since increasing my weekly milelage from 10 to 16 i started noticing mild pain on the medial sides of both of my knee caps (my right more so than my left). i also added superfeet arch insoles into my shoes at around the same time, so that may have also affected my running mechanics.
from what i’ve been able to research, the most likely culprit is patellafemoral syndrome aka runners knee given the proximity of the pain to the knee cap. it’s on the medial side just underneath the knee cap. this hasn’t really seriously affected my daily mobility or even my running since it’s very mild, but it’s something i want to make sure i nip in the bud before it develops
here’s a table of common causes and which ones i believe apply to me
| cause | applies? |
| kneecap misalignment | don’t know |
| overuse | most likely. 10 -> 16 is a 60% increase! recommended is closer to 10 – 15% |
| injury or trauma | no |
| week thigh muscles | possible – i haven’t incorporated quad strengthening into my routine yet |
| tight hamstrings | unlikely, esp. because i stretch these during yoga often |
| tight achilles tendons | maybe, i don’t stretch my achilles |
| poor foot support | could be affected by my new arch “supports” that may be throwing off my normal gait |
| feet rolling in | maybe? most of the roads and sidewalks i run on have camber/slope. when i run on the road, i run on the left so there’s a leftward slope which i’m sure affects my foot roll motion |
of this set of causes, the top ones are likely
- overuse
- weak thigh muscles. quadriceps in particular play a huge role in knee cap stabilization and when the knee cap isn’t stable it’s more likely to result in inflammation when it’s not tracking smoothly
- tight achilles tendons. tight achilles leads to more of a forefoot strike during walking, and that in turns causes the quads to remain tense and pull on the knee cap
- feet rolling in. so the knee tends to go the same direction as the foot, but the quads will kick in and try to balance by pulling the knee cap in the opposite direction which can also lead to tracking issues
my current recovery plan is
- incorporate quad strengthening exercises with focus on compound movements
- sumo squats
- bulgarian split squats
- squat jumps
- lateral jumps
- stretch calfs and achilles post-run
- reduce weekly miles from 16 to 14 or even back to 10-12 per week
- shift my current 8,2,3,3 pattern to 4,1,2,3 (halving my long run, then progressive increase throughout week)
- remove the arch supports from my shoe (it’s an extra variable i don’t want to keep around…)
- icing knees at end of day to reduce inflammation
- knee cap mobilization exercises, also EOD
i’ll do another report in 3 weeks and let you know how it went!