The Knee Mutiny
May 27, 2015 9:27 AM   Subscribe

Recently did my first 5K, which went great, except my knee got tweaked. Now it won’t go back to normal. What are some good exercises I can do to make my knee feel better and stronger? Hoping to avoid physical therapy.

SO. As you can see in a recent question, a few weeks ago I did a 5k. I did a week of light training beforehand (jog 60 seconds, walk 60 seconds, etc). Everything was going great until I very, very stupidly trained two days in a row and on the second day, my right knee started to hurt. I iced like crazy, did nothing but stretching for the next week, and did my 5K with 80% walking. Since then (3 weeks ago) my knee still feels… a little off. I’m desperate to get back to training but I don’t want to do serious damage. It doesn’t HURT per se, and I’m not limping or anything. But it feels off. I can’t explain it. It feels tender like it's swollen but it’s not. If I press on it, there’s no pain and it doesn’t look different from the other one.

Here’s a pertinent fact. I spent my entire childhood sitting in the infamous “flying W” position. I still love that position now in my 30s, although I know it’s terrible for you and I never ever sit like that amymore. It’s so comfortable though  But yeah, supposedly that effs up your knees and ankles and hips etc. I’ve had ankle problems before but after some vigorous physical therapy, my ankles are now awesome. My knees however are crap. If I bend down/squat, they pop like a gunshot every single time. I do yoga but it hasn’t helped.

So what do I do to A. fix whatever I recently messed up with the right knee and B. strengthen both knees in general? I know, I know, physical therapy. My phys therapy for my ankle was a life changing miracle but it was also months of expensive, time consuming, super painful torture. Realllly hoping to avoid that here.
posted by silverstatue to Health & Fitness (12 answers total) 10 users marked this as a favorite
Does it feel like it's kind of making up its own mind on whether or not to bear your weight? Especially for stuff like walking down stairs or down inclines? I would start off by foam rolling the ITB on that side (both sides, really, it can't hurt) every day, especially after walking/running. Ice it whenever it seems even slightly off.

Depending on what's wrong with it, stuff like leg press and leg extensions to strengthen your quads can help. Also squats, so many squats. But knee issues are really difficult for a bunch of ppl on the internets to diagnose for you, and I think another round of PT is really your best bet. You are now at the age point where you can't just let things like this go without future long term headaches. You also want to make sure your gait isn't affected by any knee problems, which can lead to further problems with ankles and hips and feet and lower back.
posted by poffin boffin at 9:45 AM on May 27, 2015

What you probably need most is time, time and patience. But in the meantime find support options, elastic knee brace or big ace bandage. Swimming or biking or other exercise that puts less stress on the knee is a good idea.
posted by sammyo at 10:01 AM on May 27, 2015

Strength training for your legs can help with this. But if you want to make 100% sure you aren't going to make it worse, go to a doctor.
posted by chaiminda at 10:07 AM on May 27, 2015

Best answer: Knee issues are hard to diagnose, and you didn't state where the pain is. Generally with running, it's IT band or patellofemoral. Read up and see if either seems to be the issue for you. Generally, from my experience, and reading various running blogs, quite often knee pain is actually going to be from weak hips or glutes. I'd advise going to a physio therapist if you can.

Exercises that I've done (searching should get descriptions, or even youtubes).
1 legged standing calf extension
clam shells (progression: add resistance band).
side leg raises
1 legged bridging
front single leg lift (progression; add ankle weights)
Posterior Tib Arch Lift
mule kicks

As my legs were/are asymetrical in their strength, it's important that any exercises that use both legs (I.E. calf extension and bridges) be done with only one leg at a time so the strong leg doesn't do most of the work and results in the weaker leg not getting a full workout.

Additionally I stretch out my hips *after* running, and after my exercises.

I had acute knee pain fitting IT band description back in January. I had to severely cut back my distance, but the pain went away fully by March when I started bringing my distance back up. Currently in May I'm finally around the same distance (while being faster) as I was back in January except my knees feel great. Be patient in healing; I'm assuming you want to keep running.

Previously I never felt any weakness/soreness in my hips, I suspect that was mainly because my body wasn't developed to have much awareness there (I sit most of my day). Heck, the only place that ever felt tired were my calfs. Now, especially after a long run, I can feel how my hips or glutes feel, and this helps me to keep better form while running. With all of the calf extensions I do, I can't remember the last time my calfs actually felt tired while or after running.
posted by nobeagle at 10:15 AM on May 27, 2015 [4 favorites]

I had some knee pain after taking up running and have a balance ball (it's like half a ball) that rests on the floor and I balance on it with one leg at a time... It strengthens all the little muscles that hold your knee in place. That, stretching, and time.
posted by flink at 10:18 AM on May 27, 2015

Best answer: This could be so many different things, which are impossible to diagnose online. It may not even be your knee that's the issue - you could be getting referred pain from a back or hip problem, your trainers might be wrong for your gait, etc.

The good news is that if it's relatively minor (as it sounds), PT isn't going to take months. I've had running niggles sorted out in three physio visits, as long as I stick with the exercises they give me to do at home. It's a hell of a lot cheaper to go for short intervention at the start of a problem than to try and fix it yourself and have it get worse, especially if you're planning on running long-term.

I look on occasional physio visits as one of the running (ahem) costs of running, which is generally a pretty cheap sport otherwise.

It can be useful if you go to your first appointment and say "I can only afford to see you three times for this, do your best..."
posted by penguin pie at 10:24 AM on May 27, 2015 [1 favorite]

Don't rule out physical therapy. It's true that PT can be long, drawn-out, and painful. My PT for recovery from a broken arm certainly was. But when I was having severe back pain, the PT I got involved a 30-minute session with a physical therapist who gave me some core exercises to do twice a day. I did them faithfully for a week and had another follow-up session, by which point my pain was much less. I kept doing them, switching to once a day and then two out of three days after a while. I didn't need a third session, and as long as I do the exercises regularly and keep my core strong, the pain is almost entirely gone, and when it does occur, it's easily bearable.

First thing to do, though, is to consult a doctor, ideally someone who specializes in sports medicine (and ideally, one who's a runner himself or herself). S/he can help you figure out what's wrong and whether it is serious.

And the next time you decide to run a 5K, I'd suggest beginning 10 weeks before the event with the Couch to 5K program.
posted by brianogilvie at 4:07 PM on May 27, 2015

Also popping in to say check with doctor and then physical therapy, especially one familiar with sports injuries. I had a knee injury several years ago falling off my bike. The doctor confirmed that nothing was broken or torn but it definitely felt 'off' and I literally couldn't even bend my knee when walking.

The takeaway I had from my physical therapist is that knees are complicated and rather than just focusing on knees, you need to think of the leg as a whole, moving part.

For example, the exercises I had to do focused on calf, IT band, and glutes and my therapist would tweak my regimen depending on my recovery. A good physical therapist will also be able to do things other than just exercise such as physiotaping muscles for added support and electrical muscle stimulation. I think I had a weekly session for 3 weeks then a follow up a month after by which point I was walking normally again

It still took me a full year to get back to full functionality, as in, I was comfortable hiking and running without a brace or added support. Even now I have 'off' moments with my knee so I bust out some of the old physio exercises every now and then.

So yeah, tl;dr knees are complicated, so +1 for physio. Maybe see if you can set a limited regiment up front eg "I can only afford XX sessions so what progress can we make in this given amount of time?"
posted by kitkatcathy at 6:10 PM on May 27, 2015

Best answer: W-sitter / knee popper here as well. Nth-ing what everyone said in terms of PT ideas, finding a sports therapist, and someone who can think of the legs in a top-down (could be imbalance in the hips?) as well as a bottom-up (checking your gait/feet) approach. But knees are funky, for sure.

I was also diagnosed with IT band syndrome and patella-femoral syndrome and your symptoms sounds super familiar (running makes my knee feel...weird, off, like their going to give out but never do, sore but not swollen, if something bumps into my kneecap though I'm down for the count for about 5min). I also do yoga, even became a yoga instructor hoping to learn more about how my stupid knees do their stupid, but only learned that knees are complex. Did PT for 4 months before my therapist discovered there was something off with how I walked/ran/did anything on my feet which directly tied to my knees. Might be helpful...

Recommendation: For one week, pay attention to what you do with your big toes when you walk. By consciously pressing down on my big toe when I walked for a week I noticed a huge difference in my knees. Apparently, there's a muscle/ligament that runs all the way from the underside of your big toe, under your foot, to the outside of your knee. I first noticed in yoga intermittent pain in Eagle pose - if I tried to do the full wrap my knee all of a sudden hurt. Seems I had a tendency to walk with my big toe lifted which tightened that ligament and it would pull on the outside of my knee and throw the MCL all out of whack. Obv., IANAD, IANYD, but maybe an anecdote that I hope helps you! Feel better and good luck!
posted by danapiper at 7:03 PM on May 27, 2015

Response by poster: Wow, lots to think about here. Danapiper, I just did a quick eagle pose and didn't feel any pain. Those syndromes sound scary! Was your PT able to fix things? Brianogilvie, I was doing the Couch to 5K schedule but then I missed a day and tried to double up and... that's how I hurt myself.

I've never had any trouble with my knees before (other than the cracking noise they make when I squat). This is literally the first time they've ever hurt (but also the first time in about twenty years that I've ran further than a few blocks at a time). So I'm hopeful that it's not anything too serious.

But I hear what you're all saying and will see if my ankle doctor can suggest a good knee doctor for me and then see about at least a couple sessions of PT. SIGH. Stupid getting older! Thanks everyone for the advice.
posted by silverstatue at 8:24 PM on May 27, 2015

The best thing would be to go to a good doc and get a diagnosis, but unfortunately a lot of docs will just throw muscle relaxers and painkillers at it in hopes you'll feel better in the short term and your body will heal itself in the longer term. If it doesn't, you're back to square one.

I'm a massage therapist and I just saw someone the other day with unexplained right knee pain. After the session, not only had his pain gone away, but he commented that he didn't even feel his knee. I strongly suggest a session or two with a good, medical- or sports- oriented massage therapist.

You should also try using heat on your hams, quads, and calves. The ice is good for the knee itself but those supporting muscles would almost certainly prefer some heat at this point.
posted by mysterious_stranger at 9:26 PM on May 27, 2015

see if my ankle doctor can suggest a good knee doctor for me

Definitely try and see a sports med doctor over a regular orthopedist, since you want someone who understands that your focus is being able to continue your workout rather than just get rid of pain. The difference between the two when I had a hip labral tear was astonishing: the regular ortho office was full of +70 year old hip replacements who just wanted to be able to walk again, and he immediately recommended surgery for me; the sports med doctor's office was full of athletes who wanted to get back in the game, and she had me back on my feet in like 2 months with cortisone and physical therapy.
posted by poffin boffin at 9:17 AM on May 28, 2015

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