Knee Pain: Three While They Run

Thu, 13 Oct. 2011 - 1:12 a.m. MT
Credit: ARA Staff - American Running Association

As a companion piece to Leaving Knee Pain Behind, here we explore three common knee injuries associated with running, along with their various treatment options.

Patellofemoral pain syndrome. This condition, also known as runner's knee, occurs when the patella moves improperly and is characterized by pain at the front of the knee, behind or underneath the kneecap. The pain may be in one knee or in both, and generally gets worse when you run, go up or down stairs, or sit with your knee bent for a long time (as you do when you're watching a movie or driving a car).

In most cases, runners can beat PFPS by taking a break from training, putting ice on the knee after exercising and, if necessary, following a physical therapy program that includes strengthening the surrounding muscles and making them more flexible. Taping the knee or using shoe inserts, or orthotics, can also be helpful.

Tendon injury. By far the most common tendon injury in runners is iliotibial band syndrome, or ITBS, which strikes many long distance runners—as well as cyclists, tennis players, and other athletes—who put active, long-term stress on their legs. The iliotibial tendon runs along the outside of the upper leg, from hip to knee. In runners with alignment problems, such as overpronation (in which the ankle rolls too far inward with every step), the tendon will rub against the knee joint, causing inflammation and pain.

ITBS is characterized by pain on the outside of the knee (or hip) that typically starts a few miles into a run. Once it starts, the pain will continue and may even get worse as you keep going and will often feel worse if you run downhill. The discomfort will often go away if you stop running and begin to walk slowly, a phenomenon that has led many runners to try to "run through" the pain. To treat ITBS, cut back on the intensity and volume of your training and use ice (and possibly NSAIDs) to reduce inflammation. You may also perform the classic ITB stretch: crossing the legs in a standing position, lean toward the hip of the front-crossed leg, and bend with opposite arm raised and curved overhead. The stretch works best performed against a wall or tree for support.

Osteoarthritis. This is a wear-and-tear condition that occurs when the cartilage in your knee deteriorates. It usually develops gradually and is characterized by pain and swelling when you run, and stiffness, especially in the morning and after you've been active.

If your doctor determines that you have osteoarthritis, you'll probably be told to use NSAIDs to manage the pain and inflammation. In some cases, you may be given injections of corticosteroid medications, hyaluronic acid substitutes, or the nutritional supplements glucosamine and chondroitin sulphate. The jury is out on the effectiveness of these latter two treatments, partially due to the lack of dosage and potency regulations in the supplements industry. For more information, see FitNews Nov/Dec 2006.

(Health After 50, The Johns Hopkins Medical Letter, 2006, Vol. 18, No. 5, pp. 1-2; Plancher Orthopaedics & Sports Medicine, PLLC, New York, NY, www.plancherortho.com; Orthopaedic Foundation for Active Lifestyles, Cos Cob, CT, www.ofals.org)
 
(RUNNING & FITNEWS® September / October 2007 • Volume 25, Number 5)


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