Over the last weeks / months I have digested everying I could about knee injuries - causes, prevention, cure, exercises etc. At the same time I've been to see doctors and specialists - admitedly not that many (!) but I would have thought a reasonable stab at a dianosis might be in order.
Anyway, as a result of my reading and elimination of things that it wasn't by doctors, I believe I've arrive at the correct diagnosis - Patella Tendonitis (or jumpers knee as its commonly known). I've come to this conclusion based on the symptoms, the fact that there are things I can do to alleviate the pain, and the fact that, now that I know what it is and can avoid the aggravating factors, its not getting any worse.
Anyway, I thought I would share my thoughts on the forum as it might help others.
The injury apparently arises as a result of an increase in running stress (i.e. increasing training or significant alterations in training regime). In my case, I'm certain its due to the rapid return to racing I made this year and the amount of downhill running I do (uphill running is fine - but what goes up etc...).
What does it feel like?
If you relax your leg with the knee slightly bent then just at the bottom of the kneecap there is a tendon which when pressed or masaged is sore to the touch.
The pain isn't under the kneecap, nor is it at the side (which has helped me eliminate runners knee and ITB).
The other thing is that the tendon is a little stiff - this means starting my runs at a gentle jog to warm up after which the pain subsides.
What to do about it?
Essentially rest is the only long term cure, however unlike some other running injuries, the wisdom seems to be that running on it is possible. With a marathon debut now 7 weeks away I am anxious to avoid total rest if I can.
Secondly, avoid the things which inflame the injury, in my case this means.
1. Avoiding agressive downhill running (it seems to be OK if I take it easy).
2. Avoid speed training (Not ideal, but mileage is what matter now in my marathon build up - I can do marathon paced runs which will help).
How to avoid it happening in the future?
1. First of all rest to clear it up.
2. Strengthen , stretch and cross train to become a more balanced athlete.
3. Proper bio-mechanics - I will go and see a podiatrist to get properly match my shoe to my posture but I definitely now believe more than ever that you should buy the best shoes you can afford.
Anyway, for now I will keep on running with the intention of reaching the marathon and then taking a longish rest. I am working on the cross training and stretching and my avoidance of aggravating events means I am in less pain now than at any time over the last 2-3 months...........of course I could be completely wrong and have a one-way ticket to a wheelchair.