runners knee not fully healed. I don't know how to ask my doc for help.
October 12, 2010 3:57 PM   Subscribe

during training for my last marathon I've been having trouble with my left knee giving out and being extremely painful in the end, so about five weeks I got an MRI done. the recommendation my doc gave me was to not run at all for four weeks. it has now been five weeks and while I am pain free I am hesitant to pick up my training again because I don't feel it's working properly again. I am not sure how to communicate what my problem is to my doc and what to ask for.

my left knee still 'feels' different than the other. it's a fullness, a pressing sensation. it's not painful at all but it's definitely there, kind of as if you hold it between two fingers, one on the outside and one on the inside. sometimes I feel a pressing sensation even above the knee itself.

my doc has decided that I don't need surgery and correctly predicted that at least the pain will go away. I am however not sure how to communicate properly to him that I am not happy with the current situation. I do not feel comfortable sitting with my knee angled for long periods of time and am thus worried about running. I have been taking the prescribed doses of ibuprofen but truth be told I'm worrying about continuing that for long. I know people who swear it screwed up their digestive tracks.

the MRI determination, which I have, is that I had retropatellar chondromalacia grade four lateral, a rupture of a muscle fibre (musculus popliteus, back of the leg), slight tendinopathy in both collateral bands* at the femoral triangle and a minor injury of the ligament*. also a medium suprapatellar bruise in a joint* with fibrin deficiency (?) DD and a tiny baker cyst. the MRI pictures look like this and this (I do have hi-res and animations as well).

what I've found on the web especially about the chondromalacia sounds exactly how this feels for me, causing me to suspect this is the main issue I need to talk about to my doc. I will talk to my coach about helping me with the quad exercises.

I just don't know what to ask my doc to do. I don't know what else is out there that might help me.

from certain runners forums I gather asking for therapy might be one way to go and that I would have to do certain exercises. do you agree? have you had any specific kinds of therapy that worked for you? or what is your advice?

thanks to everyone who answers. just to be clear: I will go and see my doc again, I just want to be as prepared as possible for the "so what do we do now" conversation.

I'm translating terms I'm not fully familiar with from german. my apologies.
posted by krautland to Health & Fitness (5 answers total) 1 user marked this as a favorite
 
I haven't had your problem, but I'd certainly ask to see a physio-therapist who is familiar with runners and running injuries.
posted by OmieWise at 4:20 PM on October 12, 2010


I also haven't had your problem, but I enthusiastically second OmieWise. Find a good physical therapist. Better pain management is something you might want to bring up, as well. You may want to see a second doctor if this doc can't give you any further steps to take.

I've gone through two rounds of PT myself. The first was something of a miss, and caused some problems in other body parts after a few weeks. For my second round, I did my homework and found a great DPT who specialized in my issues. I've gone from constant pain and difficulty using stairs and walking distances, to pain-free weeks and easy activity. I imagine PT isn't a miracle cure for everything, but it was life-changing for me.
posted by moira at 7:34 PM on October 12, 2010


not a runner nor a doctor, but when i hurt my knee ligaments while biking it took months to go back to normal; I seriously worried I'd never recover. Do try physiotherapy, but i seem to understand that a slight discomfort is part of the healing process.
posted by 3mendo at 10:42 PM on October 12, 2010


I have had your problem.

I've found that the best solution for me has been regular exercise that strengthens my quadriceps and other leg muscles. Muay thai works well for me in this regard, as I frequently perform squats and lunges as part of every training session. I occasionally run distances between 10km - 21km, and do not experience any more discomfort during or after the run. However, if I go for a week without exercise, the old discomfort/ache returns, even when I'm just standing in the shower cubicle.

I saw several doctors about this problem and got an MRI before I figured out how to deal with it. The doctors I saw prescribed me physiotherapy and glucosamine supplements. One doctor suggested keyhole surgery to sever a tendon that might have been pulling my knee cap out of alignment as a result of overtightness (thus causing the knee cap to track wrongly and abrading the cartilege under the knee cap in the process, leading to the patella problem). Physiotherapy was hit and miss, and I found it too time-consuming and boring. The glucosamine supplements may have helped, but even if they did I found their effects negligible at best. I did not opt for surgery.

I think the best approach is to exercise, and exercise regularly. Perhaps you could start with something easy on your joints/knees, such as swimming. Remember to stretch after the exercise, and stretch often, because overtightened muscles/tendons may contribute to the problem.

I am definitely not a doctor; but all this works for me, and keeps the discomfort at bay.
posted by nihraguk at 1:19 AM on October 13, 2010


I'd agree with Omiewise too on this. I had similar problems to you (not so bad though) and I've fixed them by various alterations to form and strengthening exercises. You do need a physio who understands running though - e.g. can watch you on the treadmill and identify what's likely to be causing the problem.
posted by crocomancer at 2:21 AM on October 13, 2010


« Older It sounds like a satellite phone.   |   How do you get jobs or work as a contractor for... Newer »
This thread is closed to new comments.