Question: Knee Pain!
I have a client who hurt her knee while running a long relay race that was for two days. She did this last year, so when I started working with her we having been working a lot of on her stabilizers muscles in her upper and lower legs, but I don't want her to have that pain again when she runs the race this summer. The pain was on the top left side of her patella on her left leg, and I was wondering what other exercises or stretches you would recommend with her training program. I know it really hurts her when going downhill (normal occurrence), but also when she takes her boots off. Sort of like an isometric contraction with her resistance being placed on her hamstring. Any suggestions would be greatly appreciated.
you should also provide the opinion from the physician and physical therapist for a more comprehensive picture.
I hope that this helps.
And I agree with Brian that looking at her running shoe is a great idea. If you have access and can do a grid analysis, it would be a great way to get her the best shoe.
This may be out of your control and I agree with Karin. Have your clinet see her physician for an evaluation and any recommendations.
I hope that this helps.
Don't perform the movement open chain, perform it closed chain. The vastus medialis fires in the last 30 degrees of knee extension. Remember the SAID principle. She'll need to perform high repetitions as she is runner. Perform it with theraband attached to a fixed object and fastened behind the distal portion of her femur. Flex the knee about 30 degrees and extend it.
You can easily check to see whether her vastus medialis is underdeveloped by looking at the distal portion at the medial aspect of her femur as well as looking at how developed her vastus lateralis is. The vastus lateral is is a much more larger muscle that the vastus medialis and it could be that it is overpower the vastus medialis. Train the vastus medialis so that here is balance between the medial and lateral aspects of the femur so that the patella tracks correctly.
And, yes, she should see her physical therapist. However, I hope this is of help to you.
Then, go simple to complex. Initially stop all aggrevating activity for at least two weeks. I also recommend pre bedtime ritual icing every night to calm the excitability of any over active or over stessed tissues/muscle/neural pathways. Then look at mechanics, if you see something obvious change it. Then trying different shoes or no shoes, does that make a difference? Or Shorter strides? The list is long and I usually get cues from the client that guide me.
Then there is an entire other route that I usually only go down for competitive athletes or clients that view themselves as "runners" and insist on getting back to higher levels/paces of running. This is much more complicated, but also starts out with the simple to complex system. It just includes in training recovery/inflamation modalities and requires much more commitment and adherence from the client (and me as well).
It is something you have to learn. Contact me if you want more guidance if you are still following this question or anyone else that comes across this question.