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Longtime runner, new severe knee pain

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#1 RunningRev

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  • Event: Recreational

Posted 06 March 2018 - 07:58 PM

Hi, everyone.  I wanted to get the advice of other runners here, as I'm trying to figure out why my knees have suddenly started hurting, and what kind of specialist I might go see if I can't figure it out myself.


I've been running for 20+ years; I'm turning 45 in a couple of weeks.  This is purely recreational running--I race occasionally.  My training runs vary from 4-12 miles, depending on terrain, available time, speed, goals, and weather.  I have and continue to run on a variety of surfaces; I live in the middle of Philadelphia, but there are many parks and trails here, so I run on concrete, asphalt, grass, leaves, and uneven trails.  I have very occasionally had knee pain, but it never lasts more than one run.


So here's the breakdown on the pain: 


It starts about 3-4 miles into the run.  It's on both sides of the knee.  It's been going on for about 6 weeks.  The pain gets severe, often debilitating.  


In between runs, I've had knee pain when navigating stairways (more so on descending).  

I've been running on these shoes for about 4 months with no problems.


I haven't changed the terrain I'm running on, nor have I increased the frequency of my running (still running 3-4 times a week).  


Here's what has changed, right around the time the knee pain started: 


I stopped doing heavy lifting in the gym: no more heavy back squats or deadlifts.  I changed to bodyweight-only strength training (which has been fantastic for my balance and my long-abused shoulders).  None of those exercises are new; just doing more of them.  Doing lots of pistol squats, hover lunges, air squats.  


I got a Concept2 rower.  Been hitting this hard because it's fun--about 3 times a week, I'll do interval training, and maybe one longer workout.


If I had to take an educated guess, I'd say that the kneecaps are somewhat out of alignment, possibly due to a strength imbalance in the quadriceps created by doing more pistol squats (not likely, as I did lots of these before) or rowing erg workouts.


What I've tried so far: 


Different shoes: I tried running with a minimal-drop pair of Inov8's, with no effect on the onset or duration or severity of the pain.  Same painful experience.  


Foam roller: daily, painful work on my IT band and entire upper thighs and hips.  Lots of stretching.  Everything is bound up and tight.


Lots of rest.  As much as I hate it, I've dropped my running almost entirely until I can figure this out.  I want my running back.


What I'm considering: 


No rowing for a while--maybe cut it out for a month and see what happens.


Would love any feedback or suggestions.  What sort of specialist would you go see?  A physical therapist?  Exercise physiologist?  Thanks in advance.

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