Exercise Q & A: How should you deal with knee pain when running?

Question: If you have knee pain when running, what should yo do?
Answer: This can be especially troubling the older we get, and unfortunately once some people reach their 40s or older they just assume they’re too old to run anymore.
Actually, oftentimes some simple exercises can help you correct the situation and resume running. First, here’s a quick lesson on the knee and why people often wind up experiencing pain while running, or even just walking.
The quadriceps are on the front of the knee, while the hamstrings are on the back of the knee. Equally important to the knee’s stability are ligaments, which we often hear about being strained or torn in athletes.
If a ligament is strained or injured, or the quadriceps or hamstrings are imbalanced injured, it can cause the knee to go off track. Pain and-or further injury can occur from even a slight imbalance.
If the injury is acute (ie: very sharp and painful) obviously a person should stop working out or playing their sport and consult a trainer or doctor.
However, the when the pain is simply numb or nagging we’re often not sure what to do. Sometimes when an injury or imbalance lingers it can throw the knee off over time and pain or clicking can develop.
Also, when a person tries to increase the demands on the knee, such as playing basketball after a layoff or adding mileage as a runner, pain can develop.
One of the most common problems for the knee is known as “runners’ knee.”
Due to a muscular imbalance in the legs and-or feet, it throws off the smooth pattern in which the knee cap usually moves up and down.
When the muscles are imbalanced the knees can go off track and cause the cartilage to grind away at the knee cap.
To get your knee back on track and moving smoothly often a few simple exercises will do the trick over time.
If you experience pain while running or sometimes even walking, or a clicking sensation, it is often caused by an imbalance in the quadriceps and hamstring muscles which go over the knee.
Most often, weak quadriceps (the front leg muscles) are the problem.
If the hamstring muscles (the back leg muscles) are stronger than the quadriceps they can overpower the quads and that will pull the knee off track just enough to cause pain and-or instability.
Foot imbalance (over pronation) can also sometimes cause the knee cap to be imbalanced, or a sudden increase in physical demands on the legs
HOW TO TREAT A KNEE STRAIN – Initial treatment of a knee strain should consist of an ice pack. Also take anti-inflammatory tablets or gels such as Aleve or Ibuprofen to help to relieve the swelling.
Gradually working on strengthening the quadriceps muscles with some or all of these exercises:
* Wall sits – Sit against wall with knees parallel to strengthen quads, hold for three sets as long as you can. Usually about 45-60 seconds the first time you try.
* Slow leg extensions – Normal leg extensions on a machine can actually be bad for your knee, but to rehab a knee strain do them in a modified way.
Sit on a chair with a towel under the thigh of the knee you’re working. Slowly raise the knee close to parallel to the floor, but not all the way. Hold at the top for three seconds then lower an repeat for three sets of 12-15.
* Leg lifts – Lay back on floor with elbows supporting you and one knee bent. While keeping other leg straight, raise for three sets of 12-15 to strengthen quads.
* Hamstring raises – It’s also a good idea to work the hamstrings some too. Lay on the floor on your stomach and raise your leg slightly off the ground, focusing on glute and hamstring muscles doing the work. Do three sets of 12-15.
* Slow squats – You can also do slow squats, holding at the bottom for three seconds just above a parallel position. Avoid squatting with weight if you’re knees are particularly sore.
* Leg presses – Leg presses on a machine with low weights – don’t lock out at top – can also be helpful.
* Retro-running – Stretch and strengthen the quadriceps and hamstrings to improve stability by walking or running backwards on the treadmill. Alternate your neck position to prevent strains and limit your retro-running to two sessions per week of short distances at first.
* Exercise bike – Riding an exercise bike may be better for you when your knees are sore than running or using an elliptical machine.
FINAL THOUGHTS – Also recommended are supplements, such as glucosamine condroitin to improve joint lubrication and eat lots of fruits and vegetables.
Don’t exercise the same body parts hard two days in a row so some time is allowed for rest. Orthotics may also help, as could being evaluated to see if you have an over- or under-pronation problem.
Consult a physician before starting any new exercise program.

At Home Fitness consultant Aaron Dorksen’s blog deals with a variety of fitness topics, ranging from workout tips, motivational ideas and feature stories on how exercise impacts people’s lives. Consult a doctor before making any significant changes in your exercise routine or diet. E-mail him with comments, questions or ideas for future blogs at aaron@athomefitness.com

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