My knees have always cracked, but now they're concerning me. I had been doing full squats for around six weeks and everything was okay. I wasn't running at the time and hadn't been running for awhile. Then I started to squat 3x a week on a heavy, light, medium scheme. I also started to do some sprints 2x a week. My knees would hurt a little on the inside part but they never swelled. The patella would feel sort of loose and would grind. I can put my hand over the knee and extend it and feel it roughly moving. If I site cross legged I can feel a bunch of tension. Also when I walk my feet would underpronate?…like inwards so my knees would point sort of inwards. I think it's a patella tracking issue. I saw an orthopedist/sports medicine and he told me to stop doing squats and do leg extensions. That told me that he didn't know what the hell he was talking about. Obviously it's not serious enough for surgery. He told me I just have rough cartilage and loose joints and I can't do much about it. I hope that's not true. He also said my VMO is fine. I've been doing split squats and was going to do box squats to keep stress off the patella. Anyways what can I do to fix this. I think it's not really because or the squats or sprints, but because of my knees pointing inwards and the patella being forced outwards. When I started running and lifted it just aggravated it. If I do a Hindu squat my right knees is really loud and it's not just a crack, it's a pop and you can hear grating. I don't want osteoarthritis or anything serious to happen. What should I do?
Runner's Knee
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KeymasterPopping isn't too much of an issue but grinding and crunching and any associated pain obviously is. I think you might be looking at the symptom rather than the cause by just considering the knees. I can't quite understand what you mean when you say "underpronate" because that would typically not result in the "knees in" position you refer to. Whatever the case, I think you might want to look to your feet before you look to your knees. It sounds like it may be the cause rather than the effect of your problems. It often helps to fix things from the ground up. Sometimes, this can be done simply by balancing the foot and ankle musculature. In extreme cases, orthotic intervention may be necessary. Can you tell us a little more about your feet? Like where are they at foot strike and toe off, what parts of the shoe do you wear out first, etc.
ELITETRACK Founder
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Participant
[i]Originally posted by mike[/i]
Popping isn't too much of an issue but grinding and crunching and any associated pain obviously is. I think you might be looking at the symptom rather than the cause by just considering the knees. I can't quite understand what you mean when you say "underpronate" because that would typically not result in the "knees in" position you refer to. Whatever the case, I think you might want to look to your feet before you look to your knees. It sounds like it may be the cause rather than the effect of your problems. It often helps to fix things from the ground up. Sometimes, this can be done simply by balancing the foot and ankle musculature. In extreme cases, orthotic intervention may be necessary. Can you tell us a little more about your feet? Like where are they at foot strike and toe off, what parts of the shoe do you wear out first, etc.I'm thinking and really hoping my feet are the cause of the problem. When I said underpronate I meant like arch side of foot going inwards. But I don't know because on my shoes the outside part is clearly wearing out faster than the inside. I just looked how my feet move when I walk and how my knees move. I hit the heel on the outside part (SE of my right foot for example) usually and my right knee would move northwest and once my toes hit the knee moves back straight so it looks like my knee sort of shakes on each step. It seems like the left portion(NW) of the ball of my foot hits and then it levels out. I do know that right above the arches of my feet when I was younger my feet would sort of go in like I was trying to touch my knees together. When I walk it doesn't do that though. I don't really feel pain but the grating was getting really loud. Strangely I tried sprinting today for a few 40M's and now my knee is not grating nearly as loud. Also I didn't feel any pain although I did a few weeks before on the inside part of my knee even though the patella seems to be forced on the outside part and all of the looseness was there.
So my heel looks sort of like how my shoe wears out, like my right heel would be slightly angled like this /. I'm thinking it wasn't the squats since I'd been doing those for awhile but the running being the secondary cause stemming from the way my feet strike improperly. Even my shins seem to bow outward a little while my knees move inward and then outward with that abrupt shaking movement. How do I fix it?
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Keymaster
It's hard to say definitively if your feet are the source of your problem but if you think they are there might be some things you can do. First of all, you are a supinator. Most supinators strike on the lateral side of the heel and toe off at the big toe. This sounds like what you do and this foot strike pattern is pretty normal. The good thing is that many top level sprinters are supinators. The bad thing is that if it is extreme it can lead to problems. Here's a couple things to try:
1. Strengthen your feet and ankles by walking barefoot in sand, running barefoot on grass, and doing foot exercises with a towel, a partner, or isometrically.
2. Check and treat for adhesions in your foot that may worsen your problem. If you have a very high arch, run your thumb hard in the arch to see if there is a lot of adhesions and scar tissue buildup. If you feel as if there is crunchy tissue in there, get some lotion and continue to apply hard pressure to the arch to break up the adhesions.
3. In the exercises, emphasize ones that will strengthen your lateral ankle and increase flexibility in your medial ankle.
4. Never wear your shoes to the point where you see your heel get extremely worn out. This is even more true for your everyday walking shoes. You take more steps per day in these shoes than your training shoes and if your shoes are terribly worn this may cause the problems that manifest themselves when you feel pain in training.
5. Switch up shoes on a daily or bi-daily basis. This not only extends the life of the shoes but allows the tiny muscles of the feet and ankles to be strengthened in slightly different ways.
6. Consider seeing a podiatrist to see if your foot problem is indeed serious or in need of custom inserts (orthotics).
ELITETRACK Founder
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Participant
Thanks for the help. Do you recommend any specific exercises. So do you think I might try changinge the way my feet strike as best as I can to eliminate the way my knee shakes and avoid supination? Also, are there any general type inserts I could try to see if it fixes the problem. Hopefully this is the source of the problem. Strangely the grinding has decreased greatly over the last 2 days also btw.
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Keymaster
I wouldn't try to actively change your foot strike…..that's only asking for more trouble. As for the foot and ankle exercises, I'd pretty much just get creative with them but you'll want to focus on exercises where you're working on the lateral muscles of the ankle and lower leg. That means you'll want to do exercises where you are pronating the foot (moving from a supinated to a pronated position under resistance).
ELITETRACK Founder
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Keymaster
Take your hand on the outside edge of your foot (lateral side) and push it into a position of supination / inversion. Once it is at a stretched position, push your foot against your hand until the bottom of your foot is facing slightly outwards (pronation). Repeat.
ELITETRACK Founder
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Participant
One more question…
Sometimes when I stand my knees have a tendency to hyperextend. Maybe by knees do this when running as well. I was reading a powerpoint presentation that was posted on this board about the core and it mentioned tight psoas causing patellar problems in basketball players. Don't know if that's relevant, but how would you fix that? -
Keymaster
Hyperextension at the knee joint is very common but the likelihood of it happening at anything faster than a walk is practically nil…..I wouldn't even worry about this one bit. As for the tight psoas issue, the psoas muscle is one of the muscles grouped into the hip flexor muscle group. If you think this is a problem here's a stretch I've found effective:
Stand with feet split forward and back as if you were in a 'lunged' position with the back leg almost straight and the front knee slightly bent; straighten your torso back to an upright position; move your hips forward towards the front leg until you feel a stretch in the hip flexor of the back leg; FLEX THE GLUTE of the rear leg.ELITETRACK Founder
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Participant
Does this make sense? Looking at how my shoe wears down and how my knee wobbles when my foot strikes the ground it's clear I supinate. However, I was getting a sharp pain on both my shins. I don't think they are shin splints though. The pain is mainly on my left shin, but I feel a little on the right one also. It also only comes when I'm running. The pain is on the inner side of the shin about 4-6 inches above the ankle and is only on about a 2 inch long area. I think what's happening is that when I supinate the outer portion of my heel strikes first and then the inner portion of the ball of my foot strikes and it's putting pressure on this part of my shin. I get the same pain whether wearing shoes or running barefoot. Do I need to get orthotics or do some sort of exercise?
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Keymaster
It's tough to make a diagnosis without seeing you run (or without being a podiatrist :D) but one thing I can tell you is that your foot strike is not abnormal (the lateral to medial rotation from heel strike to toe off) unless your supination at ground contact is extreme.
ELITETRACK Founder
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