Posterior knee pain

With now just over 2 weeks to go before the WHW race I’m really starting to feel the nerves.  I did my last long run on June 2nd from Hathersage home.  Some friends dropped me off on their way to a lovely relaxing spa weekend that I was due to go on.  Financial reasons meant I was unable to go so instead I opted to spend most of the day on my feet running!! (this definately wont be happening again!!).  I got the train to Hathersage and set off at about 9am on what is now a route I know fairly well. I met a friend at Matlock and we ran together the last 24 miles.  We finally made it back at around 5pm.  We’d been soaked, bitten to death and stung by nettles along the way so I was glad to get in the shower.  My salomons are definitely not for long distances as my feet felt really sore so I need to sort out what I’m going to run the race in.  I also have developed a bit of an ache at the back of my right knee.  Its not painful at all when I do anything but it does feel uncomfortable when I squat down after Ive been running.  I’d sort of been rubbing it a bit after running but if I’m honest I had been putting it out of my mind (dont ignore your niggles I’m always saying!!!).  The only time it really bothers me is on longer runs when I need a toilet stop.  I end up trying to stick my leg out or having to hover in mid/high squat which can be a bit risky in a breeze!!!

So whats going on with my knee?? I’d had a good prod around and was happy it wasnt hamstring tendons (which cross the knee) and my calfs felt ok.  There are a couple of really small muscles at the back of the leg so one of those is a possibility.  The pain isnt a sharp pain and only comes on when I compress the area by squatting.  I couldnt feel any lumps or bumps.  My right lower leg does feel tight sometimes around my arch and up the inside of my leg but its never stopped my doing things and nothing hurts when I run.  I’ve spent the last year working on my strength and stamina so am confident in my body’s abilities.  It was just a little ongoing issue that I didnt want to ignore.  My friend Kathryn from Arcadia Physio often comes over for CPD sessions (and often a good catch up).  She had a prod round (technical term!) and found a really sore bit in a small muscle right at the back the knee called popliteus.  This muscle medially rotates the lower leg (turns it in)  and helps bend the knee.  It can be injured by over use activities such as running, if there is a muscle imbalance in the lower leg and if the hamstrings are tight.  3 things which apply to me (!).  http://www.sportsinjuryclinic.net/sport-injuries/knee-pain/popliteus-injury

So it would make sense that with tight hamstrings and and slight imbalance in the muscles in my right lower leg that this small muscle may be getting overloaded when running.  Kat kindly did some soft tissue work to the muscle; I say kindly but I think she secretly enjoys watching me squirm.  There was one very sore point in the muscle.  These are often termed trigger points and can produce intense pain when palpated.  https://en.wikipedia.org/wiki/Myofascial_trigger_point

Working gently into a trigger point can often help ease the painful signals and can often produce good short term effects when treating patients.  Its important though to then address what may be causing the problems in the muscle itself.  Its tricky detective work being a physio!!!  Kat also did some Muscle Energy Techniques to stretch out the muscle.  This type of stretch applies a gentle contraction of the muscle which is followed by a period of relaxation of the muscle in which the fibers can be further stretched. https://www.physio-pedia.com/Muscle_Energy_Technique

Now physiotherapy isnt witchcraft.  We cant instantly make people better but often results can be seen in one session and its then a case of building on that improvement. This usually involves some exercises and possible some self massage by the patient.  After Kat’s METs my knee did feel different and I noticed the improvement when I spent 2 hours build a bathroom cabinet that night.  I didnt even notice my knee niggling at all.  So is this a result or is it simply that I was focused on something else?  To really test it I need to go for a run!

Today I have a really busy clinic but my goals over the next week are to do daily dynamic hamstring stretches, use my hand roller for some self massage and perform some METS.  If you want any advice on dynamic hamstring stretches or think you may be suffering from this issue please get in touch or book in online.

With 2 weeks left I have to now look after myself both physically and mentally.  I have one more weekend to do a longish run and try out my new saucony peregrines to see how they feel over distance. I’m trying not to take too much on both at home and at work and as those gremlins of self doubt creep in I banish them with positive thought and the teaser of what life will be like once the race is done and I can chill out for a bit (until my next crazy idea!!).  I’m hoping to do a few miles today to see how things feel.  I’ll keep you posted!