Running Problems of the Knee
Patrick D. Kain ATC/L
Licensed Athletic Trainer
Buffalo Grove High School, Buffalo Grove, Illinois
The knee is considered one of the most complex joints in the human body. Due to the
fact that many activities place various degrees of stress on the knee, it is
also one of the most traumatized. As many of you already know, running is no
exception.
Because the knee is extremely weak in terms of its bony
arrangement, compensation is provided through the support of muscles, tendons,
cartilage, and ligaments. Being a repetitive activity, runners are prone to
injuries to one or more of these soft tissues over a period of time (overuse
injuries), rather than of the acute onset. This article will examine of two the
more common knee injuries, discuss how they occur, and what can be done to help
them heal. This article, like the others which have come before this, are not
intended for self-diagnosis; this is best left to physicians, therapists, and
athletic trainers. This is to be used to educate the runner as to become a more
complete athlete.
Osgood-Schlatter Disease
Osgood-Schlatter disease is an inflammation characterized by pain at the attachment of the
patellar tendon (just below the knee cap) at the tibial tubercle seen in
adolescents. This condition worsens when a bony callous growth is seen where the
tendon attaches, and the tubercle therefore enlarges. This condition usually
resolves around 18 years of age, leaving the remnant of the enlarged tibial
tubercle.
The condition is believed to be caused by repeated stress and
overuse of the patellar tendon. Many of you may have had this, or are
experiencing it now, and understand the pain involved during activity. The
runner complains of pain when kneeling, jumping, and running.
Management of the condition, once diagnosed by a physician, is usually most successful by
conservative methods. For example, most stressful activities must be decreased
in both intensity and duration, until epiphysial union occurs, usually between 6
months and 1 year. Furthermore, ice and anti-inflammatories are used to help
control pain.
Patellar or Quadriceps Tendonitis
Sudden or
repetitive forceful extension of the knee may begin an inflammatory process that
can eventually lead to lead to tendon degeneration. The tendons involved here
are in the front of the knee either above the knee cap (quad tendon), or below
the knee cap (patellar tendon). The injury has been described as having three
stages of pain:
q Stage One: Pain after running
q Stage Two: Pain during and after activity (the runner is still able to
perform
at the appropriate level)
q Stage Three: Pain during activity and
prolonged after activity (performance is affected), and may progress to constant
pain if action is not taken.
There are three goals of rehabilitation:
decreasing pain, restoring motion, and increasing strength, endurance, and
function. During the first two stages, icing the affected knee 2-3 times per
day, especially following a workout, is extremely, important in decreasing
inflammation. An extra Effort should be made to stretch the appropriate area 2-3
times per day as well. If the pain advances to the third stage, your health care
provider will instruct you as to what you should be doing following and
examination and x-rays.
This condition can be avoided by gradually
increasing workouts rather than rush progress, and also be proper flexibility
work both prior and following all workouts.
Once again, the knee is a
fascinating, complex area of our body prone to many running problems. However,
with proper training regimens, daily stretching, and recognizing pain before it
becomes a problem, you may find yourself avoiding injuries plaguing many others
who are not so educated. Furthermore, I must reiterate the importance of getting
an injury examined by a licensed professional. Happy trails!
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