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Lateral knee pain when training for 10km run

endurojcbendurojcb Posts: 167
Hi,

I've stupidly agreed to do the 10km Asics London run on July 12th for charity so have been training for about 6-8 weeks! Realisticly I'll be looking to do the run in 50 minutes if possible!

To start with I was doing Fartlek training to increase my fitness quickly which worked wonders. I was doing this from anywhere between 20 and 35 minutes at a time on a treadmill at the gym. 8kmph for the easy stuff and 16km for the sprint part. During this sprint training I have had no noticable trouble with my knee(s) probably because I'm constantly changeing speed.

I have now started to run at a constant speed of 11kmph for the time being. Last Friday I did this and noticed that after 20 mins I started to get pain on my lateral right knee area (If you look at my knee from the front the pain is between the 7 and 8 o'clock position in relation to the patella, so it's pretty much at the top of my tibia). On the picture below the pain is pretty much where the Iliotibial Band (ITB) connects to the tibia. The pain gradually comes on, getting worse and worse after a few mins to a point where I can't keep running and have to stop!

I don't know if it is actually ITB sydrome, as people tend to get pain from the ITB high up at about the 10-11 O'clock position. I;ve tried stretching my ITB at the glute end, but don't seem to be able to feel any stretch in the lower part when trying other related stretches!

Could it be unrelated to the ITB and be my Tibialis Anterior or Peroneus Longus?? Or anything else for that matter?

I really don;t want to have to pull out of the 10km because of this so any help would be greatly appretiated, Thanks!

ITB2.jpg
2007 Merlin Malt 4

Posts

  • punctureboypunctureboy Posts: 217
    this is total speculation but if you usually do a lot of riding and have just switched to running it could be related to that. either way i would say that you've been doing too much high intensity training, which is the ideal way to pick up an injury.

    only do 3 hard training sessions per week. 1 long run at 60-70% working heartrate, 1 run at around 80% of your working heartrate, and 1 speed session. all your other training should be steady jogs at about 60% working heartrate to keep you ticking over and aid recovery.

    i used this for a 10km race once and almost broke 40 minutes! not to mention all the weight i lost, and fitness gained.
  • endurojcbendurojcb Posts: 167
    I only ride once or twice a week really, and have always done a bit of running down the gym, but normally only for 10-15 minutes max. I’ve occasionally had this problem before while running but never really worried about it. Years ago (6 or 7 years I think) I was helping a mate to move his office elsewhere. The lift was out, so we had to lug all his office furniture down 3 flights of stairs. By mid afternoon I hardly walk because of the same pain. It seems to hurt when I lift my weight off the leg rather than when the weight is applied to the leg. It’s the same with my running at the mo.

    I built the high intensity training up from 10 minutes gradually up the 35 minutes rather than jumping straight in at the deep end with it, and didn’t have any problems with that at all.

    I’m currently doing 4 running sessions a week (2 easy, 2 at 80-90% of max HR) and one ride at the weekends. I’m still building up to the 10km (7.5km max at the mo).

    I’m also a supinator or under-pronator, as my shoes always wear out far more on the outside of the heal and sole if that matters. I also wear a decent pair of Asics GEL trainers when I run.
    2007 Merlin Malt 4
  • Surf-MattSurf-Matt Posts: 5,952
    Might not be related but I have a slightly flat right foot and do a lot of running (all trail) - I wear orthotic shoe inserts than compensate - I was finding my inside right knee was getting very painful and this, along with decent physio exercises has almost got rid of the problem.

    I run 2-3 times a week and cycle at least 10 miles every weekday (and usually more at weekends) - I find cycling doesn't cause any problems at all.

    Good luck with the run - I've done a few 10km races - all off road. Best so far was 42 mins (quite a hilly course). I also find road running is worse for knees - partly why I avoid it.
  • mozzlemozzle Posts: 100
    I suffered with my ITB while training for the Great North Run last year. The pain you describe is simiar to what I went through.. pain gradually coming on the longer I run and eventually not being able to walk or stand due to the pain. The best dvice I can give you would be to get yourself to a physio who will help you to stretch and strengthen all the associated muscles and ligaments. After about 6 weeks of treatment my ITB was back to normal and I could resume training.
  • endurojcbendurojcb Posts: 167
    edited March 2009
    I also find that cycling doesn't cause the same problems. Just different ones! lol

    Went to the gym tonight a did a run, but as I thought, the pain came on quicker (after 8-10 mins)! I'm guess I'm going to have to call the Sports Injury Clinic at my gym tomorrow and see if i can make an appointment with them. Hopefully they can sort me out! Only 14.5 weeks until the 10km!!

    That's fast Matt!!! Nice!!! Last years winner of the Asics 10km did it in 30.06 apparently!! That's sprinting in my book!!

    I've also ordered a pair of Asics GEL Nimbus 10's today so hopefully they'll help with even more cusioning!
    2007 Merlin Malt 4
  • Father FaffFather Faff Posts: 1,176
    I'm more of a fell running type so there isn't so much repitition but on a few of the mountain marathons I've done I've had exactly the pain you describe after about 15 miles and the general consensus was it was the Iliotibial Band getting aggravated.
    Commencal Meta 5.5.1
    Scott CR1
  • punctureboypunctureboy Posts: 217
    it would be worth going to a running shop that has that video technology to assess your running style, so they can advise you on the best shoes for your running type. that should counter your under pronation and prevent injuries.

    i would swap one of your fartlek sessions for a threshold session. after a warm up try running at 80% for 20 minutes, then build up to around 40 minutes gradually as your training progresses. this gets u used to running continuously at pace for longer.
  • endurojcbendurojcb Posts: 167
    Cheers. How do I find a running shop that does that?? I live in the Herts/Beds/Cambs area!

    I wear a HR monitor when I run. At 11kmph I'm running at 90% max HR (170ish bpm as I'm 30 now), but I don't feel particularly out of breath at all. 80% (152 bpm) seems like a really slow jog to me!

    I didn't run tonight, and I'm not going to try it until monday to give the problem a rest. I'm going biking on saturday morning. Just a short 25km session so that shouldn't aggravate it at all. Then i'll see how I get on from then!
    2007 Merlin Malt 4
  • punctureboypunctureboy Posts: 217
    heres a link to the store locater for the shop i used. click on hte nearest shop and it will tell you all about the equipment they use. http://upandrunning.co.uk/shops/index.php?page=map

    i dont think your working at the right heart rates. i presume you calculated your max heartrate as 220 minus your age? this is a very generalised method and not accurate. try 170 to 180 bpm for your 80% training. 150 will probably be a steady state pace for you.

    at 80% your body cant quite intake enough oxygen so lactic acid will build up and your legs will become heavy at some point depending on your fitness. to start with you will only manage around 20 minutes without slowing down, but after a few weeks this will build up as you fitness and lactate tolerance increases.
  • endurojcbendurojcb Posts: 167
    Thanks for the link.

    Yeah, I was using 220 - my age.

    I'll give that a go instead.
    2007 Merlin Malt 4
  • hellsteeth54hellsteeth54 Posts: 111
    EnduroJCB

    Did you get to the bottom of your knee pain?

    I'm just curious because my symptoms sound almost exactly the same as yours.

    I started doing some running over winter, to try and keep a reasonable level of fitness up, but after a couple of weeks found pain gradually increasing in my knee after 10 mins, until I had to stop and walk.

    The pain disappears almost immediately, but running is (annoyingly) a no no. Even after a few weeks rest, it occured again on the next run.

    The problem now is, I went out today for a couple of hours gentle hill walking, and towards the end the pain came back! Its more frustrating than anything, don't like being out of action.

    Thing is, when out riding I don't suffer from this. Just achy knees after 3 hour+ rides, but not this sharp pain.

    Did you get physio in the end? Still training?
  • JK in the UKJK in the UK Posts: 132
    Hmm... and I'm equally as interested as I've been suffering similar pains to both of you (but especially hellsteeth54 by the sound of things) since an enduro race over a month ago.

    I stepped in last minute covering for a team member that couldn't make it but I'd done absolutely no training whatsoever and wore an old pair of £15 shitty fake running shoes from Sports Direct (or one of those crappy discount retailers). After 14 km running and 26 km cycling and with a history of knee problems my knees were destroyed. It was awesome though and I've since upped my game - I want to make a habit of competing at such events.

    The week after the race I was totally crippled and struggled with even walking! The next weekend I went straight to my local running sports shop where I got properly fitted for decent running shoes. I've been wearing them pretty much exclusively as they deal with my low arches (as identified in the shop but as I've always suspected).

    Annoyingly it's a problem I've not really suffered from too much in the last 5 years or so and thought I'd dealt with it. Now I can't shake the pain off in both knees for love nor money and its really hampering my training regime now. I can't run or do circuit training particularly well and its even bothering my cycling which is just unacceptable!! The only thing I can do is swimming now but I suffer really bad cramping above my kneecaps.

    Long story short I'd at least recommend getting properly fitted shoes - I think that wearing them all the time had been by far the biggest help to my recovery thus far (that and swimming).

    So please, hows it going? Any tips for us?! Help!!
  • Hi folks,
    I dont really know about this particular issue although I would urge a degree of caution based on my past experiences which resulted in finding a specialist who identified my particular problem, operated and transformed my life to having pain free knees.
    So...
    1- The internet is a great resource to find possible sources of your problem but at the same time can be misleading.
    2- with all due respect, the majority of nhs docs and 'specialists' in my experience are pants.
    3- speak to your gp and get a gp referral to bupa or the like and for a few quid you can have a real assessment done and get to the source of your problem and identify a solution.

    For me, it was an operation consisting of several different procedures.
    For a friend, her gait was assessed and she was told to buy certain footwear and fitted with orthopedic pads.

    With regards to the physio - they really need to know beforehand what they are treating specifically in order to avoid doing further damage. Not to mention you could be wasting (like in my case 10 years!!!) of time and money.

    With regards to shoes getting specially fitted - great idea but if you've got an underlying problem you could be making it worse and wasting money.

    So best advice I can give to save you time, money and years of pain is to get a real specialist to have a look.

    Good luck.
  • mea00csfmea00csf Posts: 558
    Just because the heels of your trainers wear out first doesn't mean you're an underpronater!! this is wear my shoes wear first as this is where my footstrikes, however, my ankle rolls in during the stride meaning i'm a slight overpronater. Only an analysis by a running shop will get you fitted properly with the right type of shoes.

    Interestingly i get similar knee pain after about 15km, more of a niggle than a pain, so might look into some stretches for ITB to see if it helps
  • Surf-MattSurf-Matt Posts: 5,952
    I suffer from a slightly flat right foot which means an unstable and often painful right knee and more recently, a sore hip flexor - both being sorted using physio.

    I'm a huge believer in good physiotherapy - a week before the tri I managed to win I was hobbling around with a really painful hip and dodgy right lat/trapezius muscle. Using intensive physio and ultrasound, it didn't trouble me at all during the race - of which the running section won me the tri overall (4th after the swim, 3rd after the MTB race, 1st after the run).
  • JK in the UKJK in the UK Posts: 132
    Hmm... cheers guys for your help. I hope it doesn't seem as though I'm trying to hijack the thread.

    What's annoying for me is I thought the years of dodgy knees were largely behind me but after that bloody race they are ever so easy to aggrevate. :(

    I think it's time for more professional help, but I'm going to have to put that on hold for the foreseeable future due to my current financial situation. Great! That's why I'm trying to self diagnose and solve my problems (although I know its an absolute minefield out there). Problem with the NHS is that it takes too bloody long to get seen by the right person!
  • gav320gav320 Posts: 8
    Found this topic very intresting as i have experianced the sane problem just this last sunday (MAY 31ST)
    I did a 10mile trail run at swinley forest and found about the 7 mile mark i started to get a pain in my left knee, down the outside of the knee, by the 9 mile mark i could hardly walk let alone run.
    My right knee was fine, but the left was real agony, so much so that when driving home i found it hard to use my clutch....not kidding really hurt!!!

    It does sound as though its my I.T band on my left leg, does anyone know of any stretches or excercises i can do to make it stronger.

    By the way i cycle a lot, and have never had this pain before, but my first real 10mile run and this has happened and have found it very frustrating as i wish to do more in the future.

    Thanks
  • Surf-MattSurf-Matt Posts: 5,952
    JK - not sure how much you have to pay but down here it's £35 for absolutely top notch physio (per session) - hugely worth the money IMO.
  • go physs simple really, i wouldnt buy any fancy shoes either as they waste of cash and arent really worth the cash as they provide little or no support compared to proper insoles ect like i now have.
    London2Brighton Challange 100k!
    http://www.justgiving.com/broxbourne-runners
  • Steve_b77Steve_b77 Posts: 1,680
    I have exactly the same kind of pain when i run.

    The general consencious of t'internerd was ITB.

    In the end I just gave up running as I don;t wanna suffer in later life
  • mea00csfmea00csf Posts: 558
    , if it wsn't for this i feel i could easily run furtherafter checking my works health insurance plan and realising i can get £250 worth of free physio per year, i'm off to the docs tomorrow to get a referral to a sports physio. Did 10km recovery run last night and all was well until 9km when knee stiffened up and started to hurt. This was also coupled with a slight sciatic pain in lower back/ buttock and a feeling of the whole leg stiffening which makes me think it might be something more complicated.

    Hopefully since it's only coming on on long runs it should get sorted fairly easily, my half marathon is about 8weeks away and i'm really hoping i'll be running pain free for then. My training runs are currently up to 17km, and the only thing that is really affecting me by the end of the run is this knee/leg issue :cry: If it wasn't for this i feel i could easily run further
  • mea00csfmea00csf Posts: 558
    so, a quick update....

    Went to the physio for an assesment last night. Was a little worried that he might struggle to get to the bottom of it as the pain was only there when running. I needn't have had any such worries as after a little manipulation and pushing on the knee i was howling once he found spot.

    Some assesments later (posture fine, foot arches good, flexibility good etc) the diagnosis is that i have rubbish glutes and therefore my hamstrings over compensate which leads to hip instability which when i get tired my hips are all over the place which leads to legs being a bit all over the place which is giving me ITB. The general feeling was that this is a fairly minor problem and that it's best for me to carry on running as long as i don't push too hard or past the point when slight discomfort worsens to pain, and i've got exercises to improve the strength and control of my glutes :oops: .

    Apparently weak glutes can lead to back problems as well if left so glad i'm getting it sorted.

    Hope others who had probs in this thread are on the road to recovery
  • Surf-MattSurf-Matt Posts: 5,952
    Similarish to me except only on one side - I do a series of glute exercises for the bad side (hip flexor) as well as knee exercises for a dodgy knee. Get the odd twinge now but nothing bad any more.
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