Thank you for all your answers to the other questions. I'm 36 year old male.
I ran my first marathon on June 21st of this year. I trained from January
until race day, following Hal Higdon's guide on the web. I felt prepared. I
was an athlete in college, so I've alway been pretty fit, except for a hernia
injury (repaired last year), and a couple of groin pulls. At mile 23 of the
race, I felt a numbness creeping into my right knee. If my knee is a clock,
12 at the shin, 6 at the thigh, it started around 3. Now, it still feels
pretty weak around 1:30. i started to hobble, then walk. i was fine walking,
but running, the numbness crept back, then came the pain. i finished the race
with a respectable time (3:56), but i would have finished much faster if not
for the injury. i practically walked the last three miles. since then, my
running has suffered. i tried to go running two weeks ago, but the numbness
crept back in two blocks away. it feels like there's some kind of cushion
that's been pushed down or has holes in it and when i land, or pressure is
exerted on the knee, something is hitting something. i can run up stairs, no
problem, i can spend an hour on the non-impact elliptical trainers, i can lift
weights with no pain. it's only when i start to run. i miss running
terribly. help!?! and thanks.
Thanks for the complete history. Lateral knee pain is not uncommon (patello-femoral pain) also called chondromalacia patella. The actual diagnosis is that of a softening of the bone on the underside of the patella. The problem usually occurs as a function of biomechanics leading to greater loads being imparted to the knee (up the chain) as the foot hits the ground. Imagine that the role of the patella is to limit the internal rotation of the femur by smashing as hard as it can into the lateral epicondyle of the femur. Well in an abnormal situation, the loading comes earlier, lasts longer, and has more force to resolve than normal, and therefore, the cartilage and bone are subject to failure. Like so many other biomechanical issues, the answer begins with improving the biomechanics - ie orthotics for the feet. Once the biomechanics are resolved, then you have to increase the efficiency of the butt muscles to increase their ability to decelerate the femur dynamically. Make sure you start slowly, and gradually build up your tolerence to loading exercises. In the meantime, ice and NSAIDs are appropriate. Long term, I also suggest glucosamine as a supplement to help the cartilage recover.