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first off im 24 years old. Last march I was running about 20 miles a week (with 2 5Ks) and biking about 60 to 70 miles a week. Everything was GREAT! During one of my 5 mile runs (near the end) i started having some knee pain in the front of my knee at the bottom of my knee cap. Never having knee pain before i was a little worried about it and started researching it online with no luck.

to make a long story short i saw a doctor, i rested it a lot and the pain came back. i now have a LITTLE pain 1 out of 10 when i walk.

Ive been seeing a physical therapist for 2 weeks now, he says its nothing permanent. I have a weak muscle in my but that causing bad form when i run which in turn causes my kneecap to slap against my knee. Does this sound right to anyone. i wish i knew the name of the muscle but i don't. the muscle is what pulls your leg outward and back. it probably gets used a lot for rollerblading if you can imagine that pushing motion to the outside and back.

anyone have any advise?

:::EDIT:::
i wanted to add a few things.

I do bike quite a bit and there is no pain when i do. I can jump up and down on my bad leg with no real pain. I can push on my knee cap (hard) from side to side, up and down and no pain.

Start squating. The muscles that pulls your leg out and back are your abductors but I think the real problem is in the Vastus Medialis, the thigh muscle on the inside of your knee. Deep squats and step ups are the best exercises to train that muscle. The abductors are trained with squats as well.

This page talks about both types of weaknesses.
http://www.exrx.net/Kinesiology/Weaknes ... or13238820

Your activities can also cause a quad/hamstring imbalance. This can be a factor if your knees seem to be pulled outward.

the reason that the doctor said he thinks that was it was in a strength test. with my leg in the back most position, I had much less strength in comparison. Strengthening the Vastus Medialis isn't a bad idea but im still afraid that in doing so I may prolong the healing process. Im going to the gym today, I'm going to try a few sets of "deep squats" with some light weight on there.

after having this for the last 6 months, do you think there is a chance that i did any permanent damage?

I think the test you are talking about is a glute strength test and you've tested weak. There's various ways it's done, one is to get you lying on your side, lift your leg straight up, then resist against the therapist. They then they may move your leg back (into extension) and test again, and this one usually catches most people out. It's worth saying that a couple of months ago I done this test to a guy that pulls 620lb and squats, 550lbs, and he couldn't 'beat' just 2 of my fingers pushing his leg downwards (as he pushed upwards/abducted). Also worth saying that i'm not a therapist just a keen lifter. My own physio teaches me some simple tests like this so I try them out on anyone that will let me.

Anyway, I would suggest you get your glutes strong. There's a good article here by someone that really knows knees... My main tip would be to stop thinking you have a knee problem and realise that you actually have a hip problem. The knee just does what the hips tell it to do. Also, no matter what anyone tells you, 'if it hurts, don't do it'.

http://robertsontrainingsystems.com/art ... oof+Knees/

Out of curiousity, what did your Physical Therapist tell you to do about it?

Lastly - the reason biking won't hurt is because it's low impact, unlike running, which is very hard impact on your knees. Running is also repetive where as jumping up and down on the spot a few times isn't - if you done it for longer it would probably hurt.

KPj

Dead on, thats exactly what was done. The PT looked like he was about 180lbs. When he pushed down the first time, he couldn't move my leg. given, i was pushing about as hard as i could but my leg wasn't going anywhere. when i moved my leg back, it was easy for him to close the gap. im not sure how hard it was for him but I did have much less strength.



Thats exactly what the PT said and I think there may be some truth to it. several years ago, i had a hip problem that lasted for the 2 years. I babied the abductors because that was where I was feeling the pain. I finally saw the right doctor who said it was the IT band being too short. 3 weeks of stretching fixed everything. From everything that everyone has "unanimously said" i think th hip thing is correct. I've been working on that muscle for a few weeks now, but there is no change in knee pain. i figure ill give it a little time, im not giving up yet.

It most likely will be a hip problem/dysfunction. Unless it's an acute/impact injury (i.e. you fell on it), then it's deffinitly the hip. The hip has direct control over the knee joint. More so, the glutes have direct control, too. Glute Medius (the one that tested weak in abduction), attaches to the femur, where as glute maximus attaches to the shin (tibia), funnily enough it attaches to the shin via the ITBand. When the glutes don't function properly, your knees get punished for it. The hip flexors/quads cross both joints too and are often tight, or short, which causes the glutes to 'switch off' which causes the knee to get painfull.

In the same way that the knee joint is more a victim than a culprit, the same can be said for the ITband. It's a big belt of connective tissue and it's solid. As mentioned above it attaches to the top of the shin (the TFL and glute max sort of merge into it). A typical scenario is weakness in the glutes giving you compensation/overuse from the TFL which 'pulls' on the IT band which 'pulls' on the insertion on the shin which causes pain, which can be lateral OR anterior pain. Strengthening the glutes and stretching the TFL would be the solution to relieve pain... A lot more can be going on but that's it in the most basic sense. Note, i'm not trying to diagnose anything just trying to explain the relationship between the hips and the knees (and pain).

Did the Physical Therapist give you stretches or movements to do?

I would be interested to hear what you've been told to do about it and how you are trying to strengthen that muscle? The thing is if the muscle is inhibited by an antagonist (hip flexor ) then it won't matter how much you strengthen it if the antagonist isn't addressed, too, and, if you're trying to strengthen it with a short antagonist then you most likely aren't 'getting at it' with whatever you're doing. You'll probably be compensating in some way or another and not actually targetting it properly.

Also note that no matter what I or anyone was to say here, your PT is your best bet to resolve this. Everything sounds good so far though. Sometimes you can also do the right things but just not often enough (and this is really why i'm asking).

KPj

i ran 2 miles today at a decent pace and my knee was fine for the most part.

It still hurts (a little) but the running didn't seem to make it any worse. I was prepared to stop as the smallest sign of pain and it never came. Ive been doing a lot of lunges with a 30lb in each hand. Some dead lifts, and a little work with squats though i really hate the exercise. I get the feeling that if my knee is better, its going to take a long time for the pain to go away 100%

Oh, how can you say you hate squats? It grieves my heart to hear someone say this. Somebody must have got you started wrong in life. Squats are the second-best, and second most fun lift in the gym!

Maybe you're not doing them right if they're not fun.

By they way, do you really love running? That's the only good reason that I can think of for a person to run that much.

They're hard.

Most fun being weighted hip thrusts with just the right partner as the weight?

I'm up to 3 miles now without any problems. The other day I helped carry a large cooler, prob weighs a total of about 130lbs. using my right arm, I found my left knee which was the one bothering me hurt quite a bit for the next couple of days. carrying the weight with my left arm is no issue for my knee.

So its not at 100% yet but im working on it.