The orthopedic specialist was not quite as sure about the "rough spot" as the primary care doctor after reviewing xrays. The ortho for now wants to strengthen the soft tissue around the knee with PT exercises. I doubt he has ruled out DJD or RA or ? at this point. He said he may do a MRI if I am not progressing after 6 weeks of PT. The left knee and leg are getting somewhat stronger, but there is still much work to do.

For any of you doing carpentry projects around home involving knee strain (e.g. on hands and knees to paint a wall close to the floor), I would recommend knee pads or some other cushioning support for knees. This is what triggered the pain in my knee. The beat goes on!

One exercise that has helped me is doing clamshells with a thera-band wrapped around my knees. I have tight IT Bands and they seem to cause some mal-tracking of my patella laterally. I do the clamshells and also do some mobility work with a foam roller. I've also started using a lacrosse ball to massage my gluteus medius and hip flexors. For me it seems to be a muscle imbalance in the hips or something. Still haven't figure out how to totally balance things back out, but staying on top of stretching/massage and exercising(clamshells) has allowed me to recreate relatively pain free. I race mountain bikes at a pro level and get a lot of vert in ski touring during the winter. Try some different things, if they exacerbate the problem stop doing them. I think the important thing is finding out what works best for your situation. I went to a couple PT's and through no fault of their own they had me doing one legged squats, and other weight bearing exercises. This seemed to hurt more than it helped. Hope this helps!

http://www.youtube.com/watch?v=njthA4SVOT8

Thanks for the clamshell exercise suggestion, I hadn't heard of that one.

I agree that different exercises prove helpful to different people. I have muscular thigh and calf structure, so felt that having some form of stretching was helpful prior to running a 10K race when I was younger.

Brings up another question: are folks with muscular legs more susceptible to injury than someone with much smaller leg muscles?

Whether it is running a longer race (half marathon or more) or strenuous mountain climb, I have noticed that slender participants typically have a "faster time" (other things being equal such as training, technical skill, age, etc). It makes sense that moving less body mass is easier on the heart as the event becomes longer. On the other hand, many of the 100 yard dash elite athletes have very muscular legs! Oh well!

ScottHanson wrote:Brings up another question: are folks with muscular legs more susceptible to injury than someone with much smaller leg muscles?

Whether it is running a longer race (half marathon or more) or strenuous mountain climb, I have noticed that slender participants typically have a "faster time" (other things being equal such as training, technical skill, age, etc). It makes sense that moving less body mass is easier on the heart as the event becomes longer. On the other hand, many of the 100 yard dash elite athletes have very muscular legs! Oh well!

Well in terms of endurance, performance is limited by ability to deliver oxygen to the muscles, and having more body mass requires more work (and more oxygen) so your performance will decrease as you increase bodyweight, even for the same fitness level.

For sprinters, oxygen delivery is not the limiting factor, but power output for very short durations that comes from generating large forces using creating phosphate energy, both which could increase in proportion with bodyweight. So for sprinting both skinny and larger body masses could perform well.

Injury is more complicated. Some weighlifting is beneficial, but gaining large amounts of weight will just require more of your joints. Still possible to do w/o injury.

Scott,
Many years ago I ran 20 to 30 mile per week, but every time I wanted to train for a marathon, my knees would start hurting at about the half marathon distance, Before I had the first of my three arthroscopic knee procedures, I got a good deal of relief simply from using SuperFeet insoles in my shoes. It was like magic. I swear by them and put them in all my shoes now. I still have knee pain and problems, but I think my knees have degenerated beyond what relief the SuperFeet can supply. You might try them or custom orthotics if you haven't already.

Thanks for your suggestions of Superfeet and custom orthotics. I ran six marathons in a previous life (last one 30 years ago) and really didn't have foot or knee issues pop up. However a good friend (runner and backpacker) was always experimenting with custom orthotics. He had jumped off the back of a truck as a kid, and this gave him persistent flat arch problems. Thus orthotics.

btw, I mentioned a possible arthroscopic procedure for my knee to my orthopedic specialist recently, but he didn't think it appropriate for my case.

I saw my knee injury diagnosis today, they call it chrondromalacia of patella (CMP). It is inflammation of the underside of the patella. Kneecap rubs against one side of the knee joint. This injury can happen to adults who over work their knees.

Largely pain free now, and left knee is getting stronger. But still room for improvement.

My hiking this spring has been largely nonexistent; two baby hikes. Not enough training yet to be ready for SC 2013.