Wednesday, May 14, 2014

PFS: It's Not the Bees Knees

Bees Knees:  (slang) an extraordinary person, thing or idea; the ultimate.  So says   Ironic that it would be the exact opposite of what's going on with MY knees.

Yes folks, I'm bringing back the 1920's slang for this one, ha ha.  It had to be done.

If you're a regular reader of this wee blog, you know that I've been having knee problems since January.  And by "problems", I mean soreness after running, usually when walking up and down stairs.  It's also been very uncomfortable when I start running but then it usually sorts itself out and I don't notice it any more.  The big issue I've been having is not when I'm running though.  It's been when I go to extend my left leg.  I can't fully extend it without feeling pain along the side of my kneecap.  This isn't problematic when I'm running, thank goodness but it is an issue when I'm at the gym.  It's difficult for me to do any sort of exercise that involves a fully extended leg.  Like planks, push ups or hip extensions.  It also started to bother me a bit when doing single leg squats, which Ming had me doing fairly regularly.

I assumed that a lot of this was due to my insanely tight muscles.  I had been going to physio and she had said she felt that all of this was stemming from my feet and ankles.  My ankle mobility was next to non existent so I was putting stress on my calves and my feet, which in turn put stress on my knees.  So I worked on my mobility.  A friend of mine suggested I try Graston to help loosen everything up.  I've been doing that regularly and that seems to have helped a lot.  Yet the pain upon extension was still there.  So of course my mind went down the "Oh crap, I've done some serious damage to my knee" road.  I was worried I might have torn my meniscus (no thanks to googling my symptoms).  So about 6 weeks before Boston I made an appointment to see a sports doc.  I couldn't get in until AFTER Boston so the week after I got back, I went in to meet with Dr. Schofield at Pivot.  He did a bunch of tests on me and dismissed the meniscus as the source of my pain.  YES!!!!!  He sent me for an x-ray to see if there was any sort of arthritis happening in my knee.  Apparently the x-ray came back negative.  His diagnosis?  Patella Femoral Syndrome. (aka Runner's Knee)


I've been told that it's a very vague diagnosis but in my case, it means my kneecap is not tracking properly.   You can actually see the difference in the way my left kneecap lays vs. the way my right one does.  My right one lies flush to my knee and my left one is angled up.  There are several factors that can contribute to this:

1.  Weak quads (totally not my problem)
2.  A weak VMO (vastus medialis) muscle.  This seems to be a bit of an issue on my left side.
3.  Very tight muscles (um hello, I do way too much moving and not enough stretching)
4.  A tight IT band (welcome to my world)
5.  Weak hip muscles
6.  Weak or inactive glute muscles

Apparently I have at least 3 of the 6 things happening, maybe even 4.   My IT bands are a mess.  Especially my left one.  I have been going to A.R.T for the last couple of weeks and I've been doing these crazy squat type exercises to try to engage my glutes more.  Because my kneecap isn't tracking properly, it's been irritating the fat pad below my kneecap.  Running irritates it anyway but when the kneecap isn't tracking properly, it makes it worse.  Needless to say, ice has become my best friend these days.  I even had my first ice bath of the year the other day.   The things we do to keep moving, right?

I think what it really comes down to is the fact that I clearly haven't been stretching or foam rolling enough.  Foam rolling used to be a regular part of my post workout stretching routine.  The more I started to do, the less time I had to foam roll.  It's a horrible catch 22.  Now, it's back in my life.  I do it after every workout.  I even do it on my rest days sometimes.  It needs to become a regular part of my routine once again.  I push myself like my body is still in it's 20's.  I have to remind myself that I'm nearing my mid 40's and that certain things, like flexibility, change as you age, especially if you don't work at it on a regular basis. 

I am relieved that it's nothing serious but it really made me think that maybe, just maybe, I need to slow things down a bit.   That will probably take more discipline for me than actual training, ha ha.



Wendy at Taking the Long Way Home said...

I'm so glad that it is nothing serious, altho it could be if you compensate for that pain! My trainer is a corrective exercise specialist, last summer she focused on some of my weak areas and the work she had me do really seemed to help. I don't think she could do anything to prevent to broken foot! I'm just putting it out there as another option for you...its a little different than PT.

misszippy said...

Glad you have a diagnosis and it's one that can be worked through. I'm going to pipe in and suggest you read a fantastic book: Anatomy for Runners by Jay Dicharry. It will change the way you think about fixing injuries and their underlying cause. Really a read every runner should have on their bookshelf!

Emma said...

I'm glad it's not something worse! Why is it so easy to slack on things like foam rolling? It's not hard to do, and I know it makes me feel better after, so why so much trouble fitting it into my schedule?

I guess of many of us need to pay more attention to these things!

Phaedra Kennedy said...

I definitely think I need to find someone like that! I also think I need to go for a gait analysis so I can figure out what's happening when I run. Maybe I can do that when I slow things down, ha ha.

Ashley said...

Have you tried one of those knee straps? I had a brief bout of PFS and that strap helped lift the kneecap above the fat pad that it was irritating. It gave my knee some space to heal, while I did that other stuff - stretching, foam rolling etc. They cost about $10, so worth a try, right?