Dear Dr. Jess,
I had ACL, miniscus repair surgery 11 years ago have pain in that knee when I run, but only sometimes.
Do think you I will be stressing my knee too much to plan to run marathon distance? Do you recommend any exercises in particular to do that can be done without a gym? (links?) Are there foods for promoting joint healing? What about glucosamine or such supplements?
Hoping to run Oakland this year!
Dear Hopeful,
Thank you for your inquiry regarding your knee and the Oakland Marathon. I think it's great you have that as a goal. First off, without doing an exam and a running analysis, it's extremely difficult to give you advice on whether to train or even give you exercises (which is the purpose of an exam and running analysis since the exercises and advice are tailored to your body, running technique, and exam findings.) Secondly, we don't have a current MRI ruling out a meniscus injury that can be causing your pain.
Other diagnoses for knee pain in running include Patellar Femoral Pain Syndrome, Patellar Tendonitis/Tendonosis, Hamstring Tendonitis/tendonosis, Pes Anserine Tendonitis, bursitis, Bakers' Cyst, IT Band Syndrome, etc.
Unfortunately, there can be many causes for each diagnosis. Every IT Band or Patellar Femoral Pain Syndrome can have a completely different cause over the span of the running population.
With that said, again, not knowing more about your exam findings, video analysis, sEMG data, it is VERY common for gluteus medius and maximus to become inhibited, thus causing aberrant biomechanics and putting unnecessary strain on the knee. Other causes can be from a weak or restricted foot/ankle, weak or restricted hips, unstable pelvis, scoliosis, leg length discrepancy, etc.
I recommend you consult with a sports medicine practitioner and in the meantime, make sure you start training your gluteus to fire correctly. Research tells us that Patellar Femoral Pain Syndrome usually is caused NOT by a glute weakness, but the glute max ENDURANCE. This is an important concept to grasp, especially for marathoners.
I recently wrote a blog on how we helped a cross country runner get back on the trails by doing glute medius and maximus endurance exercises while getting sEMG feedback. The results were astounding.
http://innersport.com/archives/2136
Hope that helps and feel free to email me any other questions you have.
Dr. Greaux is a sports medicine practitioner in Berkeley and Walnut Creek specializing in running mechanics, video analysis, functional movement and rehabilitation as well as ART, a medically patented soft tissue therapy. Learn more about running injuries at www.innersport.com and sign up for informative newsletters. drjess@innersport.com
