Don't let knee pain keep you from running
The knee is a complicated area in our body - a joint that seems to give a lot of trouble to athletes. Runner complaints about the knee joint are plenty, and for some, the reason to give up running or consider not even starting.
Don't despair. There is hope, especially if you can pinpoint the problem and work toward correcting what ails you. Giving up running does not have to be the only choice.
The most common knee problem in running is an overuse problem known as patellofemoral pain syndrome (PFPS), or simply "runner's knee." The pain is the result of inflammation of the kneecap. It can affect one or both knees and strikes recreational runners, predominately women. Symptoms of runner's knee include pain in and around the kneecap (in the inner portion and below it, or even behind it), and pain after sitting for an extended period of time with the knee bent. Pain may be felt when running downhill or going down steps.
The problem can be biomechanical or muscular in nature. The patella may be larger on the outside than it is on the inside, or it may sit too high in the femoral groove. The patella may be pulled sideways if your knees turn out, or have flat or high-arched feet. Muscular causes include tight hamstring muscles, tight calf muscles, weak quadriceps muscles, pronation of the feet and wide hips (why it affects women more). The problem also can result from softening of the cartilage in the kneecap (mistracking of the kneecap causes the cartilage to be under too much pressure to protect the knee).
Treatment of PFPS includes the following:
Rest or cross training until pain lessens. This time may include ice and use of an anti-inflammatory.
If you are able to still run: cut back on mileage, avoid downhill running, run on softer surfaces like grass, dirt or a treadmill, and limit any mileage increases to less than 10 percent per week.
Avoid other activities requiring bending your knees and don't sit with knees bent for extended periods of time without standing or walking breaks.
Visit a specialty running store to evaluate your current running shoes.
Get the recommendation of an orthopedic surgeon or podiatrist to discuss the possibility of using orthotics.
Concentrate on stretching tight hamstrings and calf muscles. A good hamstring stretch involves putting one leg up on a chair or bench. Lean forward from your hips while keeping your back straight until you feel the pull in your hamstrings. Hold for at 30 seconds. Perform this stretch on alternate legs at least three times each.
Strengthen muscles around the knee with exercises, such as leg extensions. Perform two sets on a leg extension machine.
You can also strengthen muscles by doing straight leg lifts: Lie down on your back on a mat. With one leg bent, and the other straight (and slightly bent at the knee), lift the straight leg up slowly. Do this 10 times for each leg and increase the sets over time.
Remember that all knee pain while running is not caused by PFPS. A visit to your doctor, orthopedist or podiatrist may be necessary to diagnose the problem and help you develop the proper treatment plan.
Jackie Miron's running column appears in The Post-Standard every Tuesday. Reach her at sports@syracuse.com. For a list of upcoming local races, go to www.fleetfeetsyracuse.com.