UKC

Over the past 2/3 months I've gained a new injury, which has currently got me baffled.  I'd be interested to hear any theories.  I have already had one session with a trusted physio (about a month ago) which ultimately proved inconclusive - likely to have another session in the next week or two, in an attempt to get a diagnosis.

It's 'something' to do with my left knee (maybe!).  If I attempt to walk downstairs I get a sharp, shooting pain down the outside of my left shin (and a little bit in my knee).  This only happens as the knee moves through a relatively small angle, and only if I load the left leg individually.  I can bend from standing to squatting on both legs - no pain.  But if I try similar on left leg only then I experience this shooting pain (presumably because I'm fully loading the left leg?).  In all other aspects the knee seems fine - not swollen, no reduced range of motion, no other pains.  The knee is also not keen on any high steps - e.g. it feels weak and painful if I attempt to stand up onto a chair.

Up until New Year's Day I was running regularly - as I have done for years.  Mostly without pain, but I would sometimes take a few steps where my left leg would feel like it was slightly collapsing under me, then it would recover.  Running in a straight line was generally OK.  Corners and steps (specifically steps down) would sometimes give problems.  Over Christmas I started to feel pain while running - generally after about the first 30 mins.  I had to retire half way round a couple of events over Christmas and have decided to stop running until I'm recovered.  I'm walking plenty and doing regular sessions on the turbo trainer, as well as climbing (routes indoors) - none of these seem to give me any trouble.  But my knee doesn't seem to be getting any better.

I'm really baffled!  Happy to hear any thought.

In reply to Dave Todd:

A complete punt here, but could be sciatica? The lateral muscles of you shin/knee are  controlled by the common fibular nerve, which is a branch of the main sciatic nerve.

So could be pain radiating from some sciatic injury potentially??

In reply to Dave Todd: Strained your fibularis longis? Be interesting to know what you've changed to do this

In reply to Dave Todd:

Do you cycle much more than run? Weaker muscles supporting that knee, when pedalling a weaker leg can be carried by the stronger. Plus cycling isn't weight bearing, so if people are avid cyclists they really still need a fully body circuit once a week as a minimum. 

Strength and balance test them individually? Then have a range of exercises like hunters stand, lunges etc which work legs individually, even if I'm wrong it'll help fitness! 

In reply to Dave Todd:

You could always try another physio…I’m on my 3rd in 4 months trying to get a definitive diagnosis on my knee problem. 3 different opinions 😀

I’m going with the opinion I like and trying to ignore the “it’s arthritis” one.

In reply to Dave Todd:

My guess would be that you have damaged your meniscus - it doesn't sound like tendonitis (you usually can localise that) or patellofemoral pain syndrome (that usually aches at home). Small injuries (little swelling and no locking) are common (many run marathons with these based on the literature), but as an older bloke I have now had a couple of conversations with the physio and had the checks -  no big issues, but all a bit vague (internationally recognised physio department), and then have slowly recovered. I also know I should do more strength and stretching work and my recovery times are longer now.

I would see your physio again (I trust they are a running one) and get triaged for serious problems and checked for imbalances and form and increase the amount and type of S&C based on that. One appointment is likely not enough for a diagnosis.

Caveat emptor: I am not a medic/physio. I am just a runner that has had some knee issues. HTH

 

In reply to Dave Todd:

I've had those symptoms before and am currently managing some patellar tendonitis. I'm not a physio but I'm pretty sure mine is due either to hip mobility (my external rotation is noticeably worse on that side) or a weakness in adductors.

I'd suggest

1) Hip mobility, hip mobility, hip mobility (eg couch stretch, 90:90 hip stretches, deep lunge rotations)

2) stretching quads and strengthening hamstrings and glutes

3) watch yourself doing your single leg squats and see if both legs behave the same - does one knee move out and the other stays the same? Strengthen the things that will straighten you up.

Have a look for Tom Morrison on YouTube - He explains all this really, really well.

In reply to SouthernSteve:

That's what I had on one leg from focusing too much on cycling then transitioning to more running, muscles were weak and joint took a pounding. 

My physio (as mentioned above try a few) who I trust and is quite blunt, the truth hurts sometimes, said i was weak when we timed some individual leg test exercises. Something like "it's barely worth starting the stop watch to time this".

Kept running but limited to 20mins max, then body weight leg strengthen exercises every other day, lunges etc.. pain disappeared in a few weeks and it felt stronger on things like stairs. 

In reply to ExiledScot:

Some time back now…first words out of one of my physios mouth barely 60 seconds into some exercises.

”well basically you’re really weak” 😀

In reply to The Norris:

This is definitely a possibility (which has only recently come onto my radar).  I had my first experience with sciatica in spring 2023 ( https://www.ukclimbing.com/forums/off_belay/sciatica_-_any_positive_stories... ) which eventually made me stop bouldering at the end of 2023 (still hope to pick it up again in future!).  I'm pretty sure it's caused by bulging discs in my case, and I'd previously experienced the sciatic pain down my right leg - although I'm aware it's common for the pain to swap legs.  I've not really suffered with any sciatic pain through 2024, but maybe it's back!

I'll look at 'common fibular nerve' - I'm more leaning to the idea that this is some sort of 'nerve impingement' issue as time passes and nothing improves.  It would also tally with the 'sharpness' of the pain from a small, specific movement.

Appreciate your thoughts!

In reply to wbo2:

I'll look into it - anything's possible!  Thanks.  I didn't notice anything traumatic to cause the injury, but I'm open to ideas.

In reply to ExiledScot:

No, totally the opposite.  I've barely cycled in the past couple of years, and I run between 100-180k per month.  I've recently re-started turbo-training as I've found it has helped with kneecap alignment issues in the past (and it's been too cold and icy to even go for a walk recently!)

In reply to Wimlands:

Yes - I'm trying to ignore this possibility!

In reply to SouthernSteve:

Thanks - lots of things for me to review there!  Yes, the physio I saw is a very good runner (and also a climber).  We're part of the same orienteering club so she's very aware of the kind of stuff that I'm doing to my body.

In reply to compost:

Thanks - another thing for me Google.  Amazing how much can go wrong with a body...

This was something that came out of my first physio appointment.  Also: Lateral Calf rolling.

Will do - thanks!

In reply to ExiledScot:

This sounds like a good idea: having a complete rest from running doesn't seem to have improved things (yet!) - and I was usually able to run for a short while (30 mins) before the pain grew.

In reply to Wimlands:

I've had 58 years of being really weak.  Weakness is my great strength!

In reply to Dave Todd:

have you tried the doctors???

In reply to Dave Todd: Good luck - my feeling from the gradual development that you describe is that you've basically 'overused' something, and it's now kaput.

My experience with patella injuries is that you would notice that climbing. I also worked out that I was very weak . But at least that can be positively improved with benefits all round

In reply to SATTY:

No, not yet.

In reply to Dave Todd:

Could be referred pain from your hip...

In reply to Paul McWhinney:

Thanks - it could well be referred pain from somewhere.  The difficulty is knowing 'where'!  Unfortunately the body reacts to the pain as if it's from the knee/shin and acts accordingly.  Resulting in more muscle and structural aches and pains around my left leg in general.  I'll keep investigating. 

In reply to Dave Todd:

Get this book:

https://www.awesomebooks.com/book/9781608824946/trigger-point-therapy-workb...

If it is referred pain, this will show you where from and how to treat it.

Used it stop stop many niggles become injuries over the last 20 years.

In reply to Dave Todd:

No mention of shoes. Shoes worn down at the heel alters your gait. Cushioning will be better with a new shoe.

When I had leg issues the best advice I read, and was told, was to try new shoes; i.e the problem is under your feet. Can be expensive but has worked for me then and later.

In reply to Diddy:

Good call - but I'm pretty convinced this isn't the problem for me at the moment.  I've just checked and I'm currently using 8(!) different pairs of shoes (not all at the same time...) depending on what kind of running I'm doing (from sprints on tarmac, through all sorts of terrain with orienteering, to long mountain days) and I don't think any specific pair are causing the issue.

Thanks for the suggestion anyway - all ideas welcome!

In reply to everyone:

Thanks again for everyone's input to this thread - I've been pondering all the suggestions.

I'm settling into the idea that I have some sort of 'nerve impingement' thing going on.  I'm basing this on (a) very slow recovery over past few weeks, despite plenty of active rest - makes me think it's not muscular, (b) very specific type of pain in a very small area of my leg - nothing like the muscular or tendon pains that I've ever experienced, (c) definite feeling of some sort of issue in my lower back at the moment - and given the sciatica that I've had (on and off) over the past 2 years, I suspect that this may be connected.

I've been trying a few more of the rolling exercises that the physio gave me and I have finally found one that seems to reduce the pain and instability.  Rolling my lateral calf is the first treatment that actually seems to help.  I've also been doing lots more general stretching, core strengthening and conditioning exercises - in the hope that this will strengthen the muscles around the spine and hence reduce any sciatic nerve issues.

Something that did strike a chord with me when reading the replies to my OP was that I definitely don't do enough strength and conditioning work.  I'm 58 and I need to keep my musculoskeletal system in good shape - starting immediately!  This also extends to considering my diet (approximately pescatarian for 40 years) - need to keep my protein intake up to keep the muscles happy!

Cheers

Dave