A Pain in the Knee

Recently I've had a few runner friends contact me to ask about pain in their knees. It's a pretty common complaint, especially for any runner who is ramping up his or her training by increasing frequency, mileage, intensity, etc. As the autumn marathon season approaches, this includes a rather large percentage of runners out there.

Ow!

Pain in the knee is really annoying for runners. Of course, I'm assuming here that we are talking about so-called "ordinary pain": your knee is hurting, but there is no discoloration or obvious swelling, and you did not bang your knee into something hard or fall down/twist your leg to cause the problem in the first place. In fact, you can't really pinpoint the exact day that the pain started, but it's there now and it just won't go away. And it's begun hurting so much that you can't really run on it. Most likely the pain feels like it's in the kneecap (patella), or just under the kneecap - although the pain *may* radiate a little bit up or down the front of the leg to the patellar tendon or the tendons that attach to the lower quadricep.

In other words, it's probably a classic case of "runner's knee", which isn't serious but could set you back for a time. And runners do not like being set back!

Caveat 1. I've written it before and I always mean it - I'm NOT a doctor, not even close. I am a runner of many years who's seen a lot - and personally experienced a lot - of injuries. I've coached and supported hundreds of fellow runners, and my home-spun advice has seemed to work in the past, but it may not work at all for you. Really. So promise me that if the pain gets worse (or the knee becomes discolored or swollen or you really can't bend it without wincing), please ignore my advice and go see a real physician.

There, there ...

Caveat 2: If you have different symptoms than described above, it could be another problem entirely. In that case, stop reading this post and go see your doctor!

In the meantime, try this:

1. Ice your knee, 2 to 4 times per day, for 20-30 minutes each time. Do this for one week. Ice wraps are great, so are ziploc bags full of ice cubes. The old runner's trick is to buy a cheap bag of frozen peas and just use it over and over (but I don't recommend eating them later, yuck - so mark the bag with permanent ink just to be sure).



2. Take at least 48 hours off of running, walking fast, cycling, or other leg-intensive exercise. After two days, cycling might be your best bet as cross-training. You may need to take up to two weeks away from running (let pain be your guide here, if it hurts don't do it).

3. Go to your favorite natural vitamin store and buy some Bromelain in pill form. This is a natural substance from pineapple that helps to reduce inflammation. Take 2-4 of the pills per day for 1- 2 weeks, then re-evaluate based on pain. Please don't take the stuff year-round, of course, it's for treatment not maintenance.

4. Strengthen your quadriceps. Do the exercise shown at the very end of this Runner's World article .
You can also do simple leg lifts (just straighten your leg and hold it for a count of five, 10 times in a row, a few times per day) when seated at your chair at work. The key is to work your quadriceps - when they get stronger your knee cap will track in the appropriate plane and the pain should go away. This is the most-important thing you will need to do, so be diligent about it. You are a runner, diligence should be part of your middle name!

5. Runner's World also has a short video that demonstrates several exercises that can help runners prevent knee pain. Some of these may seem almost silly, but taken as a combined set they essentially create strength in several muscles which can then take some of the strain away from the knee area. Well worth a try.

Be patient, work those quads, and you will get back out there quickly. If you ignore the pain and refuse to stop running (try to "run through" this injury), I predict that it's going to set you back even longer in the near future. Yeah, I know you hate to hear that, but truth hurts sometimes. What's the old adage? An ounce of prevention is worth a pound of cure? That's similar to the case here: when runner's knee arises, quickly nip the injury in the bud or suffer with a very long layoff and possibly lots of appointments with doctors and physical therapists.

Good luck!