The Orion Online

Issue date: 10/1/08 Section: Sports

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In my last column, I suggested how to start a running program. But some may have experienced unexplained knee pain.

With the pain, a self-prescribed excuse to not run may have been made.

But the cause of the pain could have been because of overuse, poor mechanics, anatomy or all the above.

Patella femoral syndrome, or runner's knee, is a common injury among runners. It occurs when the kneecap becomes misaligned in its groove. Pain develops as a result of irritation from grinding and popping. The knee will become swollen and tender upon touch.

The condition is further aggravated by step and squatting exercises. Factors for developing runner's knee include muscle imbalance and pronated feet. And females are more prone to runner's knee, according to Andrew Feldman's book "The Jock Doc's Body Repair Kit."

It is important to keep these factors in mind while working out to avoid pain.

For some, the quadriceps and hamstrings are too tight, causing the kneecap to grind improperly. Therefore, it is advised to stretch.

Weak quadriceps can cause the same tracking problems. To strengthen the quadriceps, do partial knee extensions - knees should be only slightly bent. Straight leg raises can be done if more tolerable or convenient.

To find out if you have pronated feet, which act as a twisting force on the knee, look at the underside of your shoes. If the inner side is worn down more than the outer side, you have pronated feet. Try buying shoes at a runners' store for help purchasing the right shoes.

Runner's knee is common among women because of large "Q angles" created by wide hips. The angle is formed by the line of pull of the quadriceps and the line of the kneecap attachment to the shinbone. When the angle is large, the kneecap tends to get tugged out of alignment.

Another common injury for runners is iliotibial band friction syndrome, which pain tends to develop a couple of minutes into a run and gets progressively worse until you stop. The pain is broad and normally near the knee.

The iliotibial band attaches from the hip to the knee on the outer side. The band can become stressed and irritated, resulting in micro-tears.

Factors for this condition include pronated feet, "bowed" legs and running conditions. People often make the mistake of running on the side of the road excessively, which can aggravate the condition when the surface is uneven and hard, according to Orthopedist Harry B. Skinner's book "Current Diagnosis & Treatment in Orthopedics." Running down hills can also take its toll, so a rubber track is more kind to knees.

Try stretching and strengthening exercises to correct the problem. While standing, cross your legs and lean sideways. Hold for 30 seconds and repeat twice for each leg. In addition, one-legged squats are an effective way to strengthen the knees.

These highlighted conditions have similar causes and emphasize the kinetic chain of injury development. These conditions rarely require surgery and can be handled with conservative methods.

Let the above mentioned measures be a guide to counteract the problem. If pain persists, reduce exposure and, in the meantime, find knee-friendly strengthening exercises that are enjoyable, such as swimming.

Mikey Acuna can be reached at
macuna@theorion.com

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