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762 Views 1 Reply Latest reply: May 30, 2011 11:52 AM by JamesJohnsonLMT RSS
JudysSon Rookie 1 posts since
May 29, 2011
Currently Being Moderated

May 30, 2011 12:33 AM

Pain in back of knee near Lateral Ligament

I was training for the NY Marathon last year and I had to pull out due to a severe pain in the back of my knee.  This was my first marathon and I haven't run any long distances for the last 10 years.  I was at the point where I could run 8 miles regularly and then something just seemed to happen one day at the gym.  While running on the treadmill I started getting this sharp pain in the back of my knee (right leg) at the one and a half mile point.  I just ran through the pain for another 3 miles assuming it was some random pain that would go away, but the pain got a lot worse.  I could hardly walk for the next several days.  A week later I tried running and I could not run over the one and a half mile point.  The pain always came back right at the one and a half mile point.

 

I stopped running for the next 6 months.  I tried running after the long break and the pain was still there, so I stopped running again.  I just went running yesterday and the pain is still there.  It's been almost a year now.  The pain in my knee won't let me run over one and a half miles.  However, I can climb a stairmaster or do the elliptical for hours with no pain.  I've been mountain climbing and no pain.  So, it seems exclusive to running, whether I'm on the treadmill, on concrete, or in the park on a dirt trail.

 

The pain is in my right leg, behind the knee, just inside the lateral collateral ligament on the right side of the knee.  It doesn't feel like the ligament though.  It feels like its behind the ligament on the right side of the back of the knee, towards the bottom of the back of the knee, just above where the calf starts.

 

Does anyone have any idea what this could be?  It's very weird that I can't feel any pain unless I'm running, and only until the one and a half mile point.

 

Thanks!

Roy

  • JamesJohnsonLMT Legend 1,147 posts since
    Aug 23, 2009
    Currently Being Moderated
    1. May 30, 2011 11:52 AM (in response to JudysSon)
    Re: Pain in back of knee near Lateral Ligament

    One thing to know about pain is that is not always exactly   self-diagnostic, that is there are causes of pain that feel like where they are, and many that feel like where they aren't. The easy thing is   to tell you what pathologies potentially inhabit the area where you feel pain, but the realistic thing is to address the whole picture.

     

    You   did not run for years and decided to train for a marathoncold-turkey.  I'm not making fun, because I did the same thing a while back. Marathons are inspiring and we all need a little inspiration from time  to time. Your goal is likely within reach despite this temporary setback.

     

    Marathons  test your endurance. Endurance is a   product somewhat of genetics, but    most certainly of training and   fitness. If you are fit you can train  well, but you can train yourself   out of fitness as easily as into it.  Right now you probably do not have some of the overuse pathologies that  plague seasoned runners and are often blamed for the pain you have. Chances are good you have overworked a muscle or group of muscles in  your quest for marathon   glory. Not to worry, we have all done this to  various extent, and your prognosis is probably very good.

     

    One    of the most frequent contributors to back-of-knee pain is a muscle that is not actually at the back of the knee, but is involved more in  running and other activities than it might be in stair stepping or  non-impact   activities because of its structure and when it is called  into play. I am referring to the upper calf muscle known as the  Gastrocnemius.   While only its two heads cross the knee on either  lateral side to   their mooring point on the femoral condyles, a frequent  and mysterious side effect of its overuse is a pain felt between those  two heads where the muscle does not exist, as if the brain were  averaging its   location. you can rub all day where you feel the pain and  not affect  the cause.

     

    There are also a couple of  deeper muscles involved in unlocking the knee to begin flexion, so it  is helpful to  isolate all these players before settling on a culprit.  The Gastroc is  engaged as a plantarflexor when your knee is straight and  you stand on  your toes, but because of its design across the knee and  ankle (via   the achilles tendon), it also acts as a non-loaded knee  flexor when   your foot kicks back and heel upward during running. Other  movements may not load the muscle at all, hence your exercises that  involve  the  knee with impunity.

     

    Probe this upper  rear calf  muscle with your fingers to see if you can replicate your  symptoms. It  is frequently overworked to dysfunction in new or  returning runners. After that, you can check the deeper Popliteus  muscle in the crease  of  your knee, but take care to avoid sensitive  nerves and blood  vessels  in that area that will also resister pain if  irritated. This  muscle  helps to unlock the knee by rotating the joint  when it is  straight. It starts on the rear medial tibia and ends on the  lateral  femur above. There is another tiny vestigial muscle that runs  from the  back of the  knee all the way down to the heel via a long  skinny  tendon. Though it does little in its title job as a  plantarflexor, its  small size helps it escape attention during  diagnosis). All of the  hamstrings can also  produce back-of-knee pain, and sitting on them  all day for years makes  this even more likely.

     

    An   extract from the following copyrighted article on muscular pain   sources (note bottom right, "Ts"  representing dysfunctional area and   red shading the associated pain  pattern):

    http://ts4.mm.bing.net/images/thumbnail.aspx?q=964490038039&id=4ec2de2ec31a306f2eaf1f10cb5989fc&url=http%3a%2f%2fwww.gadibody.com%2fimages%2fcontent%2ftreatments%2fsymptoms%2fknee%2fknee-pain-2.gif

    The   copyrighted article referenced (please note textual error in  discussion  of Popliteus, which actually connects upper medial lower leg to lower  lateral thigh, hence its action):http://www.gadibody.com/treatments/knee-pain.php

     

    Disclaimer:   I own  these charts, use them in my practice, and paid a lot of money for them  before digital versions were available on the web. That may  get me out  of copyright infringement, but any professional use beyond advertising  should involve purchase. They are based on many years of expensive medical  research, available from many channels, and should be taken  seriously.

     

    Message was edited by: JamesJohnsonLMT

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