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Health & Medical UnderGround >> Knee/Shin Pain


7/18/09 7:08 PM
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Schadenfroh
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Need some advice!

I've been running 3-5 miles a day for a little while and I started to get a sharp pain in my knee around the patella...i think as well as stiffness.

So I took ibuprofen and rested for a week. Started running again and anything past 2 miles my knee would start to hurt.

So I took ibuprofen and rested for 3 weeks. I still lifted, biked, and used the elliptical. I ran 2 miles the other day with no pain but I do noticed sharp shin pain when im squating or bending my right leg. The pain is at the very top of the shin. Also there is one exact spot on the top of my shin that is sensitive.

My question is do you think the shin pain is actually related to the knee pain?
7/19/09 4:46 PM
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WidespreadPanic
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What is your weight and age? Do you have good running shoes that don't 'sink in' when you run (causing pronation)?

It can be difficult to diagnose running overuse injuries. Usually it's related to foot pronation (or supination), transfering the forces and stress up your leg. Sometimes it can be that your pelvis is tipped forward (too much back curvature). Do you have a gut or something?

It turns out the energy output for fast walking is not a whole lot different than running. Why not find a very hilly course and just walk quickly and see if you can do that instead. Time yourself and aim to reduce your time and gradually increase the distance. Sure, walking is not as 'macho' or as sportive as jogging, but it's not that difference, depending on how you do it.

What speed were you jogging at? If around 10min/mile, then you shouldn't experience any degradation in conditioning if you just walk vigorously on uphill courses.

Sometimes people are just not biomechanically adaptive to running. Keep cycling on hills and using elliptical, and with those three cardio applications you shouldn't lose much.

You might be able to get a gait analysis at a good running store - something to look into.

HTH, and good luck.

7/20/09 11:52 AM
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martinburke
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^^^^Some good advice above


Schadenfroh - My question is do you think the shin pain is actually related to the knee pain?



Most of the muscles on the front of your leg, from where tibialis anterior attaches at the bottom of the first metatarsal... to where rectus femoris attaches at the anterior iliac spine are encased and infused with the same myofascial sheath. This myofascial sheath tends to thicken and fray when subjected to repetitive movement, latching on to other tissues or being unable to slide alongside or under others.

When this "track" is adhered or impeded in one spot, it pulls and tugs on every tissue up and down the line, and you could feel it more in a location far removed from where the major restriction is.

Some places for you to look:

• In the arch of your foot, just behind the ball of your big toe. There could be fascial restrictions in there or calcification at the attachment. Putting a golf ball on the floor and slowly and thoroughly rolling your foot on it will help there.

• Staying on the foot/ankle, there are several bands called retinacula that act sort of like the hoops on a barrel do.

http://home.comcast.net/~wnor/ankle.htm


The tendons of tibialis anterior and all those little toe extensors have to slide freely under those bands, but the bands are often tight and inelastic. I've found the best technique is similar to "indian burn", so use a tiny bit of lotion (and some common sense) to work those retinacula.

• You could also pin tibialis anterior with your fingers right where the shin meets the ankle, and plantarflex and dorsiflex your foot. You might feel little pops(or something similar to bubble-wrap) as you flex your foot up and down.

• Moving up the shin, follow the path of tibialis. Take the slack out of the muscle, pinning it in the direction of the knee, and continue to plantarflex and dorsiflex your foot. your fingers should inchworm up your shin as your foot moves up and down. Continue up to the patellar tendon.

• The knee also has retinacula.

http://www.chiroweb.com/mpacms/dc/article.php?id=50218

That "indian burn" in that area could also help.

• A common culprit for someone with your symptoms is rectus femoris, specifically at the musculotendinous junction where it reaches the patella. Repetitive motion can cause adhesions that force the patella to move in directions it's not designed to go, and habitual postures can cause rectus and the underlying vastus
intermedius to adhere to one another...which reinforces rectus' bad influence on the patella. This can lead to arthritic conditions or bursitis.

The technique I've had the best luck with is similar to the pin-and-stretch I mentioned with the tibialis. Use a little lotion so you don't pull hair. Sit on something high enough so that your lower leg hangs freely and has room to swing. Straighten your leg and take the slack out of the tissue above the knee, pinning it in the direction of your hip. Keeping the slack out of the tissue, alternately lower and raise your lower leg at a moderately slow pace, and your fingers should inchworm up your thigh.

• There's another retinaculum on the upper thigh, so "indian burn" that, too. In addition, there's a muscle called sartorius that attaches to the anterior superior iliac spine and the medial shaft of the tibia. When sartorius tightens down it acts like the twine you put around a Christmas tree when you bring it home, squeezing everything beneath it.

Sit on the floor with your legs out in front of you. Roll your foot inwards so that your thigh turn in medially. Use your thumb to push the lateral edge of sartorius medially as you roll your thigh outward. If it's involved, you'll feel a sort of speed bump as you roll over it. The intention here is to peel it up off of the quadriceps.
Just keep re-setting your thigh as you move down the length of sartorius.
7/22/09 11:20 AM
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Schadenfroh
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I'm 24 and weigh 175. I'm using nike frees atm i enjoy them!

I'll look into finding a shoe store that will to get a "gait" analysis.

Also I will try out that Indian burn!

Thanks for the info/advice guys
7/23/09 6:13 AM
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WidespreadPanic
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OK, guess I'd need your height to get a good idea, but over 150-160 lbs and for some people, running can be a problem since you're magnifying the impact forces. Besides the above can you easily get down below 170? Your problems might be less then and if so, depending on your height and body build, try for 165-ish.

Depends on what your focus is. Are you interested in running a sub-7:00 pace, or are you just training for MMA? If so there are other ways besides running if you have a biomechanical problem.

On the shoes, please note:
  • Supposedly trains intrinsic muscles, strengthening your foot and giving you more natural stability
  • Good sole protection on pavement or small gravel surfaces.
  • Meant for shorter runs of 3-6 miles.
This means the shoes are stressing your muscles (so as to build them up). You may be upping your mileage too much.

I'd suggest a shoe that is more stable and less 'spongy' for the majority of your runs and gradually work into the Nike Frees and keep the mileage lower for them. You should also do some runs on grass or a special track barefoot if you like those types of shoe. Also, work on developing your foot muscles doing the towel grip and running in sand and soforth.

The big thing is to increase your mileage VERY slowly. I mean no more than a 5-10% per month or less at first. In a year you'll be getting good mileage so no need to rush it. Finally, CONSISTENCY. If you go whole hog on the running, then lay off for a week, you're back to square one. Better to do 4-5-6 days a week of easy running for short periods and not miss workouts.

HTH


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