A Runner That Can’t Run

July 22, 2009 at 12:07 pm (HES, Life) (, , , , , )

I am a runner.

I have not run in two years.

Why?

I have popliteal tendonitis.

I’m sure it’s no guess that popliteal tendonitis (also spelled “tendinitis”) is the inflammation of my popliteal tendon, but what does that really mean?

The popliteal (also called popliteus) muscle is a small muscle on the posterior (back) side of the knee.  It begins on the medial (inside) posterior side of the tibia and wraps around and up into the popliteal (or popliteus) tendon. The popliteal tendon then passes through the knee capsule and connects at the lateral (outside) epicondyle of the femur, basically the outside of the outside knot of my femur where the knee joint meets.

Anterior View of the Knee

Popliteal tendonitis occurs from overuse of the popliteal tendon.  Not surprising.  More specifically, the popliteal tendon is my last form of support to keep my knee from hyper-extending.  When all the little muscles in my knee get so fatigued that they can no longer give my knee the support it needs when I land, all the pressure is directed to my popliteal tendon.  The issue is with the extension and landing.  That is why my knee is most easily and intensely aggravated from going down hills.

My doctor told me that a case of popliteal tendonitis as refractory as mine meant that I wouldn’t be able to run again.  End of story.  Well, that may be the end of his story, but I’ve decided it is certainly not going to be the end of mine.

Most articles will say that the best solution for popliteal tendonitis is the basic heat/ice switch-off, accompanied by rest.  Well, I’ve had two years of heating, icing, and resting.  I’ve also gone a step further and taken the ultrasound approach.  Nothing.  So I’m left with one last option.  Cortisone  shots.  This will lower the inflammation in my knee and decrease the pain.  I should be able to run.  It’s true that this is only a temporary fix, and it’s certainly not a procedure I can repeat many times.  It might last a year, no longer.  However, case studies have shown that in some instances, the lowered inflammation and pain from the shots may enable me to do the necessary rehab to strengthen my knee and the muscles throughout and around it so that I can run even after the cortisone has worn off.  So that I can run permanently.

This rehab will include plyometrics, squats, and other exercises to focus on my gracilis, adductor longus, sartorius, and a ton of other inner and outer leg muscles.  Basically, if the muscle exists, I’m going to have to strengthen it.

So, the next step is setting up an appointment to get my shots.  I’ve honestly been avoiding it all summer because the idea of stabbing multiple needles into the back and sides of my knee just isn’t that appealing.  However, I’ve decided that going one more year without being able to run eight miles (or even one mile) is even less appealing.

I’ve got the doctor’s number.  Now it’s time to go through with the rest.

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4 Comments

  1. Gary said,

    Good god, cortisone is not your last resort (though by now you may have already had a shot or two). Try massage from an experience and registered massage therapist.

    Also, strength is only part of the solution. Muscle balance is just as or more important. As are proprioception and nervous system control of the muscle (i.e. retraining the muscle to function properly).

    Also, research trigger points.

    Cheers.

  2. Tim Kostal said,

    Hi Ashley,
    I believe I have the same popliteal tendonitis and was wondering how your shots went? Are there any specific excercises that worked better for you than others?

    Good luck with your rehab,
    Tim

  3. Alicia said,

    HI there, I am actually an ortho nurse and runner and I have been dealing with popliteus issues for over 2 years now. I am miserable and my doc wants me to get another MRI and probably a knee scope. I’ve been researching online about cortisone injections…I have some laterally but none in the back of my knee where my discomfort is now. When I run…it starts as a tight cramping sensation in the back of my knee/top of my calf and if I try to push through it then radiates to sharp pains in my lower lateral knee. The only thing I have found that helps and allows me to run a few miles now if wearing a strap really tight around this area. I wanted to find out if your case was similar and how you’ve done with your treatments. If you could please email me back…I would so greatly appreciate it. Thank you.

  4. Ian said,

    I’m a 56 year old triathlete & runner, still able to run at 3:45 km pace and I also have popliteal tendinitis. Haven’t been able to run or cycle for some weeks without severe pain. I had an MRI to diagnose the problem and today I had an ultra sound guided cortisone injection. A little local anaesthetic first and then the cortisone. It’s started to ache a little after about 4 hours, but some painkillers will fix that before I go to bed. I expect to rest and ice for a few weeks, but it’s a small price to pay to fix the problem. My triathlon season is effectively over for this summer, so I’ll work on improving my swimming. Good luck.

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