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LloydT

Registered: 06/04/04
Posts: 508
Reply with quote  #1 

Nilesh,

 

Help me id my pain. Directly below my left knee, I have a bump at the top of the tibia. It is tender to touch and I also can feel it when I kneel down on my knees.

 

I did a cursory search on the web and the best thing I found to describe it is Osgood-schlatter syndrome, but I understand that this diagnosis is for adolescents. Yet this is the best description I've found for what's going on with me.

 

I've felt this mild pain for a couple months now. During runs, I sometimes feel it at the start (first 5 minutes) and then it goes away. It hasn't effected my volume--I am up to my weekly milage of 45-55mpw. Like I said, it is sore to touch and when kneeling, otherwise its not a problem.

 

I wonder if this is something I should have looked at, or can I continue until it gets worse? Should I keep up my volume? 

 

Thanks,

Lloyd

RunDoc

Registered: 10/26/05
Posts: 744
Reply with quote  #2 

Lloyd,


This can be a couple of issues.  I had something very similar this past year.  You probably had Osgood's as a kid (thus the bump).  Now, the issue is whether you had any fragmentation of the growth plate at that time.  This can leave some pieces of bone in the tendon (usually not a problem, but can occasionally cause trouble).  Usually this is just bad patellar tendonitis/ tendonosis.  Does it cause you pain going down stairs?  There is also a bursae (bursae are like a slippery water balloon to help decrease friction) right at the patellar tendon attachment site.  More rarely, you can actually get a stress fracture in this area.  I think the most likely cause is a patellar tendonitis/ tendonsis (pretty much the same term, but please don't make me try to write a post on this issues surrounding the terminology - takes too much time and really not worth the trouble).  The good thing is that is sounds like it is early in the problem, but it can progress quickly like it did for me last year.  I had the problem for about a week and after one of my runs it really starting hurting bad enough it made me limp just walking.  Like most of us (I didn't even do what I knew was right) I tried to keep up with my training.  I had a track workout scheduled and I did my warm-up and then started my 800's on the track.  I did 2 and the knee was really killing me.  So what did I do, did I stop... no.  Smarty pants me decides to see if running the track the opposite direction would decrease my pain enough to get through the workout (12 repeats).  Now you see why it is hard to treat runners - we are just not normal.  Anyway, by about the 6th one it was "feeling better," but then I came to my senses and realized this was doing me no good.  I then took almost 2 weeks off running totally and just cross trained on the elliptical trainer (3 hours on an elliptical is no fun - even if you rent a movie). 

 

Alright, so what is the point to all of this.  Be careful of you are going to try to run through this.  Look back into you log and look for increases in mileage that was too much, too fast, too many hills etc.  Something that may have stressed you patellar tendon at its attachment site.  Ice, Ice, Ice.  I also did ice, took some NSAID's (with food!!!) and did some cross friction massage to the area, not fun but can be effective.  Make sure you are watching your flexibility, shoes etc.  If you are weight training with your legs, this can also be a culprit.

 

Hope this helps.  Long winded, as usual for me.

 

Nilesh

bgalizio

Registered: 06/04/04
Posts: 229
Reply with quote  #3 
Quote:
Originally Posted by RunDoc

 

Hope this helps.  Long winded, as usual for me.

 

Nilesh

 

But very informative, as usual for you

LloydT

Registered: 06/04/04
Posts: 508
Reply with quote  #4 

Thanks Doc!

 

Yes, I played youth soccer and little league baseball for 10+ years growing up, but have never noticed the bony bump at this location. It could have been there for years without even noticing.

 

No pain going down stairs.

 

On today's run it was the same: slight soreness for first few minutes and then pain went away. I ran normally, except that I did notice that I favored the opposite leg for those first 2-3 minutes when starting. Other than that, no problem with running. I am currently building up to marathon season volume, which is for me 55-60mpw. This is the same volume as last year.

 

I will continue to observe and will post again if anything else different develops. So far, I haven't had to stop short or cancel any runs due to the "bump." 

 

When you say cross-friction massage, what do you mean?

RunDoc

Registered: 10/26/05
Posts: 744
Reply with quote  #5 

Lloyd,

 

X-friction massage is a style of massage that uses a decent amount of pressure.  The fibers of the tendon run vertically.  The massage you would do to this area would be perpendicular to the fibers - side to side.  This is something many therapists do and can help.  It is painful to do, but over time it can help.  Sometimes this is best done with a reduction or stopping in running. You may do OK without the x-friction.

 

Nilesh

FridayNight

Registered: 01/06/09
Posts: 1
Reply with quote  #6 
Quote:
Originally Posted by LloydT
Nilesh,

Help me id my pain. Directly below my left knee, I have a bump at the top of the tibia. It is tender to touch and I also can feel it when I kneel down on my knees.

I did a cursory search on the web and the best thing I found to describe it is Osgood-schlatter syndrome, but I understand that this diagnosis is for adolescents. Yet this is the best description I've found for what's going on with me.

I've felt this mild pain for a couple months now. During runs, I sometimes feel it at the start (first 5 minutes) and then it goes away. It hasn't effected my volume--I am up to my weekly milage of 45-55mpw. Like I said, it is sore to touch and when kneeling, otherwise its not a problem.

I wonder if this is something I should have looked at, or can I continue until it gets worse? Should I keep up my volume? 

Thanks,
Lloyd
LloydT

Registered: 06/04/04
Posts: 508
Reply with quote  #7 
Mr. FridayNight:

Please direct your questions to Dr. Shah (the RunDoc). I am not qualified to answer the questions you sent to me via email.

SDCARunner

Registered: 09/19/09
Posts: 1
Reply with quote  #8 
I see this is an older post. What happened? I also have a bump on my tibia, but I don't feel pain. I did a month or so ago. I assumed it was just him splints and didn't pay too much attention to it. So, if I don't feel pain, what's the problem? Well, my doctor noticed the bump during my annual physical and ordered an x-Ray. When she got the results she said it showed a stress fracture. She says I should stop running for 6 weeks. Does this make sense? I was running farther and faster than I ever had, I'd lost 15 pounds and was feeling great. I can't believe I really have a fracture. Also, I thought you couldn't detect these on an x-Ray.

Thanks!
RunDoc

Registered: 10/26/05
Posts: 744
Reply with quote  #9 
SDCARunner,

Can't remember specifically what happened in the above case but for your case, part of the issue is where is the bump?  If it is at the top of the tibia in the mid-line, where the patellar tendon inserts, then it is likely remnant of an Osgood Schlatter's problem.  If it is lower or along the inside edge then it could be a stress fracture, especially if it is where you had pain.  If you are no longer having pain, then I am much less concerned.  A lot of it has to do with where the bump was and where the stress fracture showed up on the x-ray.  However, you are correct, if you are not having pain, for the most part it is OK.

Nilesh
akegalj

Registered: 01/24/10
Posts: 1
Reply with quote  #10 
I started playing basketball over the last 2 mounths and im fealing pain on bouth legs where the patellar tendon inserts (at the top of tibia bone). On the left leg pain is over the left side of patellar tendon insertion, and on the right leg its over the right side of patellar tendon insertion. Pain starts after 20 minutes of playing, and since then my motorics are decrising in such way that after 50 minutes of playing i can barely run/walk. I even feal the pain when goin down stairs, or trying to kneel down.

After resting for a weak, pain goes away but that does not fix my problem. Is there any good exercise for this kind of injury, maybe working out tibia muscule?
RunDoc

Registered: 10/26/05
Posts: 744
Reply with quote  #11 
akegali,

Sounds like patellar tendonitis (jumper's knee).  Some quadricep stretching and hamstring stretching helps.  Cross friction massage of the tendon will help.  Eccentric loading of the muscle on a decline slant board is helpful.  Ice and rest is helpful.  Core strength.  I do not think anterior tibial strength will help too much.  Also, if your foot mechanics are bad, fixing them with an orthotic can help.  If you look for "Jumper's knee" on the internet I am sure you can find some good pics/ descriptions for rehab for the problem.

Nilesh
skullx

Registered: 06/04/10
Posts: 2
Reply with quote  #12 
Sorry to revive this old thread, but I have had knee problems since the my second years of high school, roughly 6 years ago. A couple days ago I was playing softball and injured my right knee. The pain is high on the tibia mid-line on the bump you have described. The pain was very sudden during running around the bases. I have been icing it during night before bed, but I still have the pain.
I have a history of knee problems from football, as I have dislocated my left knee (which is the opposite knee of the current knee injury) multiple times from just simply running.
RunDoc

Registered: 10/26/05
Posts: 744
Reply with quote  #13 
Skullx,

Is your pain on the bump?  Did you have pain there as an adolescent (since you describe knee pain in high school, is this where it was)?  As described in my post on 1/3/06 - an old Osgood's problem can come back as an adult if there is fragmentation at the site.  Also could have a small tendon tear of the patellar tendon.  Any swelling?  Pain with stairs?  Limping?  If still a problem by Monday (especially if it is swollen or you are limping) I would recommend you see a specialist.

Nilesh
skullx

Registered: 06/04/10
Posts: 2
Reply with quote  #14 
My pain is located on the bump and I have never had the pain in that area, as far as I can remember. I just have a history of dislocating my knee. 
There is some swelling in my knee and I have extreme problem with stairs and I am slightly limping.
RunDoc

Registered: 10/26/05
Posts: 744
Reply with quote  #15 
skullx,

Sorry, I thought I posted an answer on the 7th.  If you are still having swelling and are limping, you should see a sports specialist.

Nilesh
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