Monday, October 28, 2013

Going House

My freshman year roommate S__ used frequently to describe over-the-top conduct as "going house."  "He went house on that slam dunk!"

I'm a big fan of Hugh Laurie's creation, House, a brilliant but idiosyncratic diagnostician that was the main character in the TV series of the same name.  I've decided that "going House" (proper noun) now means self-diagnosing.  Or, this being a blog, group diagnosing.

Whether a testament to our age or to our going house (original usage) by overtraining, we go House here at runningprofs with some frequency.  Hips, knees, heels, arches . . .  Over the last weekend I've been going House on my knee.

History:  inside-of-knee pain for about 12-14 months now.  Hard to locate by touch, but when I did find it the best guess was a tendon.  Most clearly felt when bending the knee outward (pulling the ankle inward) as in a cross-legged seated position or in that fabulous hip stretch performed face-down with one leg under you bent with knee out and the other straight behind you.  Never an issue while running, but an issue when tightening after running.  No apparent swelling associated with it.

Recent:  about two months ago the pain became more acute and sometimes could be felt while running.  I don't have the dates exactly in mind, but I did communicate with Coach Mike the concern that doing the run leg in Lake Tahoe in late September might be a problem. (It wasn't, but the knee wasn't exactly quiet.)  During the more recent and more acute episodes the pain seemed to associate with extreme soreness on the inside of my quads (that little bump of a muscle just above and inside the knee).

Last few weeks:  As I've shifted into running full time in preparation for the Rehoboth Beach Marathon, the tightness post-run has become acute.  It is also felt down through the shin, almost more on/in the bone than in the muscle.  I.e., it's not a shin splint, a pain with which I am embarrassingly familiar.  The primary location is immediately below the knee cap, although over the top of the knee cap is also a problem, and the original assumed tendon is still hot.  Another difference beside its being acute is that I've felt it while running.  A third difference is that I've noticed relatively mild swelling.  Strangely, the pain disappears when the leg is bent more than 90 degrees.  Thus, sleeping is difficult, because my legs are normally straight.  Driving is a disaster -- my car has a low bucket seat and the leg position is basically straight forward.  Sitting at my desk is just fine.  Standing is not.  The pain relaxes over a few days of rest but returns if I run again and even, to a lesser extent, while walking the 1 1/4 miles to and from the office.

Icing helps but does not solve it.  Foam rolling does not appear to affect it at all.  NSAIDS obviously help somewhat.

Cartilage?  Tendonitis?  Stress fracture?  Hypochondria induced by fear of upcoming races?

In any event, serious running is over for me for 2013.  I'm going to see a doc. on Friday in the hopes that there is an answer that allows for a spring marathon.


  1. Sounds like patellar tendonitis to me. I have had it (though not in a long while). It flares when I am rolling my forefoot to the outside (pushing off from the pinky toe), rather than rolling through the ball of the foot (pushing off from the big toe). I usually associate it with worn out shoes or shoes with a too narrow forefoot (Nikes). It has generally gone away when I get new shoes.

    1. This diagnosis is consistent with my belief that the Newtons were the precipitating cause. The funky fore-foot ridge causes excessive rolling, sufficient to lead to outside-of-foot blistering. Many thanks! And hopeful that the cure is that simple.

  2. That funky forefoot ridge has always looked scary to me. It may be a while before I'm running in minimals at all, but I'll stay away from the Newtons in any case. You're not my only friend who's been a victim.

  3. Hope you get good news from the doc

  4. Answer: indeterminate. No stress fracture. Would need a MRI to find a cartilage tear, but based on my range of motion the doc. thinks that is unlikely. I'm on an aggressive prescription NSAID in the hopes that a downward cycle of tendon inflammation can be arrested. Low pain since I started taking the pills, but I'm not running so the evidence not necessarily determinative.