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Bad pain just below knee
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Hi,
I'm new to the forums, thought I'd drop by and seek some advice.
I've been training for the Paris Marathon on April 15th. It's my first marathon, though I've done a few half marathons last year, and basically tried to keep that fitness from October, with the official marathon training program starting at Christmas.
Everything's been going fine in the training program until last week. I pulled up during the long run at about 24km with very sharp pain on the outside of my left leg, just below the knee. At the time, I thought it was joint related, because the pain was so sharp, but then gone when I stopped flexing the knee.
I took the week off running, and some days I had difficulty walking, other days there was no difficulty at all - except walking up and down stairs.
Having done some research, I now think the problem is actually in a tendon just below the knee, not anything in the joint. If you have a lok at http://www.foottrainer.com/images/anatomy4.jpg - the tendon I'm talking about is the blue area around the top of the peroneus brevis and tibialis anterior muscles. When I have pain, it's in that location.
I've found that stretching my leg seems to help reduce the pain, but I need to do a lot of stretching. I've never had very flexible legs and that probably hasn't been helped by all the strengthening from the training program.
Today I ventured out to try another long run. Basically this week and next week are my last chances in the program to get up over 30km in a training run, so I felt I had to try. Everything was going fairly well, occasionally a twinge from the tendon, but it would settle down. Then around 24km again it came on strong, and when I stopped to stretch, I got too cold to continue the run, so went home.
Later in the evening, after spending some time sitting down at a restaurant table, I was basically unable to walk because straightening or bending the left knee caused that area to flare up intensely. I've now had a warm bath and it's helped the muscles relax enough that I can stand and flex the leg carefully.
Anyway, this is a very long first post, but I felt I had to give a good description because this is nothing like any of the other niggles I've had and worked out how to solve. I'm seriously worried that I won't be able to run the marathon at all, and I don't know if this could be doing bad damage to the tendon.
Or perhaps there's just one particular stretch I need to learn and it will be fine. But not knowing is worrying.
Does anyone know what on earth I'm talking about, and have any advice? I'll take anything, witch doctors, rubbing raspberry jam on it... whatever will work.
I appreciate any help I get
I'm new to the forums, thought I'd drop by and seek some advice.
I've been training for the Paris Marathon on April 15th. It's my first marathon, though I've done a few half marathons last year, and basically tried to keep that fitness from October, with the official marathon training program starting at Christmas.
Everything's been going fine in the training program until last week. I pulled up during the long run at about 24km with very sharp pain on the outside of my left leg, just below the knee. At the time, I thought it was joint related, because the pain was so sharp, but then gone when I stopped flexing the knee.
I took the week off running, and some days I had difficulty walking, other days there was no difficulty at all - except walking up and down stairs.
Having done some research, I now think the problem is actually in a tendon just below the knee, not anything in the joint. If you have a lok at http://www.foottrainer.com/images/anatomy4.jpg - the tendon I'm talking about is the blue area around the top of the peroneus brevis and tibialis anterior muscles. When I have pain, it's in that location.
I've found that stretching my leg seems to help reduce the pain, but I need to do a lot of stretching. I've never had very flexible legs and that probably hasn't been helped by all the strengthening from the training program.
Today I ventured out to try another long run. Basically this week and next week are my last chances in the program to get up over 30km in a training run, so I felt I had to try. Everything was going fairly well, occasionally a twinge from the tendon, but it would settle down. Then around 24km again it came on strong, and when I stopped to stretch, I got too cold to continue the run, so went home.
Later in the evening, after spending some time sitting down at a restaurant table, I was basically unable to walk because straightening or bending the left knee caused that area to flare up intensely. I've now had a warm bath and it's helped the muscles relax enough that I can stand and flex the leg carefully.
Anyway, this is a very long first post, but I felt I had to give a good description because this is nothing like any of the other niggles I've had and worked out how to solve. I'm seriously worried that I won't be able to run the marathon at all, and I don't know if this could be doing bad damage to the tendon.
Or perhaps there's just one particular stretch I need to learn and it will be fine. But not knowing is worrying.
Does anyone know what on earth I'm talking about, and have any advice? I'll take anything, witch doctors, rubbing raspberry jam on it... whatever will work.
I appreciate any help I get
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Comments
See the picture on this site and see if you agree;
http://www.aafp.org/afp/2005/0415/p1545.html
What stretches are you doing at the mo?
I hadn't considered it would be an IT band issue because the pain was below the knee, and the knee itself has been largely fine. I was suspecting tight calves. However, reading that article makes me suspicious that it is an IT band issue.
As for what stretches I do, I don't know what official names they have, but I do:
- Hamstring stretches from lifting a straight leg onto a raised surface and leaning towards it, as well as lifting a bent leg onto a high surface so that the knee is basically touching my chest and leaning forward into it
- Standard calf stretches leaning forward against a wall
- Soleus stretches by bending the back leg in the calf stretch
- This stretches by pulling the heel back towards the buttocks
These are my main stretches. I try to do them after every run, and recently I've been doing them more frequently since the injury. I hadn't found a decent IT band stretch, so I go over it with the foam roller, but I've only just started this. I had minor problems with my left knee a couple of months back which was solved by just doing some decent thigh stretches after the runs.
So there you have it. The information you pointed me to is very helpful. I'll get to work on the IT band and hope that I can recover in time for the race.
Oh and yes, I now have a booking with a physio
Hopefully they'll be able to really pinpoint the issue so you have a clear plan on how to treat it.
I did take part in the race. I had to drop all training for the last month to let the knee recover fully, and because any serious training was likely to just re-injure the knee and prevent me from starting the race.
I managed to run till 34km before having to walk most of the rest of the race, but making sure I ran the last km. Finished in 4:40, which is a long way off the time I was originally targeting, but after so long training, I was glad to be able to take part and complete my first marathon.
The physio was very knowledgeable. He got me doing some one legged squats and instantly noticed that I was much faster and more stable on the right leg than the left, because the right thigh is much stronger than the left. So basically the right thigh could keep up with the training schedule but it was gradually becoming too much for the left.
I didn't break down in the race as I had in the training runs, which is great - I just lacked the muscle strength to run the full distance. My left knee is a bit sore now, but it's nothing like it was during the training.
I would advise seeing a good physio and getting some advice about what was wrong. I was expecting the problem to be related to not stretching a certain way, but he spotted a muscle imbalance that's been there a very long time and will not be quick to correct. As soon as he pointed it out, it was obvious to me. The earlier you find this stuff out, the more you can benefit from it.
I have a similar imbalance where my right thigh and calf is much stronger than the left after years of being a very one-footed footballer. I have been doing one-legged squats as part of my strengthening and stretching regime, and am noticeably less stable on my left knee and can hear and feel it clicking during squats or descending stairs. I often get left knee pain when I up my mileage then have to let it recover for a few days, it's not so bad that I feel the need to see a physio just yet, but I'm only at around 25-30 miles per week, so do wonder what I have ahead of me if/when I start training for the longer distances.
You might want to check out a lower mileage training routine. I followed the program from the Run Less, Run Faster book. The longest mileage in a week was about 35 miles. Other training comes from non weight-bearing, non impact training such as cycling, rowing, etc. There's no way I could have done one of those 50-60 mile a week, 6 days a week running programs - I think they're insane.
The RL,RF program is about 3 strong runs in a week combined with non impact training. The aim is to actually get something out of each run. If you're always tired, you can't run fast enough in the intervals or tempo runs, or long enough in the long runs. Or you increase the risk of injury. Doing a spin (cycling) class was a great way to build strength in my thighs as well as actually recovering from the long runs. I would do the long run on Saturday, spin class on Monday. Then intervals tuesday, tempo thursday.
Running the extra mileage may help you develop the strength to cope, or it may just put you on a course to injury. I think keeping your runs to specific goals is the best way to get value from the running without destroying yourself. One thing I learned is that just because you're feeling ok after runs doesn't mean you're safe from injury over time. I lost the three most important weeks of all the training program because of injury.
If you've got the time/money, I would see the physio before you get injured. Get them to check your form, your strength imbalance, etc. Then you can benefit most from their training advice. My physio was great, but the end result of his advice was "you have to stop training". That helped me get to the race, but it would have been better to not need to stop training!
Anyway, that's long enough. Good luck! Just remember to train your head as well as your legs.
Hi Niall, Did you ever find the root cause of your knee pain? I'm facing a very similar issue for the past few weeks and nothing seems to help
It's been a few years now, and though I haven't gone back for another marathon, I've definitely progressed as a runner. I can say with hindsight that it was almost certainly over training and lack of strength that was the root cause. Better stretching of thigh and IT band would probably have helped at the time, but it would have been remedial rather than addressing the root cause.
I've done half marathons since then and during the training have gotten to the point where my knee felt similar to when this happened, but not to the same degree of pain and time to recover. But I've also had other times in training when I was actually doing harder training and feeling no problems at all. I've had other on/off troubles since then with hamstrings once I started doing more hill running.
The difference I think is purely down to my strength levels. I'm probably what you'd call an ectomorph. I never put on muscle easily, but I do lose it easily. When I stop training, I know I have to ramp up more gradually.
I've learned not to push so hard when I'm increasing intensity or distance of my training. If I start getting soreness, I cut back my running pace during training, and I do far less long runs when getting ready for half marathons. Instead, I try to remain in some form of regular training at almost all times, even if most of the time it's not particularly intense.
My strength has increased a lot and I've run several PBs. Most runs I do I'm not sore the next day, or at least only occasionally. During the marathon training, I was sore a lot. This was just a sign I was not strong enough for the level of training. I think if I had backed off the training, I would probably have done better in the race, and obviously avoided a bad experience.
That's all I can say. If you have a problem this bad, it's likely that you can't apply a quick, easy solution. Backing off might feel wrong but in the long run it's a lot better. Running consistently and slowly increasing strength works a lot better for me than pushing hard in short training programs.
That's the answer I never wanted to hear at the time, but 3 years later it's the answer that was right for me.
thanks Niall, I appreciate your feedback. yeah, I think overdoing my training (just for a short period) is what got me into this mess in the first place. I've cut right back and have focused on strength and stretching but nothing seems to be making a difference as yet. Hopefully I'll figure it out in time. If I do, I'll be sure to post here.
Take your time, you'll get there in the end. Make sure you're able to actually get out and do some form of running on race day - don't risk that hoping the problem will go away if you keep training the same way. If you have to walk some part, so be it. I walked 5km of the marathon and finished happy. If I hadn't been able to start I would have been very disappointed.
But remember that it's not the last race you'll run, and that the next time you can apply what you've learned.
Good luck!