Bit of a salutary lesson learned in transitioning from cycling to running.

Gained all my fitness from cycling – started commuting, got in to road cycling, then off-road stuff – over the last two years or so. As I’ve lost weight and improved fitness I got carried away and felt it was about time I went for a run. So, about two months ago I started training for a 10k, which was last weekend. A week before the 10k my left knee was becoming tender and pained when bearing weight. Thought I’d run through the pain on the 10k, but around the 6km mark both of my knees decided to give in. Got a 52min time, so not terrible for a first run, but I was nearly walking by the end.

Since then, both knees are excruciatingly painful, especially bearing weight. The pain is directly below the kneecap on the inside of my knee and hurts particularly when standing and walking on the ‘downstroke’ of leg movement. It’s also particularly bad on going down stairs.

Can anyone advise on how to treat this? I’ve been icing, resting and trying to stretch, but it’s only just getting slightly better nearly a week after the big run. Such a dramatic injury has been of concern considering my general fitness, but perhaps it’s to do with my cycling physique, lack of bone density, or similar.

I really want to continue running, so any input would be useful.

At age 30, and around 12 stone, I didn’t expect this trouble!

Probably something as simple as IT band syndrome. Something all new runners suffer from.

Buy one of these http://www.ebay.co.uk/itm/PE-FOAM-ROLLER-15cm-x-45cm-pilates-fitness-rehabilitation-UK-/150866495916?pt=UK_Sporting_Goods_Exercise_Fitness_Fitness_Accessories_ET&hash=item23205809ac

and do this –

Be aware – it hurts like hell! Also google ‘it band syndrome’. Its easily fixed.

Happy running 🙂

I had exactly the same problem , rest was only fix and then I went to a proper running shop and they filmed me on the treadmill, worked out what I was doing then I tried a few pairs and took what felt the best and looked best in use , I started from scratch gradually upping distances and or pace and touch wood had no problems since

I don’t know where I developed the problem as I used to run loads in the army including being in the cross country team but maybe all the runs in boots did me in lol

Good luck mate 🙂

Btw my ankles were rotating as my foot went down can’t remember if it was out or in but the different shoes made a huge difference immediately on film and on how they felt

It could be patellofemoral syndrome, if it’s immediately behind the kneecap. Muscles develop a particular way when cycling, and that leaves a bit of imbalance which stops the patella fitting properly into its groove on the femur. Result is that the back of the patella gets all roughed up and hurts like a bugger.

I can get it mildly (because I know when to stop) if I have time off the bike then hit it hard again, but it doesn’t tend to hurt when I’m standing still just when I bend my knee. I also get it if I run up the stairs too fast in my house because the stairs ahve two twists in them – pushing hard with a twisting motion seems to dislodge something, cartlidge maybe, which then irritates the back of my patella. I know then to not do anything for a few days and it settles down.

Edward that is bad advice I’m afraid and IT syndrome is not something that “all” runners suffer from. It is also occasionally very difficult to resolve.

The Illiotibial band runs along the outside of the knee not the inside and pain is localised over the point that the IT band makes contact with the joint.

Molly is likely right its typical for the patella to run misaligned due to the imbalance in your quads.
I would try sitting down then with your leg straight bringing your toe as if to try and touch your shin. After 10 seconds it should be burning in your thigh. Rest and repeat as many as you can.

My knees are in a bad way now. I damaged my cruciate 5 years ago on my right knee and the left is now getting quite sore, probably from over compensating. I love running as it keeps the weight down.

I can’t give you medical advice but I’m sure someone here can. Practically, this is what I do.

I don’t run outdoors. Avoiding obstacles twists the knees and there is greater feet impact. I have no probs on a running machine. Still manage 10k in under 45min.

Crosstrainer is great as its pretty much no impact.

I can’t use bikes in the gym. That’s what the one in the hut is for.

As a fat burner I’ve recently started swimming.

Waiting on my physio referral from the doctor for my right knee at the moment. 32 14st

Ignore all advice and go and see a physio.

Apart from that bit of advice, obviously.

You want a solution, go see a professional in person.

Could be anything. Well anything other that ITBS.
I love these threads. They remind me of the benefit of studying physio for 4 years.

It’s anterior knee pain btw. That’s physio speak for knees that are sore at the front. 😉

I’ve heard a lot of stories about physios being rubbish.

Go see a sports injury specialist perhaps…

I would try sitting down then with your leg straight bringing your toe as if to try and touch your shin.

I presume you mean sitting in a chair, with your leg out straight? That’d be like trying to bend your knee the wrong way I suppose? That hurts a spot in the middle of my thigh quite quickly!

Thanks for replies so far. I thought ITB to begin with so hit the foam roller the day after the race. However, on further investigation I hear ITB related knee injuries are generally felt in the outside of the knee rather than on the inside of the knee.

I had a gait analysis before buying some running shoes and it was only my right ankle that showed some movement inwards. I got some stability shoes anyway – because I thought the protection might be worth it to begin with – and I’m thinking that maybe the stability shoes kept my feet too confined and put some torsional stress on the knee, knocking the patella out of line or something.

It’s so frustrating because on my 7km training run the week before the 10k I was doing 7min miles.

I’ve never had knee problems before. To be honest the pain felt almost as bad as a fracture the night of the race.

There’s slight swelling, slight heat. A small bruise has lingered on my left knee (inner leg), perhaps at the tendon insertion there. There’s slight inflammation of the joint space under the knee cap but nothing major.

Looks like two months from zero running to a 10k was too much. You’re aerobically fit from cycling but your cardiovascular system may have been writing cheques your legs couldn’t cash.

Stop the running for as long as it takes for your legs recover then if you want to start again build up much more slowly than you did before.

You could also try minimalist shoes.. a lot of people have great success, and are very against support in shoes. There’s a theory that it can make your foot do the wrong thing.

Plus, not every shop that does gait analysis does it very well…

I’ll run away from this thread now. Barefoot of course.

probably just common knee worms… MTFU

I’ve heard a lot of stories about physios being rubbish.

Some most definitely are rubbish

Some are effing Gods in mortal coils.

You do have to pick ’em carefully. Kind of easy for me knowing so many fell runners you pick up on who is good. Quite a lot of physios are sports injury types as well.

http://www.sportsinjuryclinic.net/sport-injuries/knee-pain/patellofemoral-pain-syndrome

Ignore all advice and go and see a physio.

Ignore this advice (well mostly)

You can pick up lots of good advice from experienced runners and some bad advice/treatment from some very highly qualified physios.

You could also try minimalist shoes.. a lot of people have great success, and are very against support in shoes. There’s a theory that it can make your foot do the wrong thing.

Thats very badly written Molly.

I agree, it does sound like you’ve gone at it too quickly initially. Bones will still be increasing in density, muscles and more importantly tendons and ligaments adapting.
Let you knees have a break, then start gentle again.

I’d also suggest trying neutral natural style running too. But, if you do, take it really gently because your calves and Achilles will need time to adapt. Well worth the effort and perseverance because it’s such a relaxing way to run.

Thats very badly written Molly

What do you mean?

Surfer is correct.IBS is on the outside of the knee.

I had it starting after 10 minutes steady jogging. The foam roller stretching though has worked miracles. Loosening up the muscle before running means I can run at a steady pace until exhausted. That takes about 1.5 hours for me a 52 year old. Shows the importance of loosening up leg muscles first and not charging out the door and pounding on hard pavements.

Rolling before hand didn’t do much for me. A proper painful session afterwards does work miracles for me though.

http://www.ehow.co.uk/about_5231689_pes-anserine-bursitis-exercises.html

Google pes anserine bursitis as a suggestion.

I think pes anserine bursitis looks like the most likely candidate.

Is this a specific cyclist to runner injury? Can anyone recommend any good stretches/strengthening exercises to remedy?

Thought I’d run through the pain on the 10k

Sounds like you have a daft approach to injuries & possibly training. You may also have poor knees or not do the right balancing exercises as above.

Sometimes these things clear up, loosen up or are adaptation pains. But I now realise that I had a growing problem. I couldn’t have foreseen that it would affect both knees in such dramatic fashion, however. Never had poor knees before.

insertion point of semi-tendinosus? i.e. tight hamstring ?

Run through the pain, that’s just about the most mis-understood thing in sport.

It refers to running past the point where you feel exhausted and really want to stop, so you get a second wind.

It doesn’t mean carrying on despite something being wrong with your joints, so that you end up properly knackering them.

OK, I meant run despite the pain, run off the pain, not run through the wall/physical exhaustion.

I think tight hamstrings would be a major culprit here. I’m about three inches off being able to touch my toes, and hamstring exercises such as sitting and leaning on each leg in turns is twingey.

The moment I get a twinge from my knees, I slow down – if I can’t manage it I’ll walk home. Not worth the risk of a proper injury.

Bit of a salutary lesson learned in transitioning from cycling to running.

Don’t!!

I would suggest seeing a specialist but that PFPS is the main consideration. The main clue is that its worse going downstairs. Is the pain medial kneecap? Is it also worse on getting up from sitting for a while?

It is largely caused by a weakness/imbalance of the VMO muscle compared to the lateralis/ITB/hamstrings. You need to correct that imbalance by strengthening the VMO (once acute pain is sorted) and stretching the lateral quads/hams/ITB. But you may also need to work on the neurological i.e. stabilisation component of the patelofemoral and tibiofemoral joints (specific balance/proprioceptive exercises) to address any faulty movement patterns.

There may also be other biomechanical factors involved – hence why it would be best to see a good specialist. You may find this article quite interesting: http://www.aapsm.org/patellofemoraldys.html

Get some proper advice, find a specialist doctor/physio either via local running club or specialist shop.

In the meantime go to pharmachy and get some gel ice packs (£5 each) and use for 5-10 mins 2 or 3 times a day

Dont do any more running till you’ve seen a specialist, you are young, not overweight and quite fit so something’s not right

I’m no expert but I’ve got “dodgy knees” always have had and distance running always was a problem even when I was very fit and playing lots of sport. Cycling is great as its low impact, perhaps running isn’t for you

I have identical symptoms (but just in left knee) – although I can feel twinges in right.

I however, don’t do a lot of running – almost nothing outside. Have been going to the gym for 18 months and started off with quite a bit of treadmill for my cardio – varying between 12.5 kph and 18 kph, up to a max distance of 5 km. This was ok apart from tight hamstrings, but stretching sorted this. Started getting slightly sore knees though and varied my cardio – usually limiting treadmill to 10 minutes.

Anyhow, any treadmill running started seeing sorer and sorer knees the next day, so cut this down to a fast walk at a gradient, with maybe 5 mins jog at the end.

Long story short – had to park half a kilometer from my area of work (basically turning a supply pillar on) so decided to jog down the hard shoulder of the motorway (in steel toe-capped boots). Half way and my left knee gave in completely – to the point where I could hardly walk. Bending wasn’t too bad, but the slightest rotation or load bearing was agony – also clicking when I walked. 5 weeks on and still slightly tender, but a load better (I know the wrong movement would see it in pain again though). Common diagnosis from people I speak to is cartilage.

Really struggling to do much cardio that involves legs, though I have found the cross trainer OK.

Thought I’d run through the pain on the 10k

Bad idea, huh?

Loads of rest, stop running and give yourself loads of time to recover ( 5-6 weeks maybe) then slooooowly build up, and now you know when you get pain: you have to stop.

muly1976, I think you get the prize. The description, symptom profile and cause all seem to match the problem. It would also back up my assumption that cycling has strengthened particular muscles and tendons in my legs, while leaving others under-developed for running, thereby destabilising the patellar.

Today has seen some relief from the pain. Hopefully increasing my walking distances will help in rehabilitating the muscles that I’ve neglected, and following some basic stretches and exercises of the leg will get me back on track.

Presumably most cyclists would agree that cycling and running are not mutually exclusive activities? If done sensibly is there anything to prevent the leg muscles, tendons etc developing to accommodate both without risk of injury?

I’d recommend a Physio. I’ve had to see a physio twice in the last five years, once for running injury once for cycling. Both times they worked out the chronic problems and helped me recover quickly. I’d try to “self diagnose” for months before in both cases.

Pick the right one though, the physio I saw most recently is an elite level runner so he had a very good undertstanding of sports injury.

Presumably most cyclists would agree that cycling and running are not mutually exclusive activities?

Of course not, you have a specific problem that will have a fix. That’s all. Good luck!

Thought I’d run through the pain on the 10k

Its not racing if its not “painful”

the physio I saw most recently is an elite level runner so he had a very good undertstanding of sports injury.

So you were treated by a runner who happened to have a qualification in physiotherapy 😀

There is no such thing as a sports injury. They are merely injuries sustained through sport.