knee pain and half marathon in 3 weeks!

Question
Mr. Rainey,
I am participating in the Disney Half Marathon in about 3 weeks and am experiencing much knee pain. My endurance is great, although I am a relatively new runner in the 35-40 age category(lifetime of competitive sports and staying active with a 1-2 year break). I noticed prior to my Thanksgiving 10k that I would experience intermittent pain in my knees under my kneecap and more concentrated on the outer side (I don't think it is the ITB). It would go away as I ran through it and then come back intensely around 6 miles. So, since then it has been the same story--bad pain starting around mile 6. 2 weeks ago the pain started linger and get worse earlier--around mile 3. Now I have pain ALL the time. I have tried ibuprofen, ice, rest, new shoes, continuing to strengthen my core and hips and, finally, a chiropractor! I have not yet run the distance of 13.1 miles and really need to continue my training. I am currently taking cycling many days a week to keep up. I have a bulging disc, issues with my sciatic joint and am a moderate to severe over-pronator with low arches (not flat-footed). I don't have a problem with continuing to run through pain, as I've had to perform in competitive sports injured many times. I just do not want to cause permanent damage. How can I continue to train and what can I do to be able to run in this (very expensive) upcoming marathon (and be able to walk around Disney after)? TIA!!

Answer
Wow!  It sounds like you've done a lot and need results quick!  I will outline what you need to do for as much pain relief as possible immediately and for the future.  

Now!
1) See a physical therapy doctor who is trained to tape the patella (knee cap).  Often pain in the area you describe can be from a tracking problem. This means that the patella isn't travelling where it should. The pain is telling you that if it continues to do this there will be damage.  If this isn't the problem then taping won't work, but I would bet money that it will work.

2) Before the race take an NSAID (ibuprofen or something similar).  Don't do this too much with training because you want to know if the other stuff you're doing (i.e. taping) is working. I know you said it hasn't helped, but it can't hurt.

3) Ice after every run and one other time in the day. Again, I know you said it hasn't helped, but it can't hurt and twice a day combined with this other stuff should do the trick.  


Now and later!
1) Strengthen your hips!  I know you said you've been doing this, but exercises for your glute medius and other hip stabilizers will be the most effective.  Here are a few links to exercises you should try.

Home workout- Do the 1-leg stiff leg dead lift with row and 1-leg squats.

Leg side raise video

2) Forefoot running- This is not something to try before so it should fall under the "later" category.  I've seen people who switch their foot strike from heal to forefoot or midfoot eliminate pain in ankles, knees, and hips.  I would be very surprised if this didn't drastically reduce your problem.  Unlike the video though, you don't have to do this barefoot.  It makes it easier to show and some people do like to do it barefoot, but I run with this foot strike in shoes daily.  


Good luck getting ready for your half marathon in 3 weeks!  Please let me know if you have any more questions or need more guidance.