When do I call it quits with the physio and just take the painkillers?

Long story short-ish:

18 months ago I had a 'crisis' - after 4 years of increasing pain in my knees [and assuming I was just getting old - I've been running for 35years], I was doing a hill rep session with the club and had to stop with a 'panic attack' on the 3rd downhill. The pain was just too intense.

Cue months of physio, starting with the club physio - then moving on to get mri scan that confirmed tendonopathy. I have now been doing another 8 weeks so far with another physio. I have been on a couple of slow jogs [2M, with the dog] during the last two weeks and felt OK, though my right knee occasionally still flares up.

I'm seeing physio tomorrow but I now have so many exercises to do, I have to get up even earlier than usual as I have to walk the dog too, and then get to work. After work, I'm in to housework etc so am finding it increasingly hard to keep it up - 2x a day every single day, for 20-30 minutes each time.

I am feeling that right now, after 18 months of trying to fix it, it will never be fixed and I should revert to 'take a painkiller and just do 3-5M' and be damned. I don't need to do long distances any more as I have done all the usual races you want to tick off your bucket list, so just need to run to maintain my sanity. I certainly don't need to keep paying money to various experts when there isn't an easy fix. I'm no pro runner and I never was a competitive club runner

...hang on - am I talking myself into giving up?! Or is it worth persisting?


  • personally I wouldn't want to get onto a long term painkiller treadmill.... that way lays much bigger problems... 
    lets be honest.... its all prep for an Ironman on my 100th birthday
  • Tendinopathy of which tendon?
  • ftm42ftm42 ✭✭✭
    Quadri-patellar.  Quads feeding into top of kneecap. Both knees but right is worse 
  • RicFRicF ✭✭✭
    There is giving up, and then there is giving up forever. The way I see it, you've just kept running on an over use injury. And that will never clear up until you stop running.
    To heal that injury/condition, you have to first stop adding to the damage. So whether you like it or not, you're going to have to stop running and wait. Can't do both. 

  • Running with painkillers will just mask the damage that you're doing to your knees and you'll end up with very long-term problems.  Like it or not, you're going to have to do something else to maintain your sanity - something that you can do pain-free while you wait for your knees to recover.  Swimming, cycling, coaching kids, parkrun volunteering.

    And stop paying the physios - as you say, there's no quick fix here.  They probably don't have anything more to offer beyond the exercises you're already doing.

  • ftm42ftm42 ✭✭✭
    RicF: yup.

    Cycled to physio this morning. Was honest with her re 2 jogs with the dog. Discussed whether it's worth carrying on treatment.

    Upshot is - need to finish this 12 week programme. No running for next 6 weeks. Then I can assess whether it worked or not. Cycling is fine & I have an ebike so I can let battery take over when knees hurt.

    Now to steel myself as my desk overlooks the park I watch other runners going round at lunchtime.
  • ftm42ftm42 ✭✭✭
    Cheerful Dave: I'm actually getting treatment on hubby's healthcare plan from work. I just begrudge anyone paying for anything for too long.
  • Knees are inbetweeners. The source of the stress on the tendon may be from the foot up, or the hip down or both. 
    You may need a gait analysis to check features of your foot function and a pelvic check to see if the pelvis is twisted leading to a functional leg length quads of course may be involved as well, and it sounds like the Physio is already on to that. 
    Just ask to see if there are other features, or seek another opinion. 

  • I have had patella tendinopathy for a while. I found that only squatting on a slanted board (25 degree angle) has really worked! I can do the short runs as long as I do the exercises post run.
  • ftm42ftm42 ✭✭✭
    Quick update. After having not run [at all] now since January, I decided to go for a 1M round the block. Knees have been fine recently. However, within 5-10 minutes of coming home, my right knee has 'gone' again. After lots of rest and lots of very boring physio, is there really no hope?
  • FootmechFootmech ✭✭✭
    Ok, time to see a Podiatrist. To check your gait.
  • Physios range from being really bloody good to pretty naff. Tendons, with the right loading strategies get better, but they are like 3 year old kids - they are really unpredictable.  I'd give up on your Physio and go find a new one - recommendations always help....
  • ftm42ftm42 ✭✭✭
    TBH, I've now been through 2 physios and had my gait analysed more times than I care to remember in my 35 year running 'career'! I've kind of got to the stage where I will just run a mile or two every other day just so I can say I'm a runner.

    I can't be bothered spending the time and money on different treatments when I'm never going to be competitive anyway [being objective here]. I run for fun and mental health so if I can keep it fun by trying to see how many 1M routes there are round here, that's fine.
  • ftm42ftm42 ✭✭✭
    Quick update. Signed myself off physio. Still doing exercises [still...].

    She and I agreed that I'd concentrate on power-walking the dog for regular exercise and do the odd 1-3 M run when my knees have a 'good' day. I have since done 3 runs, [2.5M; 1M; 1.2M] and each time it seems to take 3/4 days until my knees settle down again. Frustrating, but maybe this thing just isn't going to go away and I will have to control it by just not running much & walking instead.
  • ftm42ftm42 ✭✭✭
    edited April 2017
    Back to physio! Every time I run - even a little, the pain comes back. I have to steel myself to NOT RUN at all for a while. Instead of spending 30 minutes running, why not just do stretching exercises instead! Duh!

    I kinda know that, but just can't resist the urge to run!

    Keep reading this:
  • Does the problem exist with other activities? Cycling might be worth a try (although there are plenty of cyclists with knee problems too!) I've got a current niggle from having done a 200km cycle event, which hurts every time I turn the pedals, but which is fine over a 10-16km run. Maybe you have the opposite?

    Also, trail running? If you have a running gait problem / your knee movement is the same for each stride, the uneven ground in trail running may not exacerbate in quite the same way?
  • ftm42ftm42 ✭✭✭
    Sadly things seem to be deteriorating. Got back to running a couple of miles in the park at lunchtime. Ran a 5K fun run on Sunday & knees felt fine. Day after my right knee was very sore & inflamed. Saw physio & now seem to have damaged the bone as it's bone pain now & possible meniscus damage. 

    She's now talking management not cure. Walking hurts, sitting hurts, cycling hurts. Only 4/10 on pain scale but just not going away.  Left physio almost in tears. So frustrated. Been a runner all my adult life. Sad but soon will have to give up. 
  • Torsional mechanics (often referred to as pathomechnics) is the scourge for all runners.
    From what you have said, you are almost certainly functioning as such.

    Torsional mechanics is what keeps your knee inflamed.
    Torsional mechanics is threatening to end your running career.

    Changing your mechanics from torsional to linear may save your running career.

    Example: Sarah Baxter and Chelsey Totten, both competed in the Mt. SAC Invitational cross country. Sarah - linear mechanics, Chelsey - torsional mechanics
    Read what happened at: http://www.iarpt.com/cross-country---runners.html

    Professor Rothbart
  • My wife is in a similar situation. I keep telling her to take up swimming for 6 months to let her knee rest and to focus on the exercises. It is the best advice but hard for a runner to take. No meds are going to counter the strain of running. At least if you run, stick to good tracks and stay off the concrete.
  • stanmorekstanmorek ✭✭✭
    Been through long periods of frustrating injury myself in 20 odd years of running. I agree with some the comments above. Biomechanics and running surfaces being two. With nothing to lose I tried changing my running style with different stride length and cadence and foot landing and shoe heel drop/cushioning. I even found that slight differences in sock thickness could affect my gait. I've never been coached in the "correct" way to run.  

    During the times when the body is in such a injured state it will compensate for it and affect other parts of your body bringing more injuries and a vicious cycle that needs to be broken. So I agree with focusing on the exercises to undo those adaptions by the body. 

    Mixing up running surfaces, trial running is great, or go with a walk run routine and see if there is any improvement.

  • ftm42ftm42 ✭✭✭
    edited June 2017
    Brian - I'll check that out - thank you!

    I've decided that for now, I have to try to replace the high I get from running, and the days of sore knees post-run, with something else. I don't feel confident on a bike and don't swim well so they are not an option. However, I do get a huge discount on my local gym, which is literally 5 mins away from home and from my office, so have joined up and had a 'rehab' program drawn up that will focus on overall strength and conditioning, and avoid high-impact - both of which should help recovery and I should come out the other side a stronger runner anyway?

    I hope that by going to the gym 3x a week, and running the odd 2/3M'r when my knees feel up to it, I can strengthen myself and set myself a long-term aim of a good 5K time by Xmas. I don't think I will ever be able to run longer distances in the future, but I hope I can concentrate my efforts on running shorter distances faster. Does that make sense?!

    I have also been advised that an arthroscopy could be the answer to my prayers - does anyone have any advice/experience of whether this would be realistic?
  • ftm42ftm42 ✭✭✭
    edited July 2018
    Thought I'd feedback where I am now. Still going through the cycle of

    pain goes / build up running / carry on with gym work
    try a hard run / feel ok
    couple of days later, my knee becomes inflamed
    back to square one

    I have been in and out of physio; recommended stretching; then strength + conditioning; then gradual build up. Gait analysis so trying to change style, but then my knee flares up - 'built up' to 4km [in 2 lap stages] on running track.

    Now I'm at 'do not run; do not walk fast; do not do anything high-impact; until pain goes to zero'. Then start all over again - again. :'(

    Added to this the heatwave is not helping as I tend to swell when its humid too! And I'm about to go on holiday, when I'd normally run a lot!

    Physio still seems to think a build up to a targetted end of September 10K is 'on' as long as I can break this inflammatory cycle.
  • ftm42ftm42 ✭✭✭
    OK - quick update - looks like rheumatoid arthritis. Physio diagnosed as my knees just refuse to stop swelling and being painful if I so much as think about running. Been trying to build up and got to 4Km and suffered a 'relapse' with painful knees and stabbing pain.

    Seeing GP next week for a 'positive' diagnosis and possible treatment with anti-inflamm's [used to take naproxen a while ago but all seemed to have settled down and I stopped taking them - my last box, which I found in the kitchen cabinet, was dated 2014]. Still hoping I can run but looking less and less likely.

    Can you still run with rheumatoid arthritis?
  • ftm42ftm42 ✭✭✭
    Referred to specialist sports doctor for second opinion. GP doesn't think it's arthritis per se, but seems to think there might be an issue with my meniscus and I'm running 'bone on bone' [ouch] so wants me to have a MRI scan and discuss remedies to get me back running. Normally he'd just prescribe anti-inflams but as I'm a runner and it's so important to me to get back to it, he wants to see if there's anything else this specialist can do.

    Now I just hope my healthcare [through work] will pay for it...
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