Sports & Knee Injuries
Part One – Running

When talking about being physically active, one of the first exercises that comes to mind is running.  Often when an individual (athlete or non-athlete) is running, there are a range of discomforts that may last for a second, a minute, or the duration of the run.  The most common knee injuries from running include:

• Runner’s Knee
• Meniscal (meniscus) Tear
• Patellar Tendonitis
• Iliotibial Band Syndrome

Runner’s Knee generally occurs when an individual is an avid runner.  It is the irritation of the cartilage on the distal side (below) of the patella.  The pain often starts during or after a long run or while running downhill or downstairs.

RISK FACTORS INCLUDE:

• Heavier individuals
• Weak glutes
• Weak quadriceps
• Weak hips
• Over pronation (excessive inward foot rolling)

When diagnosed with Runner’s Knee, one doesn’t necessarily have to completely stop their active lifestyle.  There are other types of exercises that can be enjoyed instead.  These different exercises may actually aid in the Runner’s Knee treatment as they strengthen the quadriceps and/or glutes.

• Cycling
• Elliptical training
• “Uphill” treadmill running

Other options to aid in the rehabilitation process:

• Knee Braces for Running
  • Knee braces for running are especially important if there is an issue with patella tracking (movement medially or laterally). Knee support for running is a great way to reduce the risk of runners knee and also more debilitating knee injuries such as ACL tears & MCL tears.
• Cold Therapy
  • Cold therapy is a great runners knee treatment because it provides pain relief, reduces swelling, and muscle spasms. It also decreases recovery time so you can get back to running more quickly!
• Reduce run duration, reduce how often you run, and avoid running down steep hills.
• Perform exercises that aid in hypertrophy (growth of skeletal muscle) in the quadriceps, hips and glutes.
  • Ex. Lateral side steps with band

A Meniscal Tear can be seen on an individual who shows signs of swelling around the knee joint, and could repair on its own but generally an intervention (physiotherapy, knee braces and/or surgery) is required. The meniscus sits between the Femur and the Tibia to act as a barrier or cushion for the bones. This supplies some stability as well as weight distribution for the knee.

RISK FACTORS INCLUDE:

• Activities involving twisting/pivoting of the joint
• Older individuals
  • Meniscus (padding) has been worn down over time.

 To reduce the possibility of a Meniscal Tear, a runner can:

• Run on softer ground
• Increase lower extremity strength
  • Resistance training

Patellar Tendonitis is often mixed up with Runner’s Knee, but it is actually a damaged patellar tendon.

A brief anatomy lesson:

• A portion of the patellar tendon attaches to the patella
• Another portion of the patella tendon attaches to the front of the tibia
  • This looks like the front of the patella is covered by the tendon which holds it in place from above and below

Often an individual will feel stiffness in their patellar tendon that will go away once it’s warmed up.  It is when the tendon becomes chronically painful and stiff during the run that it actually becomes an issue, often occurring during running downhill.

RISK FACTORS INCLUDE:

• Tight quadriceps
• Tight hamstrings
• Weak quadriceps
  • Especially during downhill running for absorption of impact

To reduce the possibility of acquiring Patellar Tendonitis:

• Increase flexibility via stretching
• Avoid downhill running
• Increase quadriceps strength through isolated exercises
  • Resistance training, isometric contractions.
• Patella Knee Brace for knee support

Iliotibial Band Syndrome is painful to the outside portion of the knee which is sometimes present with a clicking sound, which is the sound of the IT (iliotibial) band clicking against the patella. This syndrome starts with a general tightness on the outer part of the knee, but will move into substantial pain.

Dr. Michael Fredericson of Stanford University published a study (July 2000) in the Clinical Journal of Sports Medicine in which it was found that the runners with IT Band Syndrome had weaker hip abductors than the runners who were uninjured. This makes sense, as the IT band is an aid for these muscles.

RISK FACTORS INCLUDE:

• Weak hips
• Weak core muscles
• Uphill or downhill running
  • Weaker hips are unable to adjust to the angle as easily

In order to rehabilitate this IT band, the following may aid the process:

• Rest
• Proper stretching
• Cold therapy
• Massage therapy

 

As you can see, there are lots of different aids for the knee treatment process in these injuries.  Certain populations and individuals are at a higher risk for these knee related injuries and no two individuals are the same.  Therefore, looking at a variety of rehabilitation options,with the help of a health practitioner, is a great way to decide which process or processes are best for you personally.

As in most cases, more isn’t necessarily better when it comes to training; a runner or athlete must get the proper rest in order to stay healthier, longer.

When an injury occurs you must take the most effective steps in order to get back to doing the things that you love faster – like staying active. It is better to know your risk factors when it comes to your specific activity, as you are better able to prepare yourself to lower the risk of injury. Warming up and stretching are two activities that a large percentage of people don’t do properly. If you do get injured, make sure to discuss the injury with a health practitioner earlier in the process, as there is a general rule of thumb when it comes to any injury: the longer you deal with the injury, the longer it takes to rehabilitate yourself.

If you are interested in a knee brace for running, or have any questions relating to runners knee and knee injuries, then please feel free to contact the Arthritis and Injury Care Centre and we would be happy to help!

Author:
Brandon Downing
Orthopedic Bracing Specialist