Physical Rehabilitation Medicine/Knee/shin discomfort


QUESTION: I have been running pain free for more than a year. Recently I find that 1 1/2 miles into my run I experience pulling on my knee cap and tightness in that shin. If I stop running and walk the pain stops. I can then add in some 100 yard sprints without the pain resuming. I also find that my knee hurts after prolonged sitting at my desk. The knee does not hurt when doing squats even with weight. It seems not to be the knee joint that is the source of the pain. I am doing exercises to strengthen the glutes and lots of stretching and foam rolling to the ITB. Any suggestions or thoughts? I really would like to be able to do my usual 3 mile and 6 mile runs again. Does this sound like tendonitis of patella?

ANSWER: Dear Len,
I don't know your age. And are you an athletic? Did it start recently? Any how I feel you have to do static Quadriceps exercises while resting for for weeks. Without checking I can't say whether this is Patellarfemoral syndrome or any. But you haven't mentioned about a swelling. So please try with above and start running again.
Thank you.

---------- FOLLOW-UP ----------

QUESTION: I apologize for not giving more complete information. I am 51 years old. I am in very good shape. I am 5'8", I weigh approx 160 lbs. I was running 15 miles a week and doing core and strength training 3 times a week. There is no swelling. Even when the knee tightens up I can walk and squat free from pain. To me it feels not like a structural or joint problem but more of a muscular or ligament tendon problem. I had been running for more than a year pain free. Even through the dead of winter. It started right after I reached my personal best pace in a 3 mile run on track. I finally ran a sub 8:00 pace.

Dear Len,
According to your description I feel you give more work to your knee joint. Really when we are getting older the structures also tend to wear and tear process. So I just feel sometimes there may be having degenerative changes in your knee. We can confirm it by an x ray.
So my advises are to stop giving more works to your knee joint. To keep healthy yes definitely you have to do the exercises.
1. Pl take rest for two week doing static quadriceps and hamstring exercises.
2. Start gradually walking 30 min after 2 weeks for week.
3. Then increase the time up to an hour.
4. after a week if you want you start running for 20 min and walk for 40 min.

I think this is enough you to keep your health in good condition without hurting your knees.

Thank you.  

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MMA Ravindu Bandara


I can answer any physiotherapy related conditions.such as, 1. Any Orthopaedic condition. 2. Rheumatological conditions. 3. Neurological conditions. 4. Respiratory conditions. 5. Paediatric conditions. 6. Soft tissue managements. 7. Pr and post operative management.


I am Sri Lanka Medical Council registered physiotherapist. I have completed the Diploma in Physiotherapy in School of Physiotherapy and Occupational Therapy, Colombo in 2004. I have done my Advanced Diploma in Physiotherapy in Command Hospital Indian Air Force, Bangalore, India in 2006. I specialize in paediatric, Orthopaedic and Neurological conditions.

1. Advanced level- Bio Science stream. 2. Diploma in Physiotherapy-School of Physiotherapy and Occupational Therapy,Colombo, Sri Lanka. 3. Advanced Diploma in Physiotherapy- Command Hospital Indian Air Force, Bangalore, India. 4. Bachelor of Information Technology, University of Moratuwa, Sri Lanka.

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