By Neal Patel, Knee1/Body1 Staff
The running of marathons in locales such as Boston and New York, often motivates the would be runner in many of us to try and tackle the 26 mile course as a personal challenge. For you potential marathoners out there, preparing for such an event requires extensive training with many miles of running. Although, this training may lead you to reap the glory and exultation of completing a marathon, when the magnificence of the occasion fades, you may be left with nagging pain if you are not careful in your preparation. A common source of this irritation is runner’s knee, technically known as chondromalacia patellae, which is an all too regular consequence of careless running.
Runner’s knee occurs due to a softening or deterioration of the cartilage under the kneecap (patella), which normally provides a cushion for the kneecap to glide smoothly within the knee joint. With damaged cartilage, the kneecap no longer slides easily within the joint and in severe cases can even grind on the joint as it moves.
Symptoms resulting from this condition are pain under or to the center of the kneecap and possibly inflammation and swelling. Usually the pain gradually increases over time as the cartilage further softens. Ultimately, sufferers will find difficulty in sitting for extended periods, walking down stairs and running down hills.
Risk for runner’s knee begins in the sports good store when you decide which running shoe to buy. A shoe with improper support at the arch of the foot can cause the foot to over rotate inward leading to a twisting of the knee joint. As the joint twists, the kneecap is forced out of its normal path and damaging pressure is placed on the underlying cartilage. Continued application of this pressure, eventually leads to sufficient cartilage damage resulting in runner’s knee. Also, if a shoe lacks an appropriate heel counter, good cushioning and adequate flexibility, further harmful pressure can be inflicted on the knee leading to increased risk for runner’s knee.
Additional risk can be acquired with improper weight training. The muscle group most specifically involved in runner’s knee is the quadriceps which are the four muscles located on the front of the thigh used to extend the knee. Weakness in the quadriceps can cause the kneecap to track improperly within the knee joint. This weakness is further increased during running as the quadriceps fatigue. Again, with the kneecap displaced from its track, harmful pressure is created on the underlying cartilage and eventually runner’s knee develops.
Further risk is found in where and how often you choose to run. Running on a slanted or uneven surface is potentially dangerous because of the increased pressure placed on the knee. Such surfaces are encountered when running on the slope at the side of the road, when a majority of the running distance is across the slope of a hill or when continually running uphill. Similarly, running too hard or for extended periods of time leads to potentially harmful amounts of pressure to be placed on the knee.
If you find that you have already developed runner’s knee, self-treatment is possible. In order to give the knee time to heal, its important to lessen your running for a while. Ice on the knee will help reduce swelling. Also, taking an anti-inflammatory, usually ibuprofen, can be effective as well.
Once you get the swelling down, there are several steps that can be taken to prevent further aggravation. Placing an insert in your shoes may provide extra support in the arch of your foot. Leg exercises to strengthen the quadriceps can help reduce improper movement of the kneecap. Also, wearing a rubber sleeve with a hole for your kneecap can help keep the kneecap stable and on its track.
Hopefully, if you prepare adequately and safely, marathon day will be an invigorating, rewarding and relatively pain free occasion.
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