Question
i have just got back from a run where i have had to be driven home because i got a pain in my knee which meant i wasn't able to carry on, i am currently training for a marathon which is in 29days and did a 17 mile run 4 days ago after which my knees ached mildly but this was obviously expected after such a long run, but after a very short while they felt fine, i have done small jogs through the week and i went to do an 8mile run tonight but after 6 miles my knee hurt so much i had to stop, it feels ok to walk and when i am still but hurt when i tried to run again, something seems to click and move just under my knee to the right hand side (of my right knee) when i bend it but didn't know whether this was normal or not, i was meant to do a 20mile run on Sunday but now wonder what would be wise as i soon meant to start tapering my distances down and am keen to get my bigger runs in before i do this, please help, thanks a lot

Answer
Ian,

This is commonly called "Runners Knee" and you can google this and see tons of information on it.   It is knee pain that is likely caused by irritation at the knee cap (patella) where it articulates adn rubs against your tibia.  There are little articulations, called patellar facets, that can become irritated.  There also can be inflammation or disruption to the smooth cartilage layer that blends against the patella.   While ice can temorarily alleviate the pain, a more appropriate treatment program would involve a mix of modalities to the knee: soft tissue therapy (e.g. www.grastontechnique.com), low level laser therapy, bracing (e.g. Cho-Pat strap), foot orthotics (to help change the angles and movements about the knee), and joint manipulation to any fixated or malfunctioning joint in the "kinetic chain" such as at the ankle/foot, hip, or pelvis.  Lastly, application of "Kinesio-Tape" can help, especially for when you are running.   This is how it's treated in my office and by other sports chiropractors.    Your doctor can test you by having you step down off of a box or stair, or have you lunge, in order to provoke the pain.  Then you can undergo treatment and see if the pain is resolved or reduced.   If so, you're heading in the right direction.  It would just be a matter of how long to resolve the problem...in time for the marathon?    Complicating factors would be if you had other things going on with your knee such as meniscal cartilage tears, ACL (ligament) laxity, etc.  This is where the hands-on examination will be helpful (not an internet chat).  Depending on how you test during physical exam, MRI may be needed to see internal knee structurs.   I hope this was helpful.   Good luck!!

Dr. G