Many times we get questions emailed to us or asked in the office that I believe can be helpful to everyone, so with this article, I want to answer I question that I received this week via email…
Hi Dave,
My right knee has been killing me for weeks now, but I can’t seem to figure out the cause…AND what’s even more confusing is that it’s most painful going down the stairs and starts 10 minutes into my run.
Sometimes it aches and sometimes it’s very tender and dull, but what I don’t understand is why could I run fine before, and now I can’t run 10 minutes without having to stop.
Can you help?
-Jen, 45, Valley Cottage
There is a chance that what is happening to Jen is happening to many people this year with the warm winter that we are having… and will happen to even more of you in the spring! (So, let’s stop those aches and pains in advance)
The warm temperatures this year (and quickly warming temperatures in Spring—every year) cause us to see these knee problems in our office, because it’s the feeling of warmer temperatures that causes people decide to be more active and take up running or long-distance hiking. Whether they feel like they are sick of being inside, want to be in shape for the coming nice weather time to be out and about with family, or to drop a few pounds before summer, people are starting to get out and move again.
And, even if you are used to running, people tend to step it up this time of year and run a little longer than they were in the cold dark days of December and January, so they can get started to those summer goals…even earlier this year (because it didn’t work as well as you wanted last year). Some people go from nothing to 3 days a week…some from 2 to 4 days…and others go full out and run 7 days a week!!!
What is most likely going on with Jen is something called “Runner’s Knee”. Runner’s Knee is really an irritation of the back of the knee cap. It’s called Runner’s Knee for the unfortunate reason that we see here with Jen…it affects a disproportionate number of runner’s (especially female runners), especially new runner’s and runners who increase distance per week by either increasing frequency or distance per run.
When we run often, we place stresses on the knee that often cause irritation around the knee and on the back of the knee cap. The resulting pain can be sharp and sudden, or irritating and dull. Sometimes it disappears when you’re running and returns after OR increases after some time running, like in Jen’s case, and goes away with rest…only to return with a return to that activity. In Jen’s case Running and stairs.
Generally, Runner’s Knee (or patellofemoral pain syndrome) pain will be worse with bending the knee for a period of time, running or walking down hill, using the stairs (down worse than up), or even sitting for a long time with the knee bent (especially after a long run that irritated the knee cap).
What Causes this Knee Pain?
Think of it like this—when you go running and bend your knee, your knee cap rubs against the femur (the thigh bone—more specifically the femoral condyles, the bumps on either side of the knee cap that make the knee thicker). To further understand it, it’s similar to if you were to rub your hand against your arm, eventually your arm would get red, irritated, and swollen. The same thing happens with the knee cap…only worse, bone against bone!
If you’re not used to running, OR, if you haven’t built up how long you run over a period of time…this is going to be a shock to your system and can irritate your knees…especially if your quadricep and hip muscles are weak and tight, they are not going to be able to support you through the run.
And without strong muscles to support your knee joints (or just tired and weak ones), you are much more likely to suffer from aches and pains.
SO What is the Solution?
It is likely that simply strengthening the knee muscles (and the hips and lower back muscles too) will help them to support Jen when she runs—not MORE running.
Jen will need to strengthen her quadraceps, her hips and her core. She will, also, need to make sure that those muscles are able to fire at exactly the right time with exactly the right force for the activity (running, in this case).
Many people believe that exercising more is the best option for them, but doing more of the aggravating activity will only make it worse. However, doing the right exercises will benefit your knee and everything else that you are doing—even helping you run farther and faster!
Doing the right exercises and stretches to Strengthen the Right Muscles will mean your knees will be strong enough to walk and run for longer—with less pain at the end of the day.
I recommend building a strong foundations before doing MORE, which will prevent further aches and pains that may creep up on you that could stop your exercise routine for weeks…
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