[briguy]

briguy on October 19, 2021 at 9:18 am · in reply to: Patella (kneecap) Arthritis #58281

Just to clarify, only the flexibility regimen is daily, the strength work I do 2-3 times a week.

I like the idea of trying the cortisone shot, at the very least it’s something I haven’t tried yet!

What’s odd about this knee condition is that even before I discovered this current semi-effective routine, I’d have “good days” where the knee wouldn’t bother me a bit on the bike and I always tried to deduce what I had done differently to bring that about. In hindsight, something I had done had allowed that patella to shift over a bit but maybe it was just having a “good day” itself. 🙂

[briguy]

briguy on October 19, 2021 at 8:01 am · in reply to: Patella (kneecap) Arthritis #58278

Thanks, I appreciate your help in trying to get to the root of this.

None of the MDs could really say “why” the patella is misaligned, just that it’s a common culprit with PFPS. Common speculation is due to muscular imbalance and or mobility/flexibility issues.

So for years I’ve been doing the #1 prescribed exercise for this condition (quad sets) which I generally do about 10 sets of those a day. They are very interesting exercises, as they can often make the pain go away – which is why I tend to do them as pre-hab before a run for example. But I think I’ve reached the limit of how much that quad-sets can help me. I have Robin Mckenzie’s Knee Pain book but other than the quad-sets that program hasn’t been helpful.

It’s interesting that you ask about the hamstrings, as I also do some hamstring flexibility stretching and that seems to help too.

Might be helpful if I list out everything in my current regimen – I do the stretches daily (At least) and the strength-work 2-3 times a week.

Flexibility:
Foam rolling (quads, IT band, etc)
Hamstring stretches
Quad stretches
Twisted leg stretch (targets the IT band/outer thigh)

Strength:
Single leg deadlifts
Step ups (when able – can be painful so I at least will do the opposite “good” leg)
Quad sets
Split squats – trying to isolate that VMO as much as possible)
Band work – targeting the glutes (this is a byproduct of my hip surgery)
Previously I have done version of the Uphill Athlete ME program too but currently on break from that.

Interesting that you asked about a cortisone shot as my MD suggested that as an option (as well as euflexxa). The pain will almost completely vanish when I go on a round of NSAIDs for 2 weeks so I’m sure the cortisone shot would do the same.

[briguy]

briguy on October 18, 2021 at 1:31 pm · in reply to: Patella (kneecap) Arthritis #58260

P.S. I’ve noodled around a bit on my own and discovered an exercise that would target my inner quad (the VMO) as that is often recommended to “pull back” the kneecap to the right direction.

Split squats dropping the affected knee straight up and down from the ground – I can feel the VMO engage on this and the lack of knee flexion means I don’t get any pain.

Meant to mention I’ve been doing these as well and they seem to help as both a “pre-hab” for my running as well something to do in conjunction with the other-thigh stretching routine.

[briguy]

briguy on October 18, 2021 at 1:16 pm · in reply to: Patella (kneecap) Arthritis #58259

Yep, I remember it happened when I was doing the sissy squats, a strengthening exercise I hoped would prepare me for the downhill pounding of a mountain race (Pike’s Peak Marathon).

Could I have dislocated the kneecap simply doing that? My uneducated imagination thinks that patella got “pulled” to the outside as a “tweak” during that exercise but I don’t know if that’s even possible.

I’ve seen several PTs for this and it’s always the same strengthening regimen – quad sets, isometric holds, etc. Some PTs recommended I just needed to get stronger and would have me do step ups and step downs and that the pain needed to simply be worked through until I was strong enough. I’m not sure how strong I need to be? I can already do pistol squats with that leg – I can do step ups until the cows come home —- lots of people don’t have that kind of strength and yet can ascend/descend stairs without pain.

[briguy]

briguy on October 18, 2021 at 12:54 pm · in reply to: Patella (kneecap) Arthritis #58254

Hi Thomas – The hip surgery was 2018, opposite side, and it was a labral tear repair (rim trim too). The knee issue started in 2017, specifically when I was doing some step-downs and sissy-squats as part of a strengthening program. I remember the day it happened…BAM, pain started and has continued since, though it will retreat a little when I cycle less. Generally it gives me trouble until I’ve warmed up on a run, and is tolerable even then.

I see as many references to runners-knee as PFS as I do for ITBS but they must be pretty interchangeable, certainly they are both afflictions of runners. Anyway I am familiar with ITBS and that is not what I have (I wish it were, I abolished a previous bout with ITBS pretty easily).

Yes, have had a few evaluations by MDs on this knee, all pointing to PFPS due to the pain description (directly behind the knee cap – and particularly bad going up/down stairs and when cycling)…and since xrays all looked okay (no arthritis in the joint). A more recent Xray clearly showed the patella/kneecap shifted to the outside when compared to the opposite knee.

That prompted an MRI which disclosed the arthritis behind the kneecap, presumably from all these years of rubbing in that area.

My conservative treatment regimen thus far has been quad strengthening (quad sets, isometric holds —- step ups and leg extensions dramatically flare up the condition). Have been foam-rolling and stretching for a long time too…but recently targeting the outer-quad/thigh area seems to have shown some improvement over my more general approach from previously.

[briguy]

briguy on June 21, 2021 at 4:53 pm · in reply to: Racing with HR #55010

Since Pikes Peak was mentioned I’ll chime in as I’ve raced there quite a bit and consider it my “favorite” race of all. My best years at PPM I used HR as a limiter in the early part of the race (the first 10K when nobody seems to entertain the idea of powerhiking what are some of the steepest sections of the course). The limit I set for myself was roughly my LTHR and I did it mostly to keep my race-crazed brain in check as a (somewhat) objective threshold.

This worked very well and I set my PRs on the course and beat all of my personal rivals (as a flatlander though, it’s hard to truly be competitive in that race overall).

HOWEVER, those “best” years also happened to coincide with my best fitness so it’s hard to say if the HR method was the difference or just a contributor.

Enjoying the discussion though, much of what has been said has gone through my mind as well.

[briguy]

briguy on March 26, 2021 at 6:53 am · in reply to: Planning a break/reduction in Training #52421

Thanks, I think my posting was my (subconscious) method for getting my thoughts in order, plus I just like discussing things with a group. And maybe someone else doing a search on UA will find this post and it will be helpful.

Rachel – what you described is sort of in line with what I planned, just a do-whatever-I-feel-like period but knowing myself that will still end up being 20-30mpw of running due to group social runs etc. I also have two dogs that would be extremely upset if their running volume got cut away!

4-6 weeks sounds about right, then I do a type of transition period, then base training and then a race plan ending with that mid-September mountain event.

Here’s hoping I get my mojo back.

[briguy]

briguy on March 25, 2021 at 12:03 pm · in reply to: Planning a break/reduction in Training #52385

Yeah, they call it the Transition Period and it’s on page 269 of the UA book.

[briguy]

briguy on March 25, 2021 at 11:03 am · in reply to: Planning a break/reduction in Training #52380

So what do you mean by transitional training?

I do some cross-training already, I’d say that 10-15 hours per week I quoted earlier includes probably a third of that as cross training, usually some combination of cycling, elliptical cycling, and uphill treadmill walking. I’m older (49) so my body can’t tolerate too much volume in running alone so I’ve been supplementing with XT for a long time.

But to the point, yeah I agree and I had planned on upping the cycling a little during this next phase since it’s more easily tolerated and more palatable than running has become lately. Agree too that I am curious about any other opinions/suggestions others might have.

[briguy]

briguy on March 25, 2021 at 6:48 am · in reply to: Planning a break/reduction in Training #52358

Thanks, enjoyed the link. That makes me feel better about the ‘floor’ of what I can do until I feel like I’m bouncing back. I guess I should look at a few months of just base work until I really need to ramp up for that mid-September event. 16 weeks out from race day should be enough provided I maintain some level of base (25-35mpw). That gives me about 2 months of cut back until then.

[briguy]

briguy on March 4, 2021 at 11:59 am · in reply to: AET from HRV? #51568

Yep, that’s the way I was leaning!

[briguy]

briguy on November 13, 2020 at 11:51 am · in reply to: Chest strap HRM recommendation #46809

I swear by my Scosche Rhythm+ 24 but I have heard good things (from DCRainmaker) about the Polar and Wahoo versions.

[briguy]

briguy on November 13, 2020 at 11:46 am · in reply to: Downhill training… without access to big hills #46808

I did R2R2R in 2014, great experience.

I didn’t know this then, but I’ve since learned that the UA ME program is VERY good at “inoculating” the legs against the kind of abuse downhill running brings. if you can time it such that you execute the full ME program prior to your taper, you’ll be well served by the work you put in.

[briguy]

briguy on November 6, 2020 at 2:12 pm · in reply to: Training + Mental Health #46577

If you’re taking a break from training, or in recovery, and you’re finding that you have a ton of energy, funnel it into something productive and/or that you enjoy.

Four days after my 110K trail run, I had not run a step nor done any training and I found myself with some energy for other small projects (landscaping) that have been put on the backburner.
Maybe you can find something similar.

[briguy]

briguy on October 28, 2020 at 12:11 pm · in reply to: NordicTrack Incline Treadmill Accuracy Issue #46354

Neat, thanks for sharing.

I don’t have a Runn but I’m familiar having read some reviews. I use a Stryd to keep my treadmill “in check” as far as pace goes so roughly the same principle.