Knee Pain

Throughout my athletic career, I have certainly had my share of aches and pains. The newest member of this "family" is chondromalacia (sometimes referred to as runner's knee). This wonderful (yes, that is sarcasm) condition is basically due to the protective cartilage covering the kneecap (patella) wearing down a bit, likely due to overuse and/or repetitive stress. So, my kneecap isn't getting its groove on any longer. No, seriously, my patella is not sitting properly in its groove right now!

For those who have experienced this before, it's not fun. If you catch it early and actually do something about it, consider yourself lucky. Mine got pretty bad. It hurt going up and down stairs, I couldn't squat, do lunges, steps-ups, or really any lower body exercise. Ugh. The pain during running fluctuated depending on the terrain (worse on hills and trails) and cycling was out of the question initially because I could hardly put any force to the pedals without that stabbing feeling in my knee.

So I read a bit more about this condition and didn't listen to much of the recommendations I came across because many of them are what I consider "old school". That is, until I came about something that peaked my interest as an endurance/strength coach: functional imbalances. I'm pretty big on finding and fixing these imbalances in the athletes I work with so I am no stranger to the process. However, it is a bit difficult to assess yourself so I asked my wife to snap a few videos of me running and still photos of my legs relaxed and contracted. I don't know if I was ready to see what I did but it sure did allow me to approach my treatment in a more methodical manner. And let's remember that this is a n of 1 case. I am not a physical therapist but I am a Certified Strength and Conditioning Specialist with training in functional imbalance assessment and exercise treatment.

Let's revisit chondromalacia. Back in the days, I remember people saying that once you got it, you couldn't get rid of it and that was the end of your running career. Well, it just so happens that chondromalacia can be due to a very simple (in my mind) muscular imbalance where the hamstrings are too tight and the quadriceps are too weak.

Taking a closer look at the videos and photos, I realized that I, in fact, do have weak quads on my right leg (probably due to having broken my foot a couple of times in the past 10 years and walking around with a boot). Once I looked at the videos and photos, it was very apparent that my right patella was not tracking properly. Yes, it was that obvious and I did not require any further testing.

So, onto fixing it right? Well, kind of. You see, I couldn't do many of the exercises that are prescribed to strengthen the quads because it involved knee extension, which hurt my knee. Hmmm...isometric contractions? Sure, but not too effective in my mind. Or perhaps I didn't choose this route due to my lack of patience. Nevertheless, I turned to a piece of technology that has been around for quite a long time: electrical stimulation. I researched "e-stim" years ago and have always kept up with the players in the market and the research but it wasn't until now that I became much more interested.

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I turned to arguably the most reputable electrical stimulation device company on the market: Compex. Armed with their Wireless 2.0, I wondered if I could make a more significant impact on improving my quad strength and thus ridding myself of this nagging "visitor". Honestly, I wasn't expecting much because I know it can take months or even years to address functional imbalances. Surprisingly though, I saw benefits within the first 9 days of using Compex. Pretty spectacular if you ask me.


Prior to using Compex, I would struggle to run 3 miles without hobbling. My pain was usually a 8/9 on a scale of 1-10 (10 being pretty bad). Today, as I write this, I have done 6 mile runs pain free and even more importantly, I can squat, do step-ups, and walk up and down stairs with hardly any pain. Every so often, I do feel a bit of a chondromalacia reminder but the pain is mostly a 1-2 on the 10 point scale. This usually happens more in the morning before I begin my Compex routine.

Of course, you will want to know what I actually did with the Compex. It was a bit of self experimentation (remember n=1) but for the first 6 days, I was religious in using the resistance, strength, and active recovery programs for at least 90 minutes. Pretty easy, especially with the wireless unit, as I would just let it run while I was doing computer work. I then took a day off, then repeated this process for another 2 days. Today marks my 10th day of using it and I will continue to cycle through this methodology.

One thing to note is that I have been using the Compex mostly without training, meaning, I just sit there and let it do its job. Since my knee is feeling 100% better, I will begin using it during exercise this week to maximize the benefits of targeting the specific muscle fibers to seek even more improvement. One of the best ways to use this technology is during training (warm-ups, on the bike, pre-exercise potentiation, and during certain strength exercises). I think far too many people pick up a great device like Compex but do not utilize it to its full potential. If you are just using for active recovery, so be it, but you are really not experiencing the true firepower of this device.

To say I am elated would be an understatement. I firmly believe all athletes should be using this technology under the proper supervision of a professional in order to guide them through the different programs and periodize these programs into their overall training plan development.

I will post more updates as I utilize the Compex more during exercise throughout this month. Until then, Happy Holidays!