Need expert advice on runner’s knee, stiffness

December 14, 2016 11:47 AM

So I have almost two decades of running experience, but I recently had to take several months off. Before the hiatus, I was at 25 to 40 miles per week (mpw). Coming back from zero, I got up to about 15 mpw in about a month, and started to have some knee pain. Nothing sharp, mostly stiffness when my knee was inactive for awhile. I know the easy answer is to back off, and I have, but I’m eager to get back to 40 mpw, so can any informed experts advise on what’s happening to me?

I was running 3 to 4 miles every other day, when the knee pain set in. It’s in the inner left knee, mostly from bending it, like when I put on my pants in the morning. I’m also stiff in the knee when I’ve been working from a sitting position for more than 45 minutes. But when I run, after a warm-up, it feels like there are no problems.

For two weeks, I cycled and swam and felt the stiffness lessen. At the beginning, I couldn’t sit cross-legged and my forehead wasn’t touching the ground in yoga child’s pose. Now I can do both, but going from child’s pose and sitting back into cross-legged, there is still some pain when I put the weight on the left knee.

- Any idea what’s causing this? Simply too much too soon?
- What’s an appropriate level of pain with which to start running again?
- Do I have to wait until it goes away completely?
- What level should I come back at?
- Are there any stretches or warm-ups I can do to alleviate this?

Thanks!

posted by Borborygmus to Health & Fitness (10 answers total)

This doesn't seem like it's based on you restarting running -- 15 a week shouldn't be doing this to you with a 25-40 base. even after several months. I'd see a doctor and/or a physical therapist, especially if you can find one with experience treating athletes.
posted by Etrigan at 12:12 PM on December 14, 2016

I don't have nearly as much distance running experience as you do, but when I started experiencing stiffness in my legs after running longer distances, I went to go see a sports physio, which has worked wonders. I think your questions are all specific to you and your body and your body at this point in your life, you'll need someone who can physically look at and feel your body to be able to answer them. I hope you recover soon.
posted by Enchanting Grasshopper at 12:37 PM on December 14, 2016

Mine (exact same spot, exact same knee!) was due to muscle loss in my butt and hamstrings. I'd have a lazy gait where I wasn't lifting my knees high enough. I agree to see a PT, and don't be surprised if they recommend strength exercises.
posted by jillithd at 12:51 PM on December 14, 2016

Do you need new shoes? In my experience, many running problems can be directly traced to worn out and/or improper shoes.
posted by whistle pig at 12:51 PM on December 14, 2016

I am not a doctor, but I recently resumed running after a long hiatus as well and also experienced pain in knee on the inside below the kneecap. After a lot of searching and reading, I think I narrowed it down to Bursitis, more specifically Pes Anserine Bursitis. For me, it would affect me the most long after a run -- say, after sitting a while much later in the day or the next day.

I used a lot of ice for the acute pain, but couldn't seem to shake it until I took some time off again. I think it sounds like we both may have tried to ramp back up a bit too quickly.

I changed to a different model of shoe and started easing back into running and it hasn't flared up much again, but I am barely running anymore.

However, take this all with a grain of salt -- this was just based off a lot of web research and anatomy guessing and youtube videos and runner's forums and friends and whatnot, but not an official diagnosis from a doctor.
posted by This_Will_Be_Good at 1:37 PM on December 14, 2016

And for what it's worth: I started getting the pain after I resumed running wearing a pair of Brooks PureFlow 2 shoes, and I have been able to resume running a bit after switching to Brooks PureCadence 4s (it was enough of a difference that I bought a couple pairs while they are still in stock since it seems Brooks has already revised the model to the 5 and I didn't want to take a chance).
posted by This_Will_Be_Good at 1:40 PM on December 14, 2016

Seconding see a sports physio. It looks like you're in the States, so I get the whole "is there any way to figure this out without spending money," but there are other ways to look at it too: getting new shoes would be spending money and probably not solve the issue, not running would be spending a chunk of your happiness, and keeping on running and getting reinjured would also do that. Seeing a physical therapist who knows atheletes will be an investment in your physical and emotional wellbeing. There are so many things that can cause runner's knee, it's really the most efficient way to know and get back up to your happy mileage.
posted by fraula at 12:55 AM on December 15, 2016

Sounds like you’ve re-injured yourself by ramping back up too quickly to me. Tendonitis can often manifest as pain after running, but be pain free when actually running - which unfortunately makes it easy to make the injury progressively worse without realising that it’s the running that’s the problem.

- Any idea what’s causing this? Simply too much too soon?

Probably.

- What’s an appropriate level of pain with which to start running again?

Are you an elite athlete under the care of a competent sports physio? Then do what they say. Otherwise, none.

- Do I have to wait until it goes away completely?

Yes, unless you have advice from a sports physio that says otherwise.

- What level should I come back at?

Go slower than you did this time! 0 -> 15 miles a week in a month is clearly too much.

- Are there any stretches or warm-ups I can do to alleviate this?

Probably. Go talk to a physio?
posted by pharm at 12:59 AM on December 15, 2016

+1 for physio. You will save yourself time and money compared to guessing what the problem is.
posted by crocomancer at 2:25 AM on December 15, 2016

I went to see a sports doc. Thanks for the advice.
posted by Borborygmus at 11:31 AM on December 25, 2016