The reason for this article is to document my journey on how I deal and heal with this knee issue. Take it with a grain of salt and make your own calls.
PS: people put knee issues under one category “runners knee” , but the cause of runners knee could be from a number of different things. I found that foam rolling the outside of the calf, the peroneus longus muscle more specifically, fixed the problem for me.
More on my journey below.
Issue:
Left knee is tight on the front of the knee cap, sometimes on the lower inside towards the front
It starts to become noticeable after long distances, more of an ache than a shooting pain.
During Ironstone 100k I dealt with this knee issue for quite a few miles. The pain was tolerable.
How I’m healing
Ever hear of RICE? Rest Ice Compress Elevate…I’m throwing that out the window. (as I do with injuries)
I believe in the concept of MOVE which is healing through movement, feeling the body, and walking it through discomfort, not pain. I believe this gets the blood flowing within the injury, which provides benefits like faster healing. Although I am still trying to prove this theory with a cyst on my wrist… any idea?
Here’s a video of “no knife” – this guy tore his pec muscle and healed it with movement instead of surgery. His teacher was Ido Portal, someone who’s been a trailblazer within the movement and “fitness” industry. – Let me know what you think about that video?
So what have I been doing during this recovery and rehab period? The last week I’ve been doing:
- Moving my knee cap tendon around with my fingers slowly. Leg straight out. Like the guy in this video. Any new movements may make us feel queasy. The spinal wave was a big one for me and so were external rotations on the shoulder joint. This kneecap movement is another one that makes me queasy but as I push my kneecap down toward my toes, it moves and cracks. I think this has something to do with what is going on.
- Animal movements (crawling on all fours forward, backward, ducks, Ido Portal stuff)
- Modded pistol squats or a step up
- Helicopters with lower limbs
And I use some of these workouts too, from the knee over toes guy.
- Sled pulls
- Sled push
- ATG split squat (try this with an isometric hold)
- Slant board squat
- Hamstring curls
- Rearfoot hip flexor stretch
- standard quad stretch by lifting the leg back and holding the ankle.
- Incline pigeon pose
Updates
For reference: Assumed runner’s knee happened July 8th 39 miles into a 100k. I rested at the aid station for a few reasons and finished the race. The knee pain went away because of the break but showed up again around mile 60.
July 30, 9:42 am
Safe to say the knee is back. Put up 47 miles this week with zero knee pain at all before, during, or after.
Still going to rehab the area – foam roll and strengthen via knees over toe exercises.
Eastern States 100 is two weeks away and things are looking extremely promising.
I will end the updates as of now since the solution was to foam roll the peroneus longus muscle. More importantly, the concept of exploring movement and injuries is a way to heal.
Always be curious, question everything.
July 27, 6:50 pm
Ended up with 23 miles in the past two days. Feeling great. Focused on heat training over speed, but no pain at all during both runs or in the morning time.
July 26, 4:14 pm
Three days since the last update, lots of foam rolling has been done since then. I ran 9 miles so far today, the longest since my injury. No knee pain. Foam rolling this peroneus longus muscle was the saving grace, quite a few times per day. Thinking back, I’m not sure when this injury actually occurred, but a few weeks ago the top of my foot was really sore and I kind of just wrote it off because it didn’t hurt per se. It’s interesting to find that this muscle runs from the knee to the top of the foot. Corie brought this muscle/area up and mentioned to foam roll it, and this is how I stumbled upon this solution. Thanks for the help CC
July 23, 11:32 am
MAJOR UPDATE: I found a super tender spot on the outside of my calves – the peroneus longus muscle. This muscle originates from the fibula and goes down into the top of the foot. The fibula is the smaller bone of the outside of the shin that is between the knee and ankle. The information I could find online doesn’t mention knee pain from this injury, but it does mention ankle pain. I find it strange that this sore spot is on the outside of my leg but I experience inside knee cap pain. What I believe to be true is that our bodies are entirely connected, so when something is tight, everything else in the body is affected. What I do know is that after foam rolling this sore spot the past few days, the knee pain seems to be nonexistent. Granted I didn’t run far or much the past few days, but I will continue to rub this area out and monitor progress. Also note, that there is not much information due to the cause of the runner’s knee… I think tight, sore peroneus longus muscles could have something to do with it.
July 21, 3:42 PM
Hiked 6 miles today with no pain. First hiking workout ever and felt great, worked on heat training and walking form, after all – we walk a lot during ultras. Toning the longer runs back for the week to not aggravate the area, still going to be moving the knee via walks, locomotion, and “rehab.”
July 20th, 2023 9:22 am
Ran 2 miles, then 6 miles later in the day, then biked 9 miles. My knee was slightly stiff during the 6-mile run, and during the bike ride too. If that were a race, I feel like this would become a problem as we got into the later miles. Thankfully, there are still 3 weeks left to heal up. I planned to hit 30 miles this week, but more importantly, I am feeling the week out. Currently at 14 miles
I’ve been sticking to rehabbing the knee too. Here are some specific knee exercises I’ve completed with no pain:
- Slant squat
- Atg split squat
- Sideband steps
- Duck walk
- Horse stance
Overall, knee is improving
July 18, 2023 11:55 am
I performed this slant board squat movement with 25 lbs overhead. I ran 2 miles today pain-free and took the bike out for four miles with slight to no knee aching. My knee is feeling better than yesterday.
Movement really does heal. Not a painful movement, not harmful. Maybe some discomfort and that’s where the growth is. Although it may be hard to find for some, we all can find that balance intuitively, keep moving and exploring with the body.
July 17, 2023: 1:03 PM
The knee is 85% healed. Started strengthening exercises today with great results and minimal to no achiness, not even pain. Really enjoyed squatting on a slant board. I found this exercise out via knees over toes guy and I could feel this strengthening the weakened area which is the front of the knee cap. I did some isometric holds in that squat position, pushing my body up but not moving up. Almost like a deep squat plank on a slant board so my knees were super extended past my toes.
I noticed my kneecap is super sensitive to being moved around (like using my two fingers to push my kneecap to either side or up and down) .
What was interesting was that when I would push the kneecap down toward the ankle, it would shift slightly and crack. My other kneecap would not do this. I believe this slant squat movement, and other variations similar will restore its strength within a few weeks.
July 14, 2023: It’s been 6 days of recovery and rehab.
After the race, if the knee was at 0% – it is now at 70%
This may be a lower grade than accurate, but I haven’t pushed it on runs yet. I ran two slow runs on the 5th day of recovery for 9 miles total and although I felt the knee, there wasn’t any pain, just stiffness around the joint.
The week after a race is all about feeling and recovery, not much of a plan.
Then the next week is when I put a plan together and start to execute it.
I mainly plan to do 30 minutes every day of knee mobility and two workouts per week for the knee, hips, feet, etc. – the ‘auxiliary’ leg stuff.
Update July 10th through 14th
My knee is super stuff, I can feel like the kneecap is inflamed and something sliding with each step.
I’ll continue to update this page as we progress further along with recovery. Eastern States 100 is coming up in a few weeks and I plan to be fully ready to go.
My hope is that you can use some of this information to figure out what is going on with your knees, or at least, spark some inspiration to figure out what is wrong. It’s easy to leave diagnosis and rehab in the hands of someone else, it’s hard to figure out the problem and take the necessary steps to heal the problem.
Do the hard work and figure it out, don’t accept things at face value, and reap the rewards from all your effort.
Any thoughts, comments, or concerns let me know!
Joe DiAndrea 