I've been marathon training for a couple months. This will be my first marathon. No injuries or knee pain previously. This past Saturday, I ran my long run (12 miles). No knee problem/pain. Sunday I woke up and it was sore. I rested Monday and ran 5 miles tuesday. it was sore while running, but never got progressively worse. After running, it felt pain free for an hour or two, then the same dull pain came back.

I would describe the soreness/pain as in the middle of my kneecap on the bottom side. Right knee only.

My marathon (Buffalo) is in 4.5 weeks. I am schedule to run 20 miles this weekend, then start tapering down.

Do I keep running, and ice it after runs?

Or, do I quit running for some time and then start back up? (I am scared of taking time off because I feel like i need to do the 20 miler for confidence reasons).

Thanks in advance.

No single run is what gets you to the finish. I like a 20 miler 3 weeks out anyway, not 4. But I didn't make your training plan, so tough to say where to move runs.

I struggled with it for about a month prior to mine I just ran. 2 weeks out a buddy let me try some glucosamine chondroitin supplements and the pain literally disappeared overnight and I had no problems during the race. Everyone is different but I wish I'd of found out about them sooner. You can get them at Walmart or Target. Worth a shot I promise.

I've been doing the Hal Higdon Novice II.
http://www.halhigdon.com/training/51138/Marathon-Novice-2-Training-Program

I understand and agree that a single run won't get you to the finish.

Maybe the real question is: How best to deal with a new case of runner's knee 4 weeks before the marathon?

Thanks waco aggie. I will check it out.

Any other comments are appreciated.

Be sure to adequately stretch out your hamstrings. It makes a huge difference for me.

foam rolling hammies and quads helped a TON with my runners knee recently. i'm also been using a dirt cheap knee "brace" (more of just a wrap than anything) during runs and that has helped a ton as well

Ice it.

Foam roller -- will make the dogs look around and wonder where the high pitched whimpers and squeaks are coming from the first few times you use it, but it's gets more tolerable - barely. Lay on it on your side, roll from your hip down the leg to the ankle and back, using hands & forearms on the floor to support the upper body. It's a little awkard, but you'll get the hang of it.

^ i've heard not to foam roll over joints - so avoiding the actual knee and just rolling above the knee and then on the side of the calf below the knee

is that not true? i've noticed improvement in my knee without ever rolling the joint itself

EPC, I have not heard about not rolling over joints, but then again I don't read up on foam rolling very much. It is worth looking into, and certainly I would believe rolling over joints should be avoided if the effects were proven deleterious or if there was significant pain (more than just the discomfort of point loading).

A few years back I had some IT band issues late in a training season (starting about week 17 of a 20 week regimen) and began foam rolling prior to a marathon. It helped, and I made no effort to avoid the knee as I rolled up/down the leg, though I can say I would quickly roll over the knee with much support from hands/arms as opposed to the "slow" roll from the hip to the knee and the knee to the ankle.

I have dealt with runners knee on and off for the last couple of years. Stretching the hamstrings and weightlifting to strengthen the hamstrings have helped me.

It's a little late in the training cycle to add the weight lifting in.

Definitely do the rolling and stretching, especially after the run.

Also, have you been doing ice baths after long runs? If not, it's a very good idea.

I've never had runners' knee, but I have had overtraining issues, which I think is in the same family. I ran a half with an IT band flare up (knowing I'd pay for it...), and it was sore, but not terribly painful, during the race, and I had to take significant time off after the race. But I got the race in. I'd suggest take it as easy as you can, add stretching, icing, glucossmine and anything else that will at least mentally help, but be prepared to take a fair amount of time off after your race. Let's face it, we all know you'll at least be attempting the race, even if you're hurting. Best of luck!

Thanks everyone. I'll scale the running back a little, ice after runs and baby it as possible.

And as tiny ag said, I'm pretty much doing the marathon no matter what, and will take time off after.

Sounds like IT band. Any regular chiropractor who works with runners could show you simple strengthening exercises. Foam roll and ice alone won't fix it.

Oh, something else that may have helped my IT band (not sure, because it was in addition to everything else I was doing) was a really painful deep tissue massage. I just went to elements and told the girl about my IT band issues, and she went to town. Hurt so bad... But, maybe it did some good. It definitely didn't do any damage. Worth a shot to give it a try. Maybe go in this weekend to see if it helps give any relief, and if it does, you could continue to go a few times before the race. A little bit pricey, but worth it. Also, if it is the IT band, there is a brace they sell at Brazos Running Co., and it's mentioned a few times on some boards on here (I'll see if I can find it). It aparently works wonders, but I haven't personally tried it. It's about $60, but again, when you're in pain, you'll pay a lot to still run. I'm a bit hesitant to say it's your IT band only because you said the pain was under your kneecap, which doesn't really fit from what I've experienced/researched. Everyone is different though.

http://texags.com/main/forum.reply.asp?topic_id=2293758&forum_id=48

A lot if the stuff here is similar to what's been said already on this thread, but still take a look. This has some discussion about the brace.

http://m.youtube.com/#/watch?v=LDhKVtkfnsg&desktop_uri=%2Fwatch%3Fv%3DLDhKVtkfnsg

This cured my runners knee in less than half a week.

I also didn't have to take any time off. I was running at that time about 40 miles a week.

[This message has been edited by TexAgs staff (edited 11/29/2013 9:25a).]

Runners knee seems to be more a patella tendinitis. Hamstrings don't attach to the patella. Quad stretching, NSAIDS, Ice after runs, and rest is what helps. Strengthening your quads is most helpful to prevent, but a little late for that now. I would rest it, ice it, and a few NSAIDS for now. Skip the long run, you'll be fine missing one.

Staff can you please ban the spammers

[We do. Using the voting function helps us. -Staff]

[This message has been edited by TexAgs staff (edited 11/29/2013 9:25a).]

As a person who had tendinitis (jumpers knee) and runners knee (aka Patellofemoral Pain Syndrome) you need to be able to recognize which one you have. The OP said they had pain below the kneecap while exercising, most of time this is because of tendinitis. With Runners knee you you could have a similar pain but your knee will also be tender/sore to touch. Your knee may also crack more than normal and if it gets bad it gives out on you at random. Runners knee is when the kneecap becomes misaligned from where it sits on the femoral groove. Tendinitis is inflammation of the petellar tendon that connects the kneecap to the shin. Both are overuse injuries but the runners knee has more to do with bio-mechanics.

For tendinitis the best treatment is rest or if you have to keep going be sure to ice the knee after the workouts. A good 5-15 minute warmup followed by stretching is very helpful. Most of the time PT is required they tend to focus on quad and calf strength. A brace or tape can also help eat the pain during exercise.

For runners knee rest is also the best treatment but the PT is different. You need to work on strengthening various muscles (depending on which way it pulled) to get the kneecap back into proper alignment. This along with targeted stretching helps relocate the kneecap. It helps finding the reason for the injury: shoes causing you to land incorrectly, bike fit, muscle imbalance, etc.

The doctor I went to (sports/triathlete specialist) and PT (also sports/triathlete specialist) believe my bike fit was the cause of my runners knee. My seat was just a tad bit low and the repeated pedaling slowly moved my kneecap over. After 4 weeks off and 5 weeks of PT my knee feels normal again without popping all the time. They also said my hamstrings were very tight and week compared to my quads and glutes making things worse.

If you are not sure go to the doctor and all you will be out is your co-pay. If it is getting close to your race the doctor can give you some anti-inflammatory drugs or in the case of runners knee will give you some shots to relax the knee muscles.

Sorry I had to respond since this thread was bumped up. There were a lot of people confusing runners knee with jumpers and then the IT band came out of nowhere. And yeah foam rolling over a joint like the knee is not ideal, one wrong move and things can go bad. Try a tennis/lacrosse ball and roll it around the knee. Find a way to warm it up and this will be great for pre-exercise (never priced an ultrasound machine but they just do not look cheap).