Knee pain is another common malaise faced by runners. There are a variety of reasons for such aches and pains to disturb the rhythm of the running enthusiast. A lot of these problems are largely preventable. I would like to discuss these with you and hopefully make a difference for you.
A good foundation is the key to a successful future… in the same vein, the foot shape and footwear that a runner uses is the key to injury prevention. In the previous column, I did discuss the ideal shoe type depending on the foot mechanics of the runner. I would draw the attention of the reader to the same. Another important aspect is the running style of the individual. The Forefoot style of running does pose itself to some risk for development of knee pain issues.
‘Start slowly and increase gradually’ – It goes without saying that you should start with the sport in a gradually increasing manner. I have frequently seen enthusiastic runners; start their running routines in an accelerated mode. Sudden unaccustomed exercise will predispose them to develop stress fractures and shin splints. These are very painful conditions that result in micro fractures developing in the shin bone and in the upper part of the shin bone (tibia). The treatment is that of forced rest, casting and very occasionally surgery.
‘Stretch and Run, Run and Stretch’ – Every time you undertake an exercise, you induce micro injuries to your muscle fibers. The muscle recovers rapidly and also undergoes development in the form of muscle fiber hypertrophy (increase in size) and hyperplasia (increase in number of fibers). A side process that happens at the same time is tightening of the muscle tissue. If an athlete fails to stretch before and after exercise, two things may take place:
- The muscle does not contract or stretch and there is a risk of a muscle tear; and,
- The tight muscle increases the force across the joint and causes softening of the joint cartilage resulting in pain and compromised joint function.
This second process causes the condition called ‘Chondromalacia patellae’ in the runner frequently. Chondro means cartilage, malacia means softening and patella is the kneecap bone in the front of the knee. So as a result of increased forces across the cartilage of the kneecap bone, there is softening and resultant breakdown of the cartilage. This will predispose to early arthritis of the knee and resultant disability.
‘Friction free runs’ – There is a large tight band like muscle tendon unit that runes on the outer aspect of our thigh. Starting from the area of the hip and running downwards – this Ilio tibial Band is an important cause of pain in the runner. Lack of stretching of the ITB predisposes to what is called the ITB Friction Syndrome. As the name implies, a tight ITB rubs on the outer aspect of the knee and leads to persistent disabling pain on the outer side of the knee. Once it sets in, I would recommend decreasing the running distance, instituting stretches and doing supervised physiotherapy sessions to alleviate the problem.
So, all you runners – take care and have a pain free running time.
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