UKC

Out running last week I experienced a sudden, sharp pain in the front of my right knee, over the kneecap. I was running on a level, tarmac path at the time. I slowed down to a walk for a few yards and the pain went away, so I carefully speeded up again and continue my run with no further problems. My return route included a couple of steepish uphills (one on grass, one on pavement) which gave me no problems at all, and one short, very steep downhill tarmac path which experience has shown me is too steep to run safely, so I now always walk down that anyway.

The day after the run, having experienced no further symptoms, I went to the climbing wall and had a problem-free session. At the weekend I went for a walk which included a couple of short uphill sections, and again I experienced no symptoms.

Since then, though, I've started to experience the same sudden, sharp pain when going up and down stairs - to the extent that at the moment I can only use my left leg for ascending and descending, with my right leg just supporting my weight without flexing as I step up or down with my left leg. The pain occurs within a fairly narrow angular range as I flex my knee and it only occurs when I have my weight on the leg. Seated, or standing with my weight on my other leg I can flex the knee perfectly freely, although actually sitting down or standing up does also trigger the pain.

I am booked in to see the physio on Friday, but I was wondering if anyone has any advice as to how to look after the knee until then. Should I ice it or use anti-inflammatories? Are there any exercises which might help in the mean time?

TIA for any helpful advice.

In reply to Martin W:

I had a similar problem at the weekend on a run, coming down some steps - I had to walk for 1km then started running gingerly. It was ok and 24hrs later its settled down. Bit worried about my next run though.

Advice is the usual RICE - Rest, Ice, Compression, elevation. Ice for 48hrs then switch to heat unless there's swelling. Ibuprofen is good as well. Get a compression bandage to wear around your knee which will help circulation and healing.
Don't do any exercises - good call to see the physio to get a better diagnosis

In reply to Martin W:

I have the same first got it last summer after a week in the Alps. Sharp stabbing pain in the front of the right knee....doesn't bother me running only when I've been out on the fells....pains not constant just sharp stabbing then disappears????

In reply to Martin W:
Rest it from painful activities. You are correct to do the stairs with bad leg leading down, and trailing up, one step at a time. NSAIDS IF you can take them. Ice indefinetly, 4-6 times a day 20 mins through a barrier. I wouldn't put heat on it for at least a week. Google static quads exs and perform some of these regularly . Maintain pain free bend with no weight on it, and also, full extension with your foot up on a heel raise.
It could be some torn quads tendon fibres. This can be hard to settle if you don't fully rest it!! If it's pain in the fleshy bit below the knee cap, transverse frictions can help. If it's pain behind the knee cap, it could be some damage to the hyaline cartilage.

In reply to Martin W:
Not good for us that running lark.

Especially downhill.

I shouldn't as I have a damaged ACL. but can't help myself.

Running uphill is fine ,and so is most downhill.

Running down Ben Nevis is the one that bites my arse.

It's those bastard red granite steps

In reply to Martin W:

Was in the same position last week, unfortunately at 900m on Stob Ban as the weather took a decidedly grim turn. Descent was straight out of Ministry for Silly Walks, hardly able to flex the knee on the way down, and as for the cycle back out to the van....well, let's just say I was gurning a bit.

Trip to A&E next day (could hardly move the joint at all) confirmed what I had unfortunately suspected - cartilage damage. Off back in tomo to see a consultant.

Sounds like your pain is/was similar - feeling of something "rubbing" or "catching" behind knee cap? I likened to to a bit of stuck gravel and the nurse immediately said cartilage...
Very painful to flex/feels "locked" but only in certain ranges? Same here...unfortunately at the basic range of moving it from a straight position!
I was given crutches (complete rest for two days) and a tight Tubigrip. Three days later and feeling back to normal (but no more hill days or vigorous exercise until I've seen consultant.

Cold weather somehow makes it worse (it's been going on since before Christmas, but always at a manageable level, until last week!!).

Good luck!!!!!

Thanks for all the advice. I tried icing the knee last night, while keeping it horizontal, and that seems to have helped a bit. I'll give it some more of that today when I have the chance. I've also cracked open a new slab of Ibuprofen, and checked out the static quad exercise.

I'm a bit miffed at suddenly turning in to Hopalong Cassidy (at least on the stairs) for no readily apparent reason; the problem really didn't emerge until a full week after I felt the twinge during the run. I actually tried a gentle jog while I was out and about in town yesterday (with the slight excuse that the car was on a meter) with no problem at all. It's just those flippin' stairs, and other careless movements when I flex my knee with my weight on it and it suddenly reminds me that it's not happy.

The NHS web site http://www.nhs.uk/conditions/knee-pain/Pages/Introduction.aspx suggests a tentative diagnosis of "Anterior knee pain syndrome": Knee pain felt at the front of the knee, around the kneecap... The cause is not understood Not terribly helpful, although the advice offered does match the general ice/rest/NSAIDs and exercises recommendation.

Oh well, at least I've got a visit to the physio tomorrow to look forward to. And the forecast for Saturday is horrendous, so it looks like the planned hill trip I thought I would have to miss because of this won't be happening anyway.

In reply to Martin W:

Just rest and self treat for a few weeks. Ice, gentle exercise that doesn't hurt and ibuprofen. If that doesn't work, then see a physio. They don't have healing hands.

In reply to Martin W:
Could be Vastus Medialis Oblique (VMO) issue?

Step Down

http://chadwaterbury.com/step-down-for-stronger-healthier-knees/

VMO - ball roll

youtube.com/watch?v=S5BDi8Oj5eM&


or, Medial Knee Pain (Pes Anserinus Tendonitis/Bursitis)

In reply to Martin W:

Sounds like a cartilage. Get to physio.

In reply to Martin W:

How did you get on? The "surgeon" I saw suggested there wasn't anything wrong with me and if it hurts again to see my doctor!! Basically he didn't want to be the one to refer me for an endoscopy. When I suggested to him that I kind of need my knees for my livelihood (outdoor instructor) and that it would be good to know whether it's going to happen again or get worse, he said that would be purely speculation!!

And as for my question about there being anything I could do to stop it happening? "Change your livelihood" was the profoundly shit answer!!!!

I feel I'll be seeking a second opinion fairly soon....

Cheers,
Gordon

In reply to peebles boy:

That's the NHS for you in my experience. They do great work patching people up but if they perceive the cause to be in your hands, tough shit. Shell out for a private consultation.

In reply to peebles boy:


The physio diagnosed a strained patellar tendon. She gave me some ultrasound (which does seem to be their default treatment for non-muscular injuries!) She also recommended some exercises, including one very similar to the static quad exercise suggested by Skol, and a variation on it with the foot turned sideways. I'm still taking Ibuprofen and wearing the Tubigrip bandage as well, both of which she was happy for me to continue with.

The pain is still there if I try to go up or down stairs normally, but it isn't as acute as it was. I shall continue to treat the knee with care as advised, and see whether the apparent improvement continues.

In reply to Martin W:

Yay! I go to the top of the class. The foot turned out version is to work VMO..
Good luck