Long distance running has many amazing benefits. It is great for physical fitness and mental wellbeing. It gets you out in the fresh air and helps to combat stress. It builds strength and endurance and, best of all, it’s free (if you don’t count the cost of running shoes).
However, running can take a toll on your knees and we often treat runners with knee injuries, particularly long distance runners who may be running for extended periods of time, sometimes over uneven ground.
Although this year’s Virgin Money London Marathon was cancelled due to the pandemic, many runners have continued to train and some are taking up the challenge of running in the virtual marathon, scheduled for Sunday 4 October. If you are one of them, or if you’re inspired to take up running, it’s worth being aware of the common injuries to look out for.
Common knee injuries for runners
The knee injuries most often associated with running are:
- Runner’s knee – this aptly named condition causes pain under your kneecap that is exacerbated by running or walking up or downstairs. It is caused by the patella moving out of alignment when you’re running, causing the cartilage underneath to become inflamed.
- Iliotibial band syndrome – The iliotibial band runs from your hip to your knee. If it is tight, it can squeeze the bursa which is a fluid-filled sac that cushions the IT band from the outside of the femur. The result is pain on the outside of the knee that happens while you are running. It may worsen as you run long distances and it tends to increase if you run down hills. The pain goes away when you rest but returns the next time you run and may become increasingly painful. Eventually you may find it impossible to run unless you take steps to treat the problem.
- Patellar tendinitis – This is pain below the kneecap and at the top of your shin which develops as you are running. It is caused by strain on the patellar tendon due to the force your knee is under when you run.
- Torn Meniscus -This can cause clicking, locking or problems straightening or flexing your knee. It is due to tearing of the C-shaped pieces of cartilage that act as a cushion between your shinbone and your thighbone.
- Osteoarthritis – This is due to cartilage wearing inside the knee joint, causing the bones to rub together. It is a degenerative condition that causes pain, stiffness and loss of movement that gradually worsens. Eventually it may interfere with normal everyday activities.
Treatment of knee related injuries for runners
If you are experiencing knee pain it is important to stop running and to rest. You can use the RICE method (rest, ice, compression, elevation above the heart) to reduce pain and inflammation and you may want to take anti-inflammatories or painkillers.
For severe or persistent pain, you may require medical treatment. Here are some of the ways we treat knee problems:
- Treatments for Runner’s knee – cut down on the distance you are running and apply ice to the affected area to reduce swelling. Try using a cross-trainer to maintain fitness levels without aggravating the problem but if the pain persists you need to see a doctor.
- Treatments for iliotibial band syndrome – knee straps and taping can help to support the knee. In addition, exercises can help to stretch the iliotibial band and strengthen the knees. You should also replace poor quality, worn or ill-fitting running shoes which may contribute to the problem.
- Treatments for patellar tendinitis – knee straps worn below the knee or patellar taping may resolve the problem. It can be helpful to do exercise to strengthen the gluteal and medial quad muscles. In some instances, gait training may help to improve your running form or more supportive running shoes.
- Treatments for torn meniscus – this depends on the size and type of the tear. It is important to rest to prevent the tear worsening and physiotherapy can help to strengthen the muscles around the knee and legs. In some cases you may need surgery to repair the tear or trim the meniscus, or a meniscus transplant.
- Treatment for osteoarthritis – in the early stages you may be able to lessen the symptoms by taking anti-inflammatory medication, staying active to keep the joints lubricated and running on soft surfaces to protect the knees. Physiotherapy exercises can help. As the condition develops you may require more invasive treatment such as injections of corticosteroids or joint replacement surgery.
Prevention of knee injuries
While it is not always possible to prevent knee injuries, you can reduce your risks by strength training to build up your core, leg and gluteal muscles, foam rolling your iliotibial band daily and ensuring you use good technique and proper running shoes. Shortening your stride can take some of the pressure off your knees.
Unfortunately, many long distance runners will experience knee problems of some sort and the quicker you get a diagnosis and corrective treatment, the more likely you are to be able to continue running.
If you injure your knee during sport or any other activity, it is important to get a proper diagnosis if the symptoms persist or are severe.
Following the lockdown, Castle Orthopaedics is now re-open for virtual and face to face appointments at both Spire Nottingham Hospital and BMI The Park Hospital. Surgery is now also being scheduled once again, which means that injuries requiring surgery can be treated.
Our orthopaedic consultants each specialise in a particular area of orthopaedics, giving you added peace of mind that you are receiving expert medical advice and highly tailored treatment.
BMI The Park Hospital
Sherwood Lodge Drive Burntstump Country Park, Arnold NG5 8RX
Spire Nottingham Hospital
Tollerton Ln, Tollerton, Nottingham NG12 4GA