CATCH Up CORNER...WEEK 3...Come on IN ! They are all we K-NEED to get byyyyyyyy !

[Oldfloss]

… and they are full of BIG words... !

Welcome to the cosy Corner... this very, very foggy morning. The weather lady says it is in the South... I can tell you, it is up here, further North, too!

The cushions are plumped up. Coffee and tea is piping hot.... smoothies blended and loads of snacks on offer this morning. I am into the blue berries and a different recipe, courtesy of the Hairy Bikers... !Blueberry Skyr muffins ! ) There are of course, other brands of yoghurt you could use!

I am late... literally playing Catch up. Again!

It is as it is... life is hurtling along and the weather too ! One day cold, and yesterday, chilly but glorious sunshine! I run when I am able... I am walking a lot,,, a heck of a lot... in all sorts of places...but I am reading posts and replies

Okay... what is showing up in those posts... ? Loads of awesome achievements.. of course... and … yet again , a couple of niggles... two actually... our KNEES !

They crop up regularly...and usually when they are causing trouble...One of mine, kept me from running for nearly twelve weeks... !

So.,,, why does this happen... ? Well, I have been researching!

Main causes of knee niggles, seem to be...

Overactivity

Too much bending of the knee and the high impact, for us, of our running, causes irritation, inflammation and pain. Front, back and sides of the knee!

Ill fitting shoes.

Shoes that do not fit, or are not suitable , can be a real issue.

Feet with problems.

All sorts of foot troubles can really impact on our knees. Hypermobility and fallen arches can lead to knee pain.

Leg muscle, tightness/weakness.

It may be caused by prolonged sitting, overuse, or neglecting our stretching. ( Pop across to the S and F, Forum later. Changing Room Chat will have a post on Stretching).

There are loads and loads of exercises around to support our niggle knees, including, the one we use many times here,

nhs.uk/live-well/exercise/k...

Simple and effective...

But there are other exercises... lots of links on the Strength and Flex Forum for those.

There are too, a few more I picked up on... I am not going to cut and paste, ( too many videos ), but if you think they may be useful to you.. just look them up ! Some are pretty obvious...

******

Wall sit.

Standing hamstring stretch

Standing Quad stretch

Single leg Glute bridge

Sitting leg raises

Forward lunges

Clamshells... (I love this one) !

***********

Okay... well now it is your turn... have you had any knee issues at all?

If you have how did you go about getting them sorted?

I know that I tried a fair few exercises to ease my twinge ...but eventually I had to see a GP... where an x ray showed up some other odd injuries, ( which turned out to be ancient, from childhood and were coincidental! ) Time out waiting for CT and CT results obviously sorted the original twinge!

Do any of you do regular knee exercises? I know I do, they are part of my warm up and cool down routine...

Please, do slip off your shoes, grab a cushion and do sit a while and share your knee news with us!

Looking forward to see who drops in

Oldfloss x

P.S.

The BIG words in our knees?

Patella condition

Vastus Lateralis

Vastus Medialis

Vastus Intermedius

Semitendinosus

Semimembranosus

Biceps Femoris

WOW!!!!! No wonder they cause problems!

[AlMorr Ambassador Graduate]

Love that post from you Oldfloss, especially all those Latin words like Vastus Intermedius and Semimembranosus 🥳, indeed it keeps it nice and simple to understand 🤣lol, I hope you and Mr OF are keeping well ✅

[Oldfloss Administrator Graduate in reply to AlMorr]

Oh yes indeed... hello Al... good to see you here...and hopefully with no knee issues!!

Yes... Latin is a truly powerful language... I did not study it at school, but did pick up a little bit ! We are getting there Al... be better after Mr Of's op' in November though...

You are doing so well with your running still... and no twinges or niggles. I don't think! Thank you so much for popping in today!

[AlMorr Ambassador Graduate in reply to Oldfloss]

So far I haven't had any knee issues or twinges Floss, yes I am still running, I ran a short 3K this morning, guess where that 3K finished? within 200 metres of a McDonald's restaurant, my neighbour gave me a free voucher to buy a double cheese burger which I ate there after my short run.

[Elfe5 Graduate]

Morning OF!🤗 I like the sound of blueberry & skyr muffins!!

Years ago I had a slight knee sprain- my GP advised me to continue cycling to keep the supporting muscles around my knees strong. ( I was so excited by my new found running that I neglected my cycling). Since then I have done both & my knees have been happy. I also find running on soft ground (grass, mud cinder track) rather than pavement makes a big difference.

[Oldfloss Administrator Graduate in reply to Elfe5]

Hello and how good to see you!

Yes indeed, very very tasty indeed! Thank you for these tips... ones that hopefully a few folk may read and take on board.

Using your cycling, to keep the knee strong... for walking and running! Mr OF was advised to do the same... he only walks though, not running!

Yes... off road can be much more forgiving, than pavement pounding... and can be a lot of fun too... It sounds as if you have got it just right... taking care of the knees, so that they take care of you !

Thank you so much for calling in today... and do seek that recipe out... it is worth it!

[MissUnderstanding]

Hey Oldfloss ! As a runner with occasional niggly knee pain, I thought I’d share my experience.

A couple of years ago. I had pain in the outsides of both knees during a race so badly that I had to pull out. I saw a physio who told me it was nothing to do with my knees-it was my weak glutes and hips. Now, I do a whole load of strength work which means I can keep running in the way that I want to. Squats, lunges, deadlifts, core work etc isn’t my favourite thing to do-I’d rather be running but I do enjoy it and it’s so important to try and keep me off the injury couch. That physio was the best thing to happen to my running and the added bonus was I took about five minutes off my 5k time just through being stronger.

I guess the moral of my story? Don’t assume knee niggles are down to problems with your knees and get someone qualified involved earlier rather than later.

And if there are spare muffins…send them my way!

[Oldfloss Administrator Graduate in reply to MissUnderstanding]

Hello and thank you so, so much for calling in and sharing with us! This is something many of us, may not have even thought about.., that something else impacts on another part of our body!

Getting expert help was key for you and would be for others too! Finding out what exactly was going on, and then tackling that issue...

I do know how much strength work you do,, and looking at your runs.. it is very, very clearly paying off! Keeping you injury free and with a PB as a bonus...

I really hope some of our forum friends read this... they will see just how important, getting expert advice is and just how much value we get from our strength and stamina work...

Muffins are winging there way to you, right now and thank you so much, for all this useful advice...

[Annieapple Graduate]

🍏 Evening Floss I am creeping in a little late in the day. Fortunately for me I have never had knee problems but your wonderful collection of Latin names may help me get ahead in our family online scrabble challenge 😆

I certainly am in the habit of squats at teeth cleaning time & something I can do even with vertigo… the other thing I can do is enjoy one of the delicious leftover muffins…

Thanks for all the information & knees are definitely a perennial problem across the boards! Xx

[Oldfloss Administrator Graduate in reply to Annieapple]

Hello and welcome to you!

I was here late today... playing catch up...again! I am so glad that you have not had knee pain, and really gad that you will be a winner at scrabble from now on.. !

Those teeth cleaning squats.. i do giggle sometimes in the morning whilst doing mine... I imagine loads of us all over the country doing our squats at the same time! Well done you for getting those squats in !

The muffins are definitely there to be enjoyed... so sit back and tuck in... hopefully, some of our new runners who are struggling with knee issues will drop in too and take a peek... and maybe have a snack... if there are any left!

Thank you so much for calling in !xxx

[Richard7 Graduate]

Hello again from a knee sufferer!!Just getting back outside and finished week 1 today - definitely enjoying being back outside again 😃

Knees were definitely feeling it yesterday after my Monday outside run and I did wonder whether today's run would happen.

Fortunately today was good to go!

I read your post this morning (thank you) and it reminded me of all the good lessons I learnt from my physio that I saw when I started out with my knee issues which turned out to be arthritic (following x-rays and multiple consultants) - one consultant went as far as to tell me it was good to run but I would probably struggle to do more than an hour!

Another Doctor gave a brilliant explanation of why we sometimes get muscular pain with arthritic knees creating a picture of squeezing a balloon in your hands and it coming out the sides saying that the knee joint causes inflammation resulting in pressure to the muscles like the balloon popping out the sides!!

Normally when back from my runs I have neglected the stretching mostly having stolen time between work responsibilities but with more time on my hands since retirement I needed the prod reminder not to just sit on the couch following my run gasping for breath 😉 so I spent a good 30-60 minutes doing various stretches. Fingers crossed it will help over the coming day or two!!

Keep stretching everyone and from someone who clearly didn't stretch enough - if you haven't started - start now 😃

[Oldfloss Administrator Graduate in reply to Richard7]

Hello and welcome... Here you are ! Cushion and snacks waiting !

It is so good to see you back here, up and running ! These knees, what a pest they can be...and we see how important the right treatment and the right exercises can be in supporting them!

That description your Dr gave... yes... that is a really great one! You can feel that !

You have had expert support and you realise also, your own limitations.

So many of us, like you, find the time constraints do make us skimp a tad, on the stretches or other support exercise. I know at the moment, I am very much sticking to basic routines, when, maybe I should be focusing on certain things! You have encouraged me to take a look at that!

Getting into a routine that suits us each, individually is key. Finding what works and finding what you can maintain and even enjoy!

Thank you so much for this... I really hope some of our newer runners, who I will be giving a shout out to, today, pop in and read your words...

On you go... and pop in any time... always a welcome here

[MrNiceGuy]

It should also be remembered that the knee sits between the hip and ankle/foot.

While reference has indeed been drawn to both foot and hip (above), when addressing knee problems (OA included), a top down-bottom up approach also needs to be taken.

For example, anterior pelvic tilt results in lordosis (over extension of the lumbar spine). Not only does lordosis result in tightened/weakened hip flexors and quad muscles and over-active hamstring muscles, such a pelvic position increases internal tibial rotation forces at the patellar joint, through feet that commonly remain stuck in a position of pronation throughout the gait cycle.

Conversely, since the WFH culture from 2020 has resulted in increased kyphosis (neck hump), many now suffer from spending far too much time in a state of flexion, whereby the pelvis becomes tucked, hamstrings shorten and quads/hip flexors lengthen. As such, in those whose pelvis is posteriorly positioned, their foot can no longer shock absorb as they remain stuck in a position of supination...impacting ability of contralateral leg/foot to fully extend through the hallux, ankle (talocrural), patellar and hip joints at toe-off.

With tight/weak hip flexors and quads that remain over-active, how can anyone expect an individual to quadruple extend without addressing pelvic position?

As I said at the outset, in attempting to address internal/external rotational forces at the patellar joint, one must also look at how the pelvis is moving in relation to the foot and vice-versa...hence the top down/bottom up approach I've spoken of.

For far too many years (until recently) the NHS simply took a top down approach - perhaps explaining why so many have undergone THA and TKA procedures. If only a far greater understanding of human movement (biomechanics) existed within the NHS, perhaps you wouldn't have written what you had, far fewer TKA/THA procedures would have been completed over the past 20 years...and my response to such (as a practising physical therapist) wouldn't have been so damning.

Rest assured, I'm not directing my anger towards you, Old Floss. As an exercise therapist/physio/OT, I'm simply expressing my anger and frustration at a system that has routinely failed many individuals for far too many years.

We, at the bottom have long seen and understood what's wrong with 'the system' for many years.

The problem with the NHS, due to the bureaucracy that has long existed within, is that it'll always be several years behind the game...particularly with regard to increasingly evidence backed practices that actually work to the improve QoL of those who continue to access it.

In comparison to the US, private it may be, given the many advancements in physical therapy over the past decade, due to slow uptake, the UK is at least 10-15 years behind where it ought to be in 2024!! 💯

The kind of stuff you see DocJenFit, The Physio Fix, Dr. Caleb Burgess and the PreHab guys implementing?

That's what I attempt to practice with my patients whenever possible. Not the rubbish demonstrated through 'not fit for purpose' PhysioTools, as it's so far behind the times.

[Oldfloss Administrator Graduate in reply to MrNiceGuy]

Interesting and thank you for your thoughts.

Here on our forums, we simply try to put forward links for supporting our runners and do try always, to use reputable links.

We also stress in all our replies and posts that the first port of call, for any physical or mental issues, is the seeking out of expert/medical help.

Personally too, I am in total agreement with you, on the failure in some areas of our own NHS. The NICE guidelines and the attitude of one size fits all, can not only be detrimental , but also dangerous. Mr OF and I have been struggling with this for while.

Many of us realise the connection between the parts of our running body and how they all impact on each other...

We focus on different issues, in different posts; too much information is often very off putting for many of our forum friends.

We are not experts and we urge any of our forum friends with a physical issue, that simply does not go away is dealt with by someone who is qualified to deal with it and to help them.

It has been quite a while since we saw you in the running forums... seven years? Are you still up and running, as they say ?

[MrNiceGuy in reply to Oldfloss]

Good afternoon.

Glad to hear you found some of the above insightful if not necessarily agreeing with all points made.

While many do increasingly recognise how movement of one body part can or may impact another, I was simply stating that pelvic position, posture and improved joint stacking remain commonly overlooked and how remaining stuck in a particular pattern of movement can prove detrimental to managing knee pain, regardless of attempts made to strengthen muscles that support knee stability, for example.

Nor was I suggesting that links provided above were not useful. Again, the need to consider posture/current movement pattern simply needs to be considered alongside exercises to strengthen and improve joint stability.

However, I was sorry to read that Mr OF has found himself victim of NICE guidelines that have resulted in a 'one size fits all' approach being taken to help treat/manage his current health condition(s).

That's the problem with mainstream medicine. For too long it has failed to recognise alternative treatments as part of an integrated approach to managing 21st Century health conditions that affect many, therefore, largely preventing holistic practices from being recommended (research the growing body of evidence backed research supporting the implementation of grounding/earthing, for example).

Guidelines and protocols are generally so strict and rigid, leaving very little room for fresh perspective and a departure from the norm.

Consider plantar heel pain (PHP), for example. While no general consensus currently exists on how to effectively treat it, within the NHS, common protocol is to simply provide an orthotic to offload the PF and send individuals on their way, with very little consideration given towards the mechanisms behind its development.

Whilst not necessarily criticising the provision of such (they may be needed), it's not a particularly dynamic approach to a condition that affects up to 22% of running populations in my opinion.

What about assessing and improving ankle dorsiflexion RoM, flexibility and strength of posteriorly located lower leg muscles (the post-tib is a big one!!), toe flexors and ankle evertors - many of which have been shown to be dysfunctional in those presenting with PHP? I could go on, but I'm sure you get the idea.

It's also the main reason why many end up going private for answers after provision of orthotics fail to reduce pain/discomfort, therefore, proving an area of failure within.

Anyhow...I did say that I wouldn't go on (you must stop me!! 😁).

It really has been a long time, hasn't it? 7 years? Wow!! 🤯🤣

Yes...I'm still running. Largely barefoot nowadays (as was also the way back in 2017) on grass and sandy beaches, but still running as and when I remain able 👣.

How are you?