Pain is a language. Ignore it and you will more often than not
pay the price. Most running injuries are
not traumatic, but present over time beginning with pain during the activity of
running and progressing to pain during and after a run. Acting at the first warning sign will shorten
the recovery time and reduce any down time that might be necessary. If you ignore pain more likely than not
symptoms will worsen and more time will be lost from your training. If pain worsens to the point that it is
painful with normal daily activities or keeping you awake at night, you should
seek a professional evaluation.
The knee is a complex joint and primary
shock absorber for running. Approximately
12 times body weight is absorbed with each stride. Patella-femoral
injuries, sometimes referred to as Runner's
Knee occur if we land with our knees extended or do not have strong
quadriceps and hamstrings along with a flexible Achilles tendon to absorb
shock. Landing toward the midfoot with a
slightly flexed knee and performing strength training exercises can help
minimize this injury. Follow this link
to learn a series of strength training exercises for runners using a simple piece
of equipment:
Training Errors
Increasing the number of times you run
per week and or number of miles per week is the biggest culprit. When injury does occur it is best to modify
your schedule and remember the ultimate goal is to be healthy come race
day. Missing a week of scheduled runs is
preferable to pushing through and worsening the injury. If you can keep the pain level below a 4 on a
1-10 scale during a run, 10 being terrible pain, it is usually safe to continue
on a reduced frequency and duration schedule.
Increase non-impact activities to either help recover following runs or
to substitute if pain is greater than 4 or present at rest. Highly recommended is water running. If a pool is not available then try the elliptical trainer or
spin bike for low impact cardiovascular conditioning.
Biomechanical Faults
“Stay in your hinges.” The late Dr. Rob Roy McGregor, sports
medicine pioneer coined that phrase and simply means to run with good
alignment. When alignment is off, the
stress on the knee will be magnified with each stride. If you have arches that collapse (excessive
pronation) the inside of your lower leg and inside of your knee is susceptible. If you tend toward valgus (knock knee) or
varus (bow legged) you are susceptible for
Iliotibial band (IT band) issues.
Strengthening
the outside of the hip is often overlooked, but is key in preventing and
recovering from many knee injuries. Here
is a link with an exercise called Scooters used to strengthen the hip abductors: http://mashpeefitness.blogspot.com/2014/11/5-burdenko-strength-exercises-for.html
Proper shoes as well as arch
supports are important as well as correcting any muscle imbalances.
Use a common sense progression of 10%
per week in your training, correct and condition the muscles that cross your
knee joint, listen to your bodies signals and your knees will carry you many
miles without a problem.
Watch the video for a few simple self-help techniques...
Blog post by Joe Carroll.
About Joe Carroll PT DPT SCS
Joe is a Doctor of Physical Therapy and
co-owns Cape Cod Rehab with his wife, Kathy. One of the first PT’s in the state
to be certified as a Sports Clinical Specialist (SCS), Joe is also a Master
Instructor in the Burdenko Method. He continues to run and support local road
races every year and knows what it takes to help athletes get to the level they
desire. Joe is a 5-time Boston Marathon finisher and ran his 7th marathon on
April 18, 2016 at the Boston Marathon raising money for Boston Children’s Hospital.
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