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1739 Views 7 Replies Latest reply: Jun 17, 2013 8:00 AM by JamesJohnsonLMT
Display90210 Rookie 1 posts since
Jun 14, 2013
Currently Being Moderated

Jun 14, 2013 5:29 PM

No one seems to be able to diagnose

Posted on this forum in the past and received great advice so I am back again.

I have had a long time, nagging knee/hip pain which does not seem to go away no matter what I do.


Basically, about 1 hour ago I injured my leg on 2 long back to back runs. Felt a pulling pain around my bicep femoris insertion on my lateral, left knee.  Had to pull up and kind of hobble/walk home.

Iced, rested a few days, stubborn me ran on it again always trying to fight through.

Finally, after 3 weeks or so I kind of gave it up and haven't had luck since.

It's hard to replicate my symptoms exactly which has made it difficult to diagnose.


Symptoms/ability to recreate pain are (stars by what I think are key    ):

Lower leg (knee down) rotation  irritates it slightly it seems

As I run, it appears as if I have a harder time now keeping my leg externally rotated. It always wants to rotate internally

***During squatting/any hip movement down to parallel or so, my sartorious, TFL become in pain. Very difficult

pulling pain by my bicep femoris insertion when running

***When I have my hips on a table or so and my legs are hanging off, off the ground, my left knee becomes in pain. Almost as if it being "pulled" downward

I am tested by a Postural Restoration as being always favoring my right side. I believe it i right hip centric...

I feel almost as if my hamstring has had some atrophy or seems to cramp up more easily??

Uncomfortable/pain when crossing my left leg over my right (left ankle on right knee bothers more then left knee on right knee)


Things I have tried:

ITB physical therapy

Peroneal Nerve nerve testings

Posterior tilting my hips and pelvic rotation via PRI therapy

glute/hip strengthening

Deep tissue massage on my bicep femoris/hamstring

Guided Cortisone shot in the knee

Popliteus muscle testing

MRI on my knee


has anyone else had anything like this?? I am not sure if I never explain it right, hard to replicate symptoms, It has been going on for a year now and driving me nuts!!

Individual doctor's haven't had much luck so I am hoping maybe the masses will have enough experience to help with any directions, keywords I can use to describe it, etc

  • hayes55987 Amateur 9 posts since
    Feb 28, 2012
    Currently Being Moderated
    1. Jun 14, 2013 7:41 PM (in response to Display90210)
    No one seems to be able to diagnose
  • Damien Howell Legend 312 posts since
    Feb 27, 2008
    Currently Being Moderated
    2. Jun 15, 2013 4:06 AM (in response to Display90210)
    No one seems to be able to diagnose

    Ask your healthcare professionals to rule out or rule in a meniscial injury.

    Damien Howell PT, DPT, OCS

  • hayes55987 Amateur 9 posts since
    Feb 28, 2012
    Currently Being Moderated
    3. Jun 15, 2013 6:50 AM (in response to Damien Howell)
    No one seems to be able to diagnose

    They have already ruled this out with the MRI.

    Also, when I rotate my lower leg against force, there is no real pain. (they place my hand against calf and I must rotate against it)

  • hayes55987 Amateur 9 posts since
    Feb 28, 2012
    Currently Being Moderated
    4. Jun 16, 2013 6:35 AM (in response to Damien Howell)
    No one seems to be able to diagnose

    Other reasons they've ruled it out for all doctor's I've talked to:

    Wasn't generated by a twisting motion (soccer or something)

    Associated with hip pain



    They do all seem stumped that whatever it is has lasted so long however...

  • JamesJohnsonLMT Legend 1,183 posts since
    Aug 23, 2009
    Currently Being Moderated
    5. Jun 16, 2013 10:47 AM (in response to Display90210)
    No one seems to be able to diagnose

    Since these injuries/conditions are not symmetrical, have you been checked/treated for leg-length discrepancy? Whether an actual bone-length difference, or functional LLD involving hip muscles, unbalanced unilateral injuries are a strong clue for LLD. Another possibility is below with arch height, so foot structure should not be ignored either. There is an explanation for everything. Only a lack of data. Are you an over-pronator?


    Remember that a year ago, you posted similar problems after back-to-backs. I suspect there is something you train for, perhaps over-train for, this time of year.

  • hayes55987 Amateur 9 posts since
    Feb 28, 2012
    Currently Being Moderated
    6. Jun 16, 2013 6:41 PM (in response to JamesJohnsonLMT)
    No one seems to be able to diagnose

    Thanks James. I've been tackling this problem for awhile now but each time I've been treated for the exact area I've felt pain at that time. (knee, hip, etc all separate).


    The latest diagnosis I have had from a PRI expert (basically checking my form/posture/body lineup) is that I am right hip centric. They've explain this to me that my entire body basically is rotated and favors my right side. This in turn rotates my left hips forward which, due to pelvic tilt, is forcing my left leg to become longer/shorter then my right, hip pain can occur which can lead to knee pain, and also why I overpronate (due to my left leg always being forward, my hips will move inward and my arch collapses with it).


    Also, being a postural issue, this can explain the long/unrecovered state of the injury as basically, my body finally "snapped" and now it can't recover because it is always being injured.


    Now, while all explained to me it sounds fine and logical but being a computer programmer, I think in logical terms and I have a hard time believing bad hips can affect neck pain, etc. My logic is...if the knee hurts, it is the knee


    Does this PRI theory, logic make sense? I've been doing some of the mind/muscle exercises and to be honest, my knee has almost hurt "more". I'm attributing this to my body having to relearn and reuse muscles it has never had to. On the plus side, my collapsing arch has gone away as has my hip-popping syndrome.


    Although I seem to have some more pain as of now, am I on the right path and just need to undo years of incorrect balance?

  • JamesJohnsonLMT Legend 1,183 posts since
    Aug 23, 2009
    Currently Being Moderated
    7. Jun 17, 2013 8:00 AM (in response to hayes55987)
    No one seems to be able to diagnose

    As a former programmer, I can relate to your need to find a logical explanation for these problems, something beyond mere theory. Study of the human body has given me a greater appreciation for its seemingly infinite complexity, its ability to adapt and repurpose according to environmental stress, as any successful organism should. Such a mechanism is the Holy Grail of programming. However, it follows that, since much of the physiology is beyond our current ability to completely understand it, it will, at times, seem illogical. When the logic does not seem to be there, theory serves to bridge the gaps in the data.


    I will assume from your text that PRI refers to the Postural Restoration Institute, and the focus has been to identify and rework your body habitus and particularly, its symmetry or lack thereof. The theory is good. As it turns out, pains in the foot or knee can indeed be caused by anatomical features in your hips and back, and vice versa, because of the adaptation in the human organism I referred to earlier. Call it posture, as a snapshot in time. If we were machines, e.g. a car or truck, we might be fitted with a larger tire on the outside for racing a tight oval, as a mechanical adaptation that is easy to see. Physiological changes are often frustratingly insidious and less visible.


    Continuing with the vehicle metaphor, an alignment problem might cause premature tire wear or bearing failure, proceeding logically from cause to effect (and eventually to a mechanic), but the body adapts and shifts burdens from one part of the anatomy to another in an effort to survive without a mechanic. This adaptation may work for a lifetime, or fail and cause further injury in the unlikeliest of places. Running tends to tease out even the subtlest of imbalances. It is all still logical, but greatly complicated by physical growth and change. Moreover, there is a special means the body uses to indicate dysfunction, beyond idiot lights to a predictive language. Learning to read these signs accurately is a lifetime pursuit.


    So, being "right hip centric" has been a sign of physical imbalance somewhere, whether anatomical or functional. It is not at all unusual for a problem of this nature to be felt at the knee, even if there is no knee problem, especially if the knee is at risk for eventual failure. We are wired in such a way that we can feel pain in an area before is at risk, because other parts of our body are operating in such a way as to eventually jeopardize the health of that area. It's still logic, but highly advanced logic. At least, to the extent that we understand it now.


    So far, it appears that what is working in theory for PRI is also working in practice, evidenced by improvement in your hip and arch. Basically, you've spent your life to this point developing poor biomechanics, for whatever reason, and though these problems will not disappear overnight, they are likely to disappear some day, if you have the patience to stick with the program. In your case, I would feel lucky, because what passes for healthcare these days is often more concerned with pain control and compensation than remediation and elimination of both cause and effect.


    To summarize, your last question answers itself, if you reverse the "am" and the "I" and eliminate the question mark. Continued good luck to you, and may you enjoy years of happy running.

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