I’m 30 years old, 5’ 11' tall and weigh 80 kg. During the past year, each time I run, my knees start paining within the first 10 minutes and the pain only goes away after 10-15 days of rest. Please tell me how I can get rid of this pain and explain what I might be doing wrong. Is this about posture while running?
Devender, New Delhi
Your complaint sounds like a patello-femoral pain. I think the first step will be to determine the cause and for that you need a thorough assessment by a qualified physiotherapist. Moving on, you need to address some other questions. How often do you change your running shoes? Do your feet pronate or supinate, which means do your ankles turn inward or outward while running? Do you have bow legs or knock knees? Is there any leg length discrepancy? Improper footwear can be a cause of this problem.
Are you activating your core while running? Your core comprises your deeper abdominal muscles that are responsible for postural alignment and balance. Two important deep core muscles are the transverse abdominal muscles and the muscles of your pelvic floor, and they must be exercised well before any kind of training. All these are important considerations to keep in mind before a diagnosis can be made.
Until you get a professional assessment, you can begin a gradually progressive training programme and perform some muscle strengthening exercises for the Vastus Medialis Oblique (which is one of the four thigh muscles located in the quadriceps) . You will also need rigorous core training. Often knee pain comes about due to muscle imbalance of the surrounding quadriceps and hamstring muscles of the upper leg. So, a strong core is also essential to any injury prevention strategy.
Hamstring flexibility and calf and quadriceps flexibility are important too. You may perhaps benefit from a biomechanical evaluation where the kinetic chain of your body is examined and the various ranges of muscle and bone motion are measured and recorded. But that’s only if things don’t improve with the basics.
Another possible cause of the pain can be that the tendon is inflamed, which is usually caused by over training and excessive hill running. The best management for a tendon injury is to ice it regularly and cut down on the aggravating factors until the inflammation reduces. It is then important to do a series of specific eccentric strengthening exercises prescribed by a physiotherapist.
Doing too much too soon following an injury can lead to a recurrence of the injury. My best advice would be regular stretching, strengthening of the surrounding lower limb muscles and especially the core, and making sure you have the correct running shoes on.
Ferguson is a sports physiotherapist with Elite Athlete Performance. Dr Mike Marshal also contributed to this reply.