CHONDROMALACIA...Runners Knee Symptoms - pain or tenderness close to or under the patellar or knee cap at the front or side of the knee. Pain is gradual, increases over several weeks, usually in one leg. The Patella’s cartilage--under the kneecap--wears away; it becomes sandpaper like, often makes a grinding sound as it no longer rides smoothly over the knee. Causes - Running on a camber--the slope at the side of the road, or if a large part of mileage is across the slope of a hill; long runs; not warming up properly; tight, weak or fatigued quadriceps; tight, overly strong hamstrings; kneeling; going up and down stairs or hills; sitting still for long periods; cycling; overpronation. And sorry people...running too hard, or too much, too early (in the training cycle). Rushed morning or lunch-time runs with¬ out a warmup can cause it. Prevention - Stabilize the foot with well-fitting shoes; use foam, heel and or arch supports to improve fit. Avoid cam¬ bers; run on a variety of soft surfaces; try pointing the toe slightly to keep the kneecap in position. Avoid downhills. Re¬ duce the cycling element of your training, or go higher ca¬ dence with lower resistance. Do a complete warmup including quadriceps strengthening exercises; don’t allow the quads to get more than 50 percent stronger than the hamstrings. Stretch the hamstrings, quads and calves. Avoid deep knee bends. Treatment - Run if you catch the problem early; experiment with the above to find the cause. High intake of vitamin C may help. Aspirin three time a day for three months can block cartilage breakdown, but don’t risk your intestines unless you’re also going to find the cause. Seek medical advice. X-rays may be needed to check the wear of the joint surfaces. When swelling is down, strengthen the quads. Orthotics may help. Swim or pool run. A rubber sleeve with a hole for the kneecap helps many--don’t use this device as an excuse to avoid quad exercises and stretching.
ILIOTIBIAL BAND SYNDROME or I-T SYNDROME. Pain on the outer side of the knee Symptoms - pain usually increases gradually on a run; it may cease afterwards. Cause - This strong band goes from the muscle at the out¬ side and front of the pelvis (tensor facia latae muscle), down the thigh to insert at the shin. Where it passes by the knee, cushioning small sacs of fluid stop it rubbing against the bone. The sacs or the band may become inflamed - typically by: running down hills; a change in surface or training; excessive foot movements; running on cambered surfaces; bow legs; overpronation; worn out shoes; worn out body--(overtraining) tightness in the band; unequal quad strength, or leg length differences predis¬ pose you to I-T. Prevention - make changes in the type of training slowly. Avoid hill reps on a camber; avoid tight bends. Do the I-T stretches; and stretch the other major muscles. Strengthen the weak quad with straight leg raises and leg extensions. Podiatrist to check if a special insert for the shoes would help. Treatment - Attack the cause, but back off the mileage and take anti-inflammatory drugs. ICE it often. Cortisone may help relieve the bursa; or the inflamed area can be removed. To decrease both types of knee insult, don’t do stair climbing in rehab. Remember the top end of the band--It can cause problems, too.
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Or send $17.95 per book to David Holt at PO Box 543, Goleta, CA 93116. (includes shipping and tax)