As a runner, I tend to think of the quad as one muscle…or maybe two…you have the left quad and the right quad, right? Wrong. In reality the quadriceps are made up of four muscles (duh.): the vastus lateralis, vastus intermedius, vastus medialis and rectus femoris. In an attempt to treat this runner’s knee issue, I have been researching Patellofemoral Pain Syndrome nonstop. I basically shrugged off the idea that my quads aren’t strong enough…I mean my thighs are like tree trunks (in a good way?). My quads are huge. I entertained the idea of the imbalance between the quads and hamstrings, but even then, I work my hamstrings at the gym to attempt to even out any imbalance that is present. As I kept reading however, I realized the problem.
From this website…
Your knee is popping because two of those four muscles are in a tug-o-war over your knee cap and one of them is winning. The two muscles causing the knee popping are your vastus lateralis and your vastus medialis. The vastus medialis is on the inner-front part of your thigh and the vastus lateralis is on the outer-front part of your thigh. These two muscles connect on either side of your knee cap. In some people, for whatever reason, the vastus lateralis gets too strong or the vastus medialis gets too weak. As a result, the knee cap is pulled too far to the outside by the overly strong vastus lateralis and as the knee moves the knee cap isn’t gliding properly in the trochlear groove, causing knee popping, clicking, snapping, and other similar noises and sensations. In a healthy knee, the relative strength of the vastus lateralis and the vastus medialis is balanced and the knee cap slides up and down in the trochlear groove as it’s supposed to.
When I looked down at my quads, I could see the difference. The vastus lateralis (on the outside of the thigh) was huge. Literally protruding off of my leg; but the vastus medialis was practically nonexistent. So I found some exercises to work this hidden muscle.
Work It
~Straight Supine Leg Lifts: Lying on your back, place your hands under your lower back for support, raise one leg a few inches off the floor, lift to 90 degrees and lower, not touching the floor. Repeat and switch sides. I like to point my toes on the way up and flex the foot on the way down, almost like you are painting an imaginary wall with your foot. (Hello Pilates!)
~Stability Ball Leg Lifts: Laury from the Fitness Dish originally got me to do this exercise but I love it. It is great for lower abs and inner thighs. Put a stability ball between your feet and lay on your back. Lift and lower the ball, squeezing it with your feet from a few inches off the floor to 90 degrees and return. Be sure to protect your lower back and lift and lower with control.
~Leg Circles: We did this exercise in mat Pilates today. Lie on your back and extend your legs to 45 degrees. Open your legs about the width of your mat (if you are lying on one), circle them up to 90 degrees, squeeze them together and return to 45 degrees. Repeat 8-12 times then reverse the movement. Start at 90 degrees, circle to 45, bring together and return to 90.
There are many other ways to work this muscle but these are some non-weight bearing ways to strengthen it without causing more damage. In addition to strengthening this muscle, I have been icing, foam rolling, taking an anti-inflammatory, and resting. *Please do not attempt to diagnose yourself and always remember to consult with a physician before starting any exercise program*
I also bought these today:
Glucosamine supplements and a knee strap. I read a lot of positive things about using this knee strap to treat runner’s knee. I tested it out today on a short 3 mile run, and let me tell you…this thing is AMAZING! This was the best I have felt since the marathon, and although I had some pain, it was 90% better than it had been. If you are suffering from runner’s knee, it is definitely worth a shot. The one I bought was about $9 from Walmart. I will let you know how the supplements go.
Okay no more about the knee. My next post will be about something else :)
8 comments:
I feel so much smarter after reading your post. I just started taking glucosamine too but I think it is working! I am going to copy you and get a knee strap and try your different leg exercises. I forget how complicated the quadricep is and think of it as just one muscle too! Feel free to talk about your knee as much as you want because I am struggling with the same problem.
I messed up my knee running a marathon and ended up using one of those Mueller knee straps for a while after. My orthopedic surgeon said it wouldn't be any help, but I thought it did. Nice technical post. I love it when people go into detail about muscles.
I use a knee/ITB support for all my runs now (and consequently have a socks tan line, then knee-bandage tan line, biking shorts tan line and running shorts tan line on my right leg and actually people ask me why my right leg looks so funny:)).
I think that it was the only thing that helped me to get through the marathon. I did not use anything for my first marathon and had to drop out at mile 20 and not run for couple months. Then I used a support for the second one, of course ITB got messed up anyway, but at least I did not have to drop out at mile 20.
I do not think that it helps to heal things but it definitely helps not to worsen them.
Good luck!!!
Whenever I have an injury I always do tons of research but you really seemed to have found some good stuff! It is amazing how all the muscles work together! I will have to try some of the exercises and hopefully they will help!
I've had bad knees in the past and I think I've recently gotten runners knee. It's horrible, but after a few days of rest and alot of care, it's doing better. I'm glad you're able to run again.
This is an awesome post about knee pain in runners! You should seriously ACE that test coming up...love how you realized the problem and are tackling it the right way!!! Thanks for the shout out also :-)
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Keri,
Very interesting post.
I have been nagged with patellar tendom and medial knee pain on my right leg lately and as you have done I have done significant amount of research just to find how crucial the Vastus Medialis Oblique (VMO) is.
Two additional exercises that help building the VMO are:
1) Terminal Knee Extensions.
http://www.youtube.com/watch?v=ZscBVtoX62U
I have done these years ago after a meniscus repair surgery.
2) Deep squats.
This is performing squats past the parallel point. To start I will use no bars nor weight. It is essential that the hips push back at the start point to help the buttocks go down as far as it is possible. In addition of activating the VMO deep squats are excellent for the glutes.
Lastly I would say to avoid leg extensions on any machine as much as possible.
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