Sunday, January 31, 2016

Knee Problems - Patellofemoral Syndrome - Remedies

Back in 2012, I was in the middle of my four-year mild obsession with mudruns and obstacle events. For a few years I took part in the Spartan Race, Tough Mudder, Warrior Dash, Insanity Mud Run, etc. If you have ever completed any of these races you know training is key to survive. I am not a runner but these events demanded such a training regimen. I worked out at Red Rocks Amphitheater and ran when I could. However, I was suffering from knee pain after my runs. The most I could go was about 3 miles until sharp pain started to affect my knees. The Tough Mudder was a huge challenge considering my knees were in pain for most of it. I was limping towards the last mile. After that first Tough Mudder I had to take a 3 month break from any strenuous activity. I RICED my knees,  popped Ibuprofen and took ice baths to help out the recovery. I thought that was it;  my days of races were over. How could I be 30 years old and already have such debilitating knee issues?

I searched everywhere for a solution and researched various causes. Was it my diet, my muscle ratio, my genes, a disease? After many hours online, I came across an article that described a knee condition very similar to mine. The culprit: Patellofemoral Syndrome, more commonly known as "movie theater knee". This is the type of pain you get when you sit for a prolonged amount of time and your knee tightens so much, that it aches on the sides and/or in the middle area. What to do? The article suggested several solutions such as stretching and heat, but overall the condition would always be there.

I thought, stretching should work. Meh...kind of. It seemed to help a little bit before my runs, but ultimately my calves would tighten and my knees would ache again. There is a whole view point on stretching that I will go into in a later post.

The most obvious answers would not be known to me until 2014-15.

Ok, so maybe it was my shoes. The more I researched, the more I read about regular running shoes being unnatural to our bodies and how our strides caused more impact to our bodies than we would like. The heel-to-toe running style bangs your joints too much and it could have been another reason why my knees felt bad after running. That's when I decided to transition to minimalist running shoes. In this case, Vibram Five Fingers. I had read some reviews on various sites and a few mentioned their knee pain subsiding after making the switch. I will do a more in-depth review and process on the Vibrams, but for now I will focus on the knees.

The shoes seemed to help. I was training up to 5 days at the Red Rocks Amphitheater and my knees felt good. So did my back. It wasn't until I started doing some long distance runs that I noticed the pain was still pretty substantial. I bought a compression brace which had similar positive but temporary results. Then as I was shopping on Amazon, I saw a recommended item, the Mueller runner/jumper knee strap. These straps are supposed to tighten the middle area of your knee and stabilize it. I tried them for a few months but they didn't work well in very active, sweaty situations; which made them useless considering that's exactly why I bought them.

So, I researched more and looked for better braces, healthy drugs, ointments, aspirin, home remedies, something. For almost 2 years I sucked it up and changed my training. I went from doing tons of cardio and running the Red Rocks Amphitheater stairs, to doing more Tabata, yoga, stretching and weights. The new training regimen seemed to help a tad but I couldn't recover fast enough. I was about to give up and accept my fate until I rethought my training process and realized the most important factor I was missing out on was practically right in front of me.


My views on massage therapy is probably the same as some of the rest of the population. It's for fancy-asses who can afford it and belongs within the same realm of getting your nails done, the spa, and typical pampering. Or does it? 

I have a friend, who at the time was studying to get her license as a massage therapist, enter the free massages to help her practice. Little did I know that she was specializing in sports massage. Well, that changed my mind on massage therapy completely. I had no idea my legs were so tight. Here I thought stretching was helping, here I thought the training was helping, the shoes, the braces, the Ibuprofen. All I needed was regular massage therapy, whether it came from a person or from myself with the help of my foam roller. The more I listened to my body, the more I realized I was training too much on the Vibrams, I was over training my quadriceps which pulled on my knees and my stair training was making my calves too big, so they too pulled on my knees. So, I changed my training regimen again. This time I would switch my shoes. I bought a pair of Inov8, which I will review later. My Vibrams were for trail running and my Inov8 were for most everything else. I also invested in some Tiger Balm, which a buddy of mine uses on his shoulder. All key tools for recovery.

Out legs are not meant to be tight all day via sitting in front of a computer or standing on your feet. Legs are not meant to keep getting tighter via training regimens that do not include more than one type of recovery aid. So, what do I do now?

For starters, maintain consistency. Even when I go a few days without foam rolling I can feel how tight my legs get. So, I keep a pool ball in my car and in my workout bag just in case I need to work a small knot. I keep a jar of Tiger Balm with me at all times, but especially when I know I will go for a run. In fact, I signed up for only one mudrun for 2015 and did not train at all for it. I was being lazy. I thought the distance was a doable 3 miles, but it turned out to be 6-ish. Tiger Balm was my savior. I rubbed some on before the race and after the race and they never felt better. The knee pain is still there, just not as consistent, as radiating or as cumbersome. It is manageable as long as I keep consistent on my recovery. Stretch, massage, Tiger Balm, braces, shoes, heat and cold when necessary and finally, patience. Lesson is, listen to your body, rest plenty and recover wisely.

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