Patella Problems

Newflash: It turns out I’ve got some messed up knees. According to my new physical therapist, they’re chilling too far toward the inside of my legs. They just miss each other and want to be closer, I guess.

Because of this, whenever I bend or straighten my legs, my kneecaps are rubbing against things they’re not supposed to rub against, and those things (cartilage) are getting really pissed off. Hence the injury. My goal, apparently, is to get the cartilage to chill out (I’ve been trying to do that for three weeks now; I don’t know why it won’t let this go), and then to make my kneecaps go back to where they belong.

Woman running

This is not me, because I STILL CAN'T RUN. And also because I know better than to run in my Nike Shox. Look at that heel strike!

Apparently, I have tight quads and weak hips, which is interesting because I had been assuming I had weak quads and tight hips. But either way, I’m strengthening my hips and attempting to lengthen-strengthen my quads and train them to work on the top/center of my leg, instead of toward the inside, which is where my knees convinced them to go before, I guess. This is all very confusing to me. The point is, my kneecaps are rebels and I need to literally get them in line.

Throughout this process, I’ve been torturing myself with one question: Why? Did I do something wrong? Am I just deformed? Was I born this way, or did I create this situation? Did I do too much too soon?

Obviously, my misplaced kneecaps are the primary cause here. But I’ve had this issue since high school, or maybe earlier – a chiropractor told me so when I was a teenager. Why is it causing such a problem now? One would imagine that it’s because running puts so much more stress on my body than anything else I’ve ever done, and perhaps I added too much mileage at once, but Brad has been putting the same amount of stress on his body at the exact same rate as I have, and he’s still sailing along without a care in the world. I’ve read that everyone’s level of “too much, too soon” is different, but why? What makes Brad sturdier than me? His straight knees, sure, but it’s not like his body is perfectly built for running, either. He has long legs and a slender build, but he also has the flattest feet you have ever seen.

Elephant Feet

OK, those aren't actually his feet, but they're pretty close to identical.

Those things are an injury waiting to happen. Why can he put so much mileage on them without any problems?

Lately, I’ve been thinking a lot about running form, and I’ve wondered if that’s my answer. Despite Brad’s relative inactivity over the past several years, he did spend his high school career training with a running coach, learning how to run properly. I just tied on my shoes and took off. Could I be running in a way that puts additional stress on my legs, while his method is more natural, gentle and biomechanically correct?

My mom has another theory. She believes that people who expect good things to come to them will eventually receive them, and vice versa. Since the first day of our new running life, Brad has headed down the road without even warming up, and it never occurred to him that he might get hurt. So he didn’t. Meanwhile, I obsessed over my troublemaker knees and took every precaution possible, just waiting for something to happen. So it did. In mid-January, my friend Courtney asked me if we had signed up for the half-marathon yet, and I told her I was waiting, just in case something went wrong. “Honestly, I’m starting to transition from being worried about my mental motivation to being worried about my physical abilities,” I told her. “I’m afraid I won’t be able to do this!”

And now look at me. Was it a self-fulfilling prophecy? Maybe there’s just one thing to blame for this injury: doubt.

Despite the implications of this new theory, I’m going to continue to be cautious. I don’t have a choice at this point, now that I’m damaged goods. But I hope to be cautiously optimistic. When I asked my physical therapist whether she thought it would be a matter of weeks or months before I was recovered, she said she was leaning toward weeks. When I asked her if I should give up on the half-marathon, she said, “We’ll see.” I’m still hanging on to my silly little dream by a very thin thread. I know it’s not likely. But I’m just not ready to give it up. There’s still too much uncertainty.

In the meantime, I’ll keep stretching and strengthening and suppelementing and icing and resting and compressing, and reading about form and biomechanics and running philosophy. Because some day, even if it’s not on April 28, I’ll be running again. I know I will. I’m too damn stubborn not to.

What do you think? Are sports injuries a result of weakness of the body, or weakness of the mind?


  • Grace

    “Our expectations wield tremendous power and influence in our lives.
    Many people tend to expect the worst. They expect defeat, failure, and mediocrity. And they usually get what they expect; they become what they believe.” Joel Osteen

    That being said, your knees need to heel. When they do, change what your believe.
    It’s certainly worth a try.

  • I know next to nothing about running, but I do believe in self-fulfilling prophesies. Who knows?

    • It definitely makes sense that a negative attitude would lead to negative results … Like you said, who knows?

  • Both…Ive been writing about this subject now for an eternity. You have to simply take time to step back and listen to your body…Pain serves a purpose, listen. Great post!!!

    • Thank you! Looking forward to checking out your blog!

      • Just went through a knee replacement after years of neglect…Its a path a would not wish on my worst enemy. Take care and rest up!

        • Oh, no, I’m so sorry to hear that! I can’t even imagine … Good luck with your recovery!

  • I don’t know if this is true or helpful, but I feel like women are more likely to have lower-body problems based on their wider lower-body bone structure. I don’t think comparing yourself to Brad is fair to either one of you. I have complete confidence that your rehab will work and you’ll be running again in no time!

    (P.S. if it makes you feel better, I was on week 9 of a 12-week training program for a half marathon and broke my foot. Then I got engaged and felt better. Maybe you should get some new jewelry!!)

    • I’ve heard that, too. I have kind of wide hips, and I’ve heard that the angle at which your femur attaches to your knees can affect the way your knees work. I wouldn’t be surprised if that was part of it! Thanks for the vote of confidence. 🙂

      Gahhh, that SUCKS about your broken foot and half-marathon! I would be devastated! So glad you had a happy ending, though! Shiny new jewelry and a shiny new fiance can fix almost any issue, huh?

  • Interesting! I never thought of it this way. I don’t remember if I thought about injuries all that much when I got injured training for Philly but I do know that while training for NYC, I told myself I would not get injured. I just would not. I definitely took a little more precautions but not THAT many and maybe it was just me being super determined to make it to that start line, injury-free.

    Running is definitely a lot mental. Since my marathon, I have a different attitude towards mileage. I used to be like OH WOW – I’m running 10 miles today! But now since I ran 26.2, it’s “oh I just have to run 10 miles today – yes I’m slightly hungover but it’s no biggie! I’ll BRB”. Also shorter races I’ll push myself much harder because mentally I’m like — it’s only a 5K — I can hurt for only 3 miles!

    Not sure the point I’m trying to make — ahahaha — but being the kind of person who over-thinks a lot of things and over-researches … personally, my injuries may be more of a mind weakness than a body weakness.

    You’ll definitely be back — you’re a strong woman — I don’t think you should give up on the half — ya never know! — but if worst comes to worst and you can’t do it … you’ve learned SO much from this experience that the next time you train for one (And you will definitely train for another one) … you’ll know what to do (And what not to do)

    Ok. That’s the end of my random ramble.

    • I wish I had tried telling myself I wouldn’t get injured! I think I spent most of my time telling myself I probably would. Who knows what effect that had on me?? I thought all the over-thinking and over-researching would be what kept me safe, but maybe it did the opposite. Booooo!
      I can’t WAIT for the day when I think “no biggie” about 10 miles! That’s some great motivation right there!

      • It’s a very bizarre feeling because deep down I know it’s still an impressive distance but while I’m running it, it’s no big thing. It’s a very weird place to be mentally. I’m quite confused.

  • Oh yes, miserable malalignment. The good news is that it’s sooo common, especially in girls (aren’t we lucky?) I had a classmate in PT school who had knees like that and she’s done and Ironman since. Your knees WILL get better! And it sounds like you have a good PT…strengthening your hip abductors is definitely the key to more stability.

    As far as the self-fulfilling prophecy thing, I definitely believe that it can be a factor in rehab and recovery. Maybe it’s a little of everything – our genes, our mechanics, and our outlook. The good news is that you can always change two of those three things 🙂

    • That is SO awesome about your friend! That really gives me hope!

  • Don’t beat yourself up, girl – it’s not your fault! You’re doing what you can now by listening to professionals and researching the shit out of everything you can. And YES, women are absolutely more prone to injury especially at the knees, so Brad had that going for him from the start. I’m glad you finally got to see the PT (I hope you made sure to give a big ol’ DUH to your doctor), it sounds like she gave you a thorough eval and knows what she’s talking about, so listen to her, not that you wouldn’t ; )

    Oh, and about this: “Apparently, I have tight quads and weak hips, which is interesting because I had been assuming I had weak quads and tight hips” – EXACTLY! This is why all injuries need evaluation, not generic protocol recommendations and x-ray orders! I’m not yelling at you, just doctors in general, of course. Feel better soon!

    • My doctor actually tried to send me for an X-ray and a trip to the ortho first (when I called and said I wasn’t getting better from his generic treatment) — I remembered what you said and insisted on going straight to PT! I figured I’d end up there, anyway.

  • Sakaili

    I’m new to your blog, but this post really struck me. I’m so sorry to hear about your patella issues. When I first started distance training I was lucky enough to have a one on one sessions to work on running form (switching from a heel to a midfoot strike); this really made the difference and my injuries all but disappeared. I also started to listen to my body more, practicing stretching throughout the day, strength training, hill training, introducing as much variation as possible into the terrain I run, etc etc. Today, I tell my body I won’t let it get injured. I’m super receptive to signals from my body that something may be wrong. There have been days when I’ve had to abandon really important work-outs just to nurse myself back from feeling, even just a bit off, but I make up for it, by pushing harder on days I feel strong.

    You might want to start incorporating running drills into your workouts once you’re recovered and doing short barefoot bursts of speed across grass, just to get into the groove of what it feels like to tend more toward a midfoot strike. Also, if you want to maintain the fitness you’ve built, talk to your doctor and physical therapist about aqua jogging. It cuts down on harmful impact but helps retain cardiovascular fitness. I have so been that person at the gym pool, chilling with Grannies doing aqua-aerobics and getting weird looks, but just tell ’em “I’m injured and still kickin’ ass. Bad ass in the water. Beware.”

    My former coach used to just have us lean against a wall and move one leg through the gait cycle, practicing best form (bringing the foot straight back rather than tilting in or out) by literally just practicing in slow motion, one leg at a time. It looks goofy, but it just sends a kind of reminder to your body: “this is the form we want to achieve” (only ever do this and the drill attached below after a light warm-up and stretch) and if you get the OK for aqua jogging, this can be practiced in the pool as well.

    I hope this helps, and I hope you feel better soon. Being injured sucks but you will come back from this stronger and better and wiser than ever! Stay positive!

    Here are a few resources:

  • Wow, thank you so much!! It’s interesting that you posted about working with a coach, because I just decided to try that. I found someone who seems great and I’m hoping to meet with him on Sunday — I’m really optimistic! He’s going to help me with my form and also come up with a training plan for me.
    Can’t wait to read all the links you sent — thank you again for all the great advice!

    • Sakaili

      This is is great news. I think the coaching will prove helpful and encouraging. Best of luck in the future… oh, and if you have tight quads why not treat yourself to a sports massage once in a while?

      • Sadly, I think the foam roller will be as close as I can get to that for a while! I’ve already thrown so much money at this problem, haha — I’ve got to draw the line somewhere. 🙂