no blood or nerve supply hence no sensation – the bone does though, and sits below the cartilage).
The other maybe a grumbling medial meniscus (not the same as a torn mensicus), which has the same sub chondral bone issues – but is a repetative overloading
The one things the two have in common are shoes. Are they broken? Worn too much? I think if you’ve rested and still feel the same, then look long and hard at the obvious. If you think your shoes are good, it maybe work a trip to see someone [sports physios] who can……

Guru Responded

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