Friday, August 26, 2011

My Knee Diagnosis and Treatment

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I've told you about my knee issues that started last week. Needless to say, it's always frustrating to have an injury that can sideline you from your goal. I tried to think about anything that I might have done to cause the problem and/or aggravate it. 

After racking my brains, this is what I came up it:

 - Maybe, it was the new Brooks (Adrenaline) that I wore for my 10 mile run.

 - Maybe, it was doing speedwork on a track (I had never run on a track prior).
 - Maybe it was doing back-to-back runs.

I have been *seriously* running now for a year and had never had any joint issues up until now. Well, actually, to be honest...I used to run more than 10 years ago and at that time, my knees started bothering me, too. I ran for fun and fitness and did a few races but I never did any long-distance, endurance type of races such as half-marathons. The reason I stopped running back then was precisely because of knee pain.

Yesterday, I saw a sports podiatrist who was super knowledgeable and an athlete himself. He spent a lot of time with me and took his time discussing my training, fitness and foot wear.

First, I had to be videotaped running and I ran on what must've been the "oldest" treadmill in existence.

After doing a thorough foot and knee exam, he had me walk barefoot down the hall a few times and noticed that I was intoe-ing on my left foot.

The diagnosis: He agreed that I have PFPS (Runner's Knee) but after watching me run both on my Asics and my Brooks...he thought there was something else.  My PFPS (runner's knee) was only a symptom of something deeper....I also have femoral anteversion.

"Femoral anteversion is the most frequent cause of in-toeing in children between the ages of 3-10 years. The femur is the long bone that goes from the hip to the knee. Anteversion literally means “leaning forward." Femoral anteversion is therefore a condition in which the femoral neck leans forward with respect to the rest of the femur. This causes the lower extremity on the affected side to rotate internally (the knee and foot twists towards the midline of the body). The in-toeing will often appear worse with running and at the end of the day when fatigued. (source)

So basically, this is the root of the problem and everything else happened as my legs constantly try to compensate. My left knee turns inward as my left foot tries to compensate with pronation. And guess what?.....the Brooks shoes actually made it worse! 

Femoral anteversion is a developmental abnormality common in children and usually normalizes in time but, unfortunately, I still have a small degree of it as an adult and as a result, is now causing athletic difficulty, which now explains the knee pain years ago as well.

  • R-I-C-E particularly after activities.
  • Knee brace WON'T help (only psychologically, maybe).
  • Stretching and strengthening exercises for quads/VMO.
  • I was fitted for custom orthoses.

I'm glad that he told me that I don't have any other pathology with regards to my knee. I could still run based on my tolerance but back off at the first sign of pain/discomfort. He didn't think it was a good idea to do the half-marathon in 3 weeks, just because I would not have my orthoses ready yet at that time. If I wanted to, I could still go for it but cautiously. I've decided NOT to take that chance.

I want to be able to have years of pain and injury free running and I don't want to jeopardize that for 1 race. Taking care of my body is an important responsibility. What I eat, the amount of rest and sleep and how I manage stress all affect how well my body and mind functions. 

We have one body for life. If we neglect or abuse our bodies, we suffer unpleasant consequences. With proper care, the quality of our lives improve because we feel better, we are healthier, and we look our best!

BTW, you can check out my post on coping with a sports injury right HERE.

On a different note: I did RPM yesterday for the first time in a long kicked my booty. I guess more *spinning* is in my future

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