Running, and that darn knee pain!


UnityPoint Health's Dr. Christopher Palmer explains knee pain related to running. 

So I have to confess, I am from the deep south; but I am being told that we are having an unusually mild Iowa winter (thank goodness!). But I have noticed a definite increase in the amount of outdoor activities during this recent spring-like weather. After storing up 'energy' over the mild winter, many of you are ready to shed some pounds or make good on those New Year's resolutions. And many of you are bound and determined to run! I would like to take a few moments to address running and, unfortunately, a frequent complaint that results; knee pain!

Distance running is a basic part of the fitness program for a significant number of people. However, runners face an injury rate of up to 50% per year, and the highest number of these injuries are related to knee complaints. At least a reported 30% of serious or regular runners will face knee issues. Luckily, most of these are not too serious and can be managed with attention to some issues that might make your early season workouts more enjoyable, or even possible!

There are many possible causes for the knee pain that you might experience after starting or renewing your running program. Patellofemoral syndrome or anterior knee pain, patellar instability, bursitis, tendonitis, meniscal lesions, stress fractures, or osteoarthritis are just some of the many causes of the pain that you might experience. Two-thirds of runners' injuries may be related to training errors, such as sudden changes in duration, frequency, or intensity of training. Athletes often succumb to the 'rule of toos' when they exercise too often, too hard, and too soon after too much rest or injury and attempt remediation or treatment too late! Many of us are just too anxious to get in shape after we'd made up our minds to do so, or to get back in shape after a long break! Remember folks, Rome wasn't built in a day! And the level of fitness or look that you desire won't be either. 

If you are experiencing pain there are a number of treatment considerations. Rest is the last thing a runner or athlete wants to hear, but sometimes even 'relative rest' and moderation of a program by reducing the intensity and duration is all that might be required. Running in water or 'aqua-jogging' or using high-tech rehab devices such as Finley Hospital's alter-gravity machine is an excellence form of reduced weight-bearing cross-training and rehab tool. Cross-training may also include other fundamental strength, endurance and flexibility activities, such as circuit training. swimming and biking. 

Shoe modification may also be a consideration. Shoes typically come in three classifications: motion control, support and cushion. Most running shoe manufacturers have shoes that fit these classifications. You may need to consult an orthopedist, foot specialist, orthotist, or even have special gate analyses done for recommendations on what modification might reduce your running pain. 

More traditional treatment recommendations such as medications that may reduce pain and inflammation, such as NSAIDS and physical therapy, may be recommended depending on the cause and severity of your pain. Injections of corticosteroids are sometimes an option as well. Luckily, most runners' injuries can be managed conservatively. As a last resort, there may be conditions that just do not respond to more conservative measures for which surgical options may be indicated.  

In summary, let me urge you to go slow with advancing your workout program. I have included some guidelines for returning to a workout/running program but keep in mind we are all starting from a different recreational or athletic background and this is meant to be a just a rough guide. Please consult a qualified healthcare professional should you have questions or concerns about what to do to get back on track if you've had a long layoff or are experiencing problems after returning to your jogging program. 

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