The Physio Report

On Monday evening, I left work early to go and meet the Physiotherapist recommended to me by fellow Plums Les and Robin.  Nelson, a lovely retired Chinese man, lived just around the corner from me in Welling Way, so was only a 5 min walk away from home, if that.

Nelson took me into his living room and sat me down on the sofa and he proceeded to ask me the usual questions.  When did the pain start?  where do I feel it?  how long has it been going on for?  what aggravates it? etc etc.

Once the questionnaire was completed, he took me into his examination room.

He gave my legs a full and thorough examiniation.

No swelling.  To touch, the knees were of normal temperature, to prove no swelling.

After a few bends of the knee in the squat position and then kneeling on the floor, I got on to the examination couch.

As Nelson looked at me, he said that one thigh looked slightly bigger than the other.  He measured and marked my thigh from the knee cap upwards and true enough, when he measured the same spot on the different legs, there was a significant difference.  At the top of my thighs, my right thigh is 3cm thicker than my left.  He asked if I was significantly right footed when I used to play football and I confirmed.

With a few gentle twists and bends, he was able to confirm there was no damage to the meniscus, the cartilage and the ligaments.  (I didnt think there was but thank god!)

Once he'd checked all that, he was then able to give me a proper diagnosis.

I've got Runners Knee...

Runners Knee occurs when the outside quad muscle (Vastus Lateralis [VL]) is overpoweringly stronger than the inner quad (Vastus Medialis Obliquus [VMO]) and it pulls the Patella tendon slightly out of line, towards the outside of the knee, causing friction on the knee joint and behind the knee cap.  That friction has led to the Patella being sore, this why I've got the discomfort known as Tendonitis, which my all accounts, although I can still feel is not painful as such, just uncomfortable if that makes sense.

A stronger VMO will prevent the VL pulling the Patella out of line.

Nelson showed me two great exercises to do to strengthen the VMO.  Having looked on the web this morning, there's plenty of exercises here too.

The second exercise Nelson showed me is demonstrated in this You Tube clip...

However, this all sounds quite downbeat and negative.

The major positive is that Nelson has given me the all clear to continue running and the discomfort will reduce as the VMO gets stronger.  Nelson reassured me I can do no long term damage so I hope to be running again on Tuesday evening.  Lets see how I get on.

Nelson also said by hamstrings were really tight and asked me how I stretch them.  When I said I generally keep my legs straight and try and touch my toes, he tutted and said thats probably the worst thing you could do as the back would always compensate.

Like so:



I dont think my hamstrings have ever been stretched like that before.  Nelson recommended the stretching twice a day up until Paris and he said within a week or so, I should be able to fully extend my leg.  At the moment, I cant which goes to show how tight my hamstrings are.

Nelson was very good with me.  He told me I'd done all my long runs now so I should be taking it easy in the taper.  No runs longer than 10k.  He advised doing some swimming too and told me to phone him with an update at the end of the week after I'd run twice, done some exercises on the VMO and done some stretching and to reduce the Ibuprofen to two doses of 400mg a day as long as my stomach can cope.

So all in all, I feel so much more positive now.  My mind has certainly been put at rest and I know that although the knees may feel sore running, the fact that I'm not doing no longer term damage to them is reassuring.

I need to get back into Marathon mode :)