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Discussion Starter · #1 ·
I am a longtime road runner who logs 20-35 miles per week for 7-8 months of the year. While I have suffered over the years from the usual running injuries that eventually resolve with proper treatment, I have recently been dealing with one knee injury that I am finding difficult to identify. I’ve considered the usual culprits (PFPS, IT Band Syndrome, Chondromalacia, Bursitis, Quadriceps Tendinitis), but they do not seem to exactly fit my symptoms. My best guess based on my research is some sort of patellar tracking disorder or Lateral Patella Compression Syndrome (LPCS). I was hoping the community might be able to help, as personal considerations prevent me from seeing a doctor. Any input/advice would be greatly appreciated. Thank you in advance.

The pain is located just above my right kneecap towards the lateral side. I would not characterize it as purely lateral or anterior in nature. (The YouTube video below does the best job pinpointing the exact location). This pain is ‘sharp’ and localized in nature, rather than diffuse and dull. It often appears at the very beginning of a run before disappearing. When I stop or ‘run in place’ at a road crossing, the pain will immediately appear when the crosswalk light changes and I attempt to start running again. I typically hobble across the street, unable to fully push off with my right foot, and spend the next mile or two trying to relieve the pain, focusing on shorter strides, keeping my body/legs/feet straight, switching sides of the road and at times, landing only on my forefeet. The pain will often eventually fade into the background only to immediately reappear at the next street crossing or if I stop and turnaround. The pain also appears on steeper downhill sections. After a run, there is no swelling or tenderness though I am often (but not always) aware that something doesn’t feel right mechanically with my knee. There is no constant ‘clicking’ or ‘grinding’ – the pain did reproduce once when I was performing a standing quad stretch and felt a sharp, stabbing ‘pop’ in the exact same location that hurts during a run. There will be stretches of time, however, where the knee feels ‘normal.’

I am sure I have some cartilage damage due to my years of running, but the intermittent nature of this pain and fact that it almost always appears when stopping/starting during my workouts makes me feel as though this is not cartilage related. What would be the chances that something ‘catches’ or clicks at every crosswalk but doesn’t seem to initially ‘catch’ or ‘click’ elsewhere during a workout? I would expect an IT Band issue to be more consistent and diffuse in nature. Thus, I lean towards thinking this might be a patellar tracking issue.

Has anyone else experienced similar pain? If so, would you have any recommendations on how to best treat or manage the problem? Is some sort of brace the best way to manage this problem?

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Video to reference specific location of pain. (~ 2:00 mark)
Lateral Patella Compression Syndrome (LPCS) -
 

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Sorry to hear about your knee pain. You did a great job describing what is going on. Before I offer any suggestions, though, what have you attempted to do so far for it?

Also, since injuries are often related (yes, even those past injuries), what other issues have you dealt with over the years?
 

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Discussion Starter · #3 ·
I tried running through the pain, while focusing on stretching and running form, but couldn't pinpoint anything that worked. I am now exercising only 2x per week at a local field with each workout consisting of: (i) "form walking" - knee raises, leg kicks, backward heel kicks; (ii) side shuffling; (iii) backward running; and (iv) lunges. My hope was to strengthen/loosen the various lower body muscles before running again. The sharp pain does reappear (albeit not as sharp as before) if I were to run longer distances and at various times throughout the day as I move around.

My recent injury history mainly consists of general anterior knee soreness (both sides), usually when I ramp up my mileage after taking the winter off or during a particularly high mileage week. The knee pain in that scenario is more diffuse (rather than sharp) and doesn't impact my daily life -- it just fades into the background. I've had achilles tendonitis in the past, though that hasn't been an issue in several years. For what it is worth, my calves are tight so I try to stretch those pre- and post-exercise. My hips/hip flexors are probably on the tighter side as well so I stretch those too.

Thank you again for any insight you may have.
 

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Thanks for that info. Right now it sounds like you aren't doing much for your knee. You are doing a lot it keep it moving, but not anything to get it stronger or address the cause of the issue. Because of the anatomy of the knee, pain around the knee typically comes from something either above (the hip) or below (the foot and ankle) not moving quite right. Until you uncover and address that issue, your problem will remain. Being that you have issues with your calves and your hip flexors, my guess is your knee situation is related to both the hips and the feet/ankles.
 

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Discussion Starter · #5 ·
Thank you for your assistance. I was initially inclined to believe the knee pain was more likely due to problems around the knee joint given that the pain is intermittent -- the thought being that hip flexor issues may be expected to more prevalent during a run. Obviously my approach hasn't addressed the issue so I am going to focus hips/glutes in hopes that is the root cause. Thanks again for your guidance
 
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