[SA Chris]

Is it classic runners knee / Patellofemoral pain?

[Fultonius]

Is it classic runners knee / Patellofemoral pain?

It'll be a mix of that and the fact I had 3 knee ligaments replaced in 2009...  So my biomechanics will be a bit "off".

Edit:the surgeon said it was early stage cartilage degradation (some minor signs of the start of fissuring etc.) and reading online it does sound a lot like:  Chondromalacia_Patellae  which is the more degenerative version (rather than a tendinitis type thing).

[SA Chris]

Ooof, forgot about the ligaments, that can't help.

[James Malloch]

I’ve got a recurring injury which i need to go back to my physio about. But its been bugging me lately due to one weird aspect.

I can happily go out for an hour or longer doing 2 mins run, 1 min walk. But if i try to do a solid run (i.e. no walking) my injury always flares up after 15 or 20 mins, without fail.

My injury is in the top of my calf(outside of leg)/back of knee. My physio said there was trapped fluid (found via ultrasound) and that my running technique was shit.

I did loads of physio (full year worth) got way stronger and my technique improved hugely, but the same thing kept happening if i tried to run without any walks.

I’ve fallen off the physio bandwagon this year, but I’m walk-running 3 times a week. Tried today to just run and the same thing happened again after 15 mins (at a pretty slow pace).

All i can think of is the lack of break might impact my technique a little, but it’s not like I’m pushing myself or anything.

Before i book back in i thought i would walk to see if anyone has heard of something similar happening as it’s got my stumped 🤔

[Mr_Cus]

I've not had that problem so can't be of much help but I was wondering if it could be shoe related?  I'm guessing you've tried a different pair for a bit?

[SA Chris]

I'm no expert but... In my mind having trapped fluid for that long surprises me.

Can you isolate the pain point, or is it a general area? IIRC there are 2 layers of muscles back there, the deeper the pain feels, the trickier it is to treat.

[James Malloch]

Ive not tried different shoes in the last 7/8months so I’ll give some a go next run. It’s nearly dry enough for me to use my road shoes on my woods loops.

And the pain is very much on the surface. Its the calf muscle at the very top of my fibula.

[Stabbsy]

My experience on various persistent problems for both me and my wife is that all physios are not the same. Is it worth trying a different one? The Wharfedale Clinic in Guiseley always had a good rep amongst runners - I think that’s fairly local to you?

Have you tried varying the run/walk splits? Can you do 4 run/1 walk for example and then slowly increase to work out where your limit is? Progressively loading might help with rehab.

[webbo]

I have something similar many years ago. When I took up running again after a long lay off. Walk and run was fine but like yourself after 20 minutes running pain in the top of my calf and needing to stop running. In those days it was advised to to stretch before running and the physio’s conclusion was this was giving a message to muscle that there was hard work coming and the muscle was shutting down.
So the advise was no stretching and a very gentle build up in the run. However in the end I just gave up on the running as it I was something I was doing when I didn’t have time to ride my bike.

[chriss]

I've had a few running injuries/ niggles over the years and personally have had more success with sports therapist or an Osteopath than physio- anyone in the profession please don't take offence.
I sourced them via running club's or running social media (FB groups).

I'd also consider going to a good running store to get an update gait analysis as it can change over the years. Thing's like heel striking aren't as bad as over striding.

Last one a 5 min warm up at home to wake up and mobilise the muscles, followed by a cool down with foam rolling/ Thera gun type machine will help.

[SA Chris]

Agree on the trainers, especially if they are due for replacement / done over the recommended 500 miles (I don't stick to this btw but can see why people do).

[T_B]

Weird sounding injury. It’s not a bursa is it? I know people who’ve had a baker cyst but that’s more on the back of the knee.

Yeah I’d get a second opinion from someone who specialises in running injuries. Good luck!

[James Malloch]

My experience on various persistent problems for both me and my wife is that all physios are not the same. Is it worth trying a different one? The Wharfedale Clinic in Guiseley always had a good rep amongst runners - I think that’s fairly local to you?

Have you tried varying the run/walk splits? Can you do 4 run/1 walk for example and then slowly increase to work out where your limit is? Progressively loading might help with rehab.

Thanks for all the replies. Lots of interesting thoughts.

I was actually climbing with a physio today and he said similar to Stabbsy. He said it could be a weird nervous system reaction where my body is shutting the movement down after a certain amount of trigger.

I don’t think the pain is actually an injury as such, more that it is immobilising my leg before an injury occurs. As once it’s settled down there don’t seem to be any lasting effects.

He suggested upping the running time but keeping the 1 min rest and seeing if i can work out a trigger, or at least get my body used to something a bit different.

I’m actually quite happy with the walk-run normally, but it would be nice to do the odd run with others but where I can just go for an hour without worrying.

Its also good to know about the Guisley physio, thanks. I think there’s also another in Skipton who used to Chair a fell running organisation who I’ve not seen before.

[webbo]

My experience on various persistent problems for both me and my wife is that all physios are not the same. Is it worth trying a different one? The Wharfedale Clinic in Guiseley always had a good rep amongst runners - I think that’s fairly local to you?

Have you tried varying the run/walk splits? Can you do 4 run/1 walk for example and then slowly increase to work out where your limit is? Progressively loading might help with rehab.

Thanks for all the replies. Lots of interesting thoughts.

I was actually climbing with a physio today and he said similar to Stabbsy. He said it could be a weird nervous system reaction where my body is shutting the movement down after a certain amount of trigger.

I don’t think the pain is actually an injury as such, more that it is immobilising my leg before an injury occurs. As once it’s settled down there don’t seem to be any lasting effects.

This is what I was saying above. It’s the muscle saying it doesn’t want to work hard or get injured.
My physio thought at first I’d torn the muscle but given I was pain free with a couple of weeks he discounted this and came to immobilising theory. He also come across in a semi professional footballer who could train and warm up fine but once he was running continuously he would get the problem.

[James Malloch]

My experience on various persistent problems for both me and my wife is that all physios are not the same. Is it worth trying a different one? The Wharfedale Clinic in Guiseley always had a good rep amongst runners - I think that’s fairly local to you?

Have you tried varying the run/walk splits? Can you do 4 run/1 walk for example and then slowly increase to work out where your limit is? Progressively loading might help with rehab.

Thanks for all the replies. Lots of interesting thoughts.

I was actually climbing with a physio today and he said similar to Stabbsy. He said it could be a weird nervous system reaction where my body is shutting the movement down after a certain amount of trigger.

I don’t think the pain is actually an injury as such, more that it is immobilising my leg before an injury occurs. As once it’s settled down there don’t seem to be any lasting effects.

This is what I was saying above. It’s the muscle saying it doesn’t want to work hard or get injured.

My physio thought at first I’d torn the muscle but given I was pain free with a couple of weeks he discounted this and came to immobilising theory. He also come across in a semi professional footballer who could train and warm up fine but once he was running continuously he would get the problem.

This definitely sounds like what’s happening with me. It’s really annoying but hopefully i can train my body to not do it…

[James Malloch]

I tested out some different shoes today and went 4 min run, 1 min walk with the aim of doing loops and just seeing what happened.

Right knee was largely fine (could feel it a tiny bit, but my other “good knee” did exactly the same thing after about 35 mins (so 28mins of running minus some stops to send the dog in the river).

Ended up stopping at 40 mins for 7.5km, got a sausage roll and wandered back home. Dropped a friend (whos a physio) a message and he said it definitely sounds like a weird nervous system response.

So I’ll keep playing with splits and keep it varied and see how i can make it work. I’d like to join the local running club so could do with getting to be able to do 5-8 miles without having to walk too much…

[James Malloch]

I tested out some different shoes today and went 4 min run, 1 min walk with the aim of doing loops and just seeing what happened.

Right knee was largely fine (could feel it a tiny bit, but my other “good knee” did exactly the same thing after about 35 mins (so 28mins of running minus some stops to send the dog in the river).

Ended up stopping at 40 mins for 7.5km, got a sausage roll and wandered back home. Dropped a friend (whos a physio) a message and he said it definitely sounds like a weird nervous system response.

So I’ll keep playing with splits and keep it varied and see how i can make it work. I’d like to join the local running club so could do with getting to be able to do 5-8 miles without having to walk too much…

An update on this injury…

Things were going well, got back to doing 10-15km (6 run, 1 walk). Took a week off and seemed to go back to square one.

I decided to get an Ultrasound yesterday just in case it was some weird psychological thing.

They identified a tiny tear where the calf attaches to my Fibula. It was small enough that she didn’t think it could be the source of any real pain.

But then she noticed that I have what she described as “stonking vein and arteries” running directly over it.

She thinks that the tear is exposing some nerves and at a certain point in a run (15-20mins) i must be reaching a critical HR/Blood pressure which is putting pressure on the nerve. Hence why the injury is so acute and means i can’t carry on, but also why it disappears very soon after i stop/cool down.

Also why walk/run was so successful as my fitness meant my HR dropped significantly with 1 min of walking, and hence delayed getting to that critical point. The fitter i got the longer it would hold off.

I’ve been advised to have 4-6 weeks of proper rest (potentially including climbing) to let the tear fully heal and then build up slowly from there.

That can start after Font next week… time for some
Campusing!

Assuming its a correct diagnosis i find it fascinating!

Also have some scans on Friday for Varicose veins in the same leg (GP this time so dont have to shell out £180  ). Not sure if it’s linked at all but good to know before then anyway.

[T_B]

Interesting!

Sounds promising. Good luck with it.

[SA Chris]

TL;DR not all carbon shoes gave a statistically significant improvement in running economy. A lot of the stuff I've read/listened to suggests that there are a couple of confounding factors when looking at carbon shoes and it isn't just the carbon plate that improves running economy. The increased stack height has the effect of increasing stride length but would be unstable without the curved carbon plate. However, the plate can only be curved because of the increased stack height and, if it wasn't curved, wouldn't have the same "propulsion" effect. Add to this that increased stack height is only possible because the density of the foam has been reduced so you aren't carrying extra weight on the end of each leg. So the end result is you can't separate the effects of the stack and the plate very easily. The Vaporfly has both, but not everything does.

Stabbsy's post in another thread reminded me of the great Science of Sport podcast about Carbon plated shoes.

https://play.acast.com/s/realscienceofsport/theshoethatmayhavechangedrunningforever

[James Malloch]

I’m building my running back up after getting some insoles and new shoes which, hopefully, are helping my calf injury…

I’ve done up to 25 mins running, sometimes in one go, others with a 2-4 minute walk around halfway through.

I’ve been going at about 5min/km pace with HR staying around zone 3 (or very bottom of zone 4). Today i was a bit faster - 4:44/km but felt good. The last km was a bit harder to keep my cadence up as i was a bit tired, but in this km my HR jumped from 155bpm to 165, and then up to 204bpm and stayed there (new max HR according to my watch).

My rate was definitely elevated but it seems so high given the pace still felt fine. I’m not sure if my watch was playing up or if there is some reason for it jumping so high.

It’s as far as I've ran for a while, but i don’t think I’m that unfit! Is there anything which could cause such a spike if it wasn’t my Garmin give erroneous readings?

[T_B]

Garmin playing up. Get an external HR monitor if you want an accurate reading (ones that fit over your upper arm seem all the rage). Or ditch the tech and run on feel.

[turnipturned]

Sounds like a garmin error- 204 for any length of time is pretty wild (had similar with my watch)

External HR are good. Get a chest strap (however remember to damp the sensors otherwise you will get similarly strange readings).

Agree with Tom try and go by feel, I use a HR monitor every now and then to gauge my heart for Z2 but don’t wear it on a regular basis. (Too much data drives you crazy)

[James Malloch]

Cheers! I assumed it must have been the watch, but it’s been so long since I’ve got to a high HR I can’t remember what it would be like!

I’m not really using the data at all, mainly using the metronome on the watch and using it for timings (building back up slowly). Once I’m more confident in my calf I’ll start to run a bit less constrained.

Good news is that some new shoes and some supportive insoles seem to be doing the trick, touch wood! I’ve ran (without any walk) for longer than 15 mins for the first time in about 5 years anyway! It’s nice to be moving again!

[Paul B]

External HR are good. Get a chest strap (however remember to damp the sensors otherwise you will get similarly strange readings).

...and remember to wash them / clean them or else they'll also do crazy things. It's worth noting that Whoop! bands still work as external HR monitors without paying the frankly ridiculous monthly fee.

[T_B]

Good news is that some new shoes and some supportive insoles seem to be doing the trick, touch wood! I’ve ran (without any walk) for longer than 15 mins for the first time in about 5 years anyway! It’s nice to be moving again!

That’s brilliant. I’ve been really lucky with injuries but went over on my (already bad) ankle in June and it’s been very unstable/weak since. Seeing a podiatrist next week (Colin Papworth who is well known in Sheffield). I run in 5 different shoes so I’m hoping he doesn’t tell me I have to chuck them all away and buy some stability shoes!