Drs. Jordan and Austin, thank you for all the valuable content. Sorry in advance for the long question, but I assume that more info is probably more helpful than lack of info.
I’ve been reading up on the various posted materials on pain rehab and especially knees, and it seems that the common message is something like this, “It is unlikely that the sport (running/weightlifting) caused the problem to happen and rehabbing likely looks like continuing to exercise in adjusted ways with less intensity of one form or another.”
My knee pain does not seem to follow this pattern. I’m 34 now and back in high school I was a cross country runner, and I used to train by putting in huge mileage during the off season in the summer - 500 miles one summer, and over 700 another. My final season I was trying a similarly ambitious goal but with actual pacing targets of 6-7 min/miles, but after my first week of training in the off season I experienced major knee pain running down my driveway for no apparent reason, less than 50 meters into the run. I attempted to rest a week and try to jog again and each time I could not and I ended up missing the whole season. For the next several years I was unable to run at all. Eventually, I tried running again and found that I had knee pain after about 1 mile, and after deliberate training I was able to get up to 3 miles but at that point I had knee pain again. After that I fell off the wagon and got out of shape with both diet and lack of exercise, eventually beginning weight lifting 2 or 3 years ago, and deliberate weight loss dieting within the last 3 months.
Fast forward to today, I still have knee problems on the same knee. I can generally jog one mile fine, but the first half mile I have to use a slight limp to get the joint warmed up. After warmup, I can run normally for the rest of the mile. As a result, I’ve just generally tried to avoid running as an exercise. I’ve found also that when I am required to wear steel toe boots for work, I’ve experienced similar knee pain, with the boots triggering the feeling of the knee buckling from under me. After wearing them for 5 work days, I was walking with a limp even when I took them off. I had assumed at the time it would be dangerous to continue weightlifting and tried a number of YouTube exercises of walking backwards pulling sandbags with ropes, etc. which did nothing positive and might have made things worse. Eventually I tried squatting and it was the key to getting the knee back in business. Oddly, I rarely experienced any pain on the squat (mostly fear) but ordinary walking was much more likely to produce pain. It also appears that when my knee problems are present, the problem side has the foot flared outward at a 15 degree angle when I walk normally, but when it is not a problem, the foot is directly forward.
What makes this so complicated is:
- It is not a traumatic injury. I have never taken a hit or done anything that decisively injured the knee.
- It is not an overuse injury. I was only just beginning my high school training program when the injury came, and the subsequent times were not periods of intense training.
- It is not under use either. I had run plenty when I was injured in high school, and in current times I was squatting in the mid-300s when the knee problems apparently triggered by boots showed up.
- Foam rolling subjectively seemed to sometimes help and sometimes not. Kinesiology tape pulling the patella inward restored my ability to walk when I was limping.
- I can still squat in the mid 300s with no pain, then immediately feel pain when I try to jog down the road for 100 meters.
Based on the content I am reading I am having trouble understanding where I would fit into the injury scheme here, and what could be done about it.
Also, based on the content on this site, I have been modifying my diet towards recommendations and attempting to add conditioning sessions as recommended (currently using boot camp style circuit training). I would like to be able to run again with confidence, ideally longer distances. Where should I begin?