Fitness Expert replies:

Dear Wonder Walker

Although I’m always reluctant to answer medical or injury questions based on an email forum, by the sounds of your description you have a problem known as anterior knee pain. Pain at the front of the knee often arises in females when they increase their mileage and or intensity (e.g. walking to running as in your case).

What happens is that the Ilio-tibial band down the side of your leg gets tight. It happens in females because we have a wider pelvis and because the IT band comes off the gluteal medius muscle (at the side of your buttocks). It will be this muscle that is getting tighter and therefore pulling on and tightening your IT band. Then what happens is that the tight IT band causes the patella tendon (down the front of the knee) to move slightly out of position (it sits in a groove in front of the knee). Pain tends to present itself when you are sitting for long periods as well (e.g. in a car or in the movies).

You need to get access to the following stretches and strengthening exercises (go into google images):

• Ilio-tibial band stretches
• Gluteal medius stretching and strengthening exercises (e.g. standing on one leg and doing squats)
• Swiss Ball squats against the wall with a soft ball between your legs (the ball should be no larger than the size of a kids soccer ball). The ball between your legs makes you squeeze your adductor muscles (inner thighs) and this strengthens up the quadriceps muscle (vastus medialis) that helps the patella tendon sit in the groove.

The biggest issue for you is to ensure that when you are running or doing these exercises that your knee is tracking over your second or third toe. If you do a squat movement and you look down and see your knee ‘rolling-in’ then you don’t have the correct bio-mechanical alignment.

I’m not sure where you live, but see if there is a qualified REPS-registered Personal Trainer (REPS stands for ‘Registered Exercise Professional) www.reps.org.nz, and get them to design you a home-based stretching or strengthening programme. Massage of your IT band and calf muscles will help as well. If the doctor is clear that you don’t have arthritic changes in your knee, then take heart in that it is treatable. It’s probably just over-use, increased intensity and improper walking and running technique.

Hope this helps.

Regards
Wendy Sweet