Monday, September 24, 2007

Run Better with Pain-Free Knees and Heels

Running is one of the most popular exercises for improving your heart health, cardiovasular fitness, burning calories, losing weight and relieving stress. Its popularity also implies that you could suffer from overuse injuries.

If you're an avid runner, you've probably trained and competed in distance running (full or half marathons) or triathlon events. You could easily log in 20 to 50 miles a week on the treadmill or on the road. That's a lot of pounding, pouncing and stresses on your legs and joints.

If you've done H.I.I.T. (high intensity inteval training) type running routine, you know the demand and you can feel the soreness on your leg muscles. Sooner than later, you'll be caught up with joint pains if you do H.I.I.T. too much too often. That's why it's recommend not to do more than three H.I.I.T. cardio sessions a week and no longer than 30 minutes each time.

Recovery is an important yet often neglected part of any training program. Many runners know how to push themselves to run harder, longer and faster. If your recovery is not sufficient, you'll break down than build up. You're prone to injuries.

As a result, many running-related injuries have occured on the knees, shins, ankles and heels. The two most common injuries are "runner's knee" and plantar fasciitis.

There are many ways of preventing and rehabiliating the injuries. Running shouldn't be a pain if you run with correct body mechanics and proper training plan.


Runner's Knee
It's called "chondromalacia" technically. It's a condition where the articular cartilage underneath the kneecap (patella) starts to soften and break down. You feel pain under or around your kneecap that worsens when walking downstairs, running hills, squatting or jumping.

Overuse is the major cause of runner's knee. Other causes are being overweight, poor running or foot mechanics, overdoing activities that involve a lot of running, jumping or change of direction.

How to fix & rehab
  1. R.I.C.E. Ice your knees for 10 to 15 minutes after running to relieve the pain.
  2. Warm up and stretch properly before running or any sports, especially quadriceps and hamstrings.
  3. Cut your milesage. Avoid running downhill until the pain subsides.
  4. Run on softer surfaces such as treadmill, dirt trail, grass or soft track.
  5. Cross train with different activities or sports. Replace a few runs with lower impact activities such as walking or using an elliptical trainer.
  6. Pick a pair of suitable running shoes that keep your knees stable, provide adequate cushioning and support. Replace for every 500 miles.
  7. Strengthen the muscles around your knees. Quad sets (quadriceps isometic exercises), short-arc extensions, straight-leg raises are a few helpful exercises. Slowly progress to full-arc extensions, knee extension machine and closed kinetic chain exercises such as leg presses, squats and lunges.
  8. Stretch your calf muscles, quadriceps, hamstrings, iliotibial band, hip adductors (inner thigh), hip abductors (outer thigh), hip flexors and glutes.
  9. Perform balance and stabilizing exercises that challenge your "proprioception", your body's ability to know where its limbs are at any time.
  10. Always consult with your doctor or physical therapist for your specific conditions. Check for any muscle imbalance, tight muscles or foot mechanics.

Plantar Fasciitis
This is another common injury of foot in runners or any athlete involving intensive use of feet. It referred to an inflammtion of the plantar fascia running along the sole of the foot. Plantar fasciitis is a chronic symptom occurring over time with repetitive overuse stresses on the plantar fascia.

People with high arch, uneven leg length or poor running biomechanics are more prone to this injury.

You feel pain on the bottom of your foot towards your heel. The heel pain is usually the worst when you just get out of bed in the morning or at the beginning of a run. The pain typically subsides after you warm up and stretch.

How to fix & rehab

  1. Rest your affected foot.
  2. Warm up and stretch properly before running or any sports.
  3. Cross train with different activities or sports. Replace running with no or low impact activities such as swimming or cycling until the pain eases.
  4. Massage the bottom (arch and hill) of your foot for five minutes several times a day with a tennis ball, a tin can or a water-filled bottle.
  5. Before getting out of bed in the morning, warm up and massage the bottom of your foot to loosen up the plantar fascia.
  6. During night time sleep, your feet are in plantar flexion position that shortens the plantar fascia. This would aggravate the pain even more due an extended period of inactivity. A night splint may be used in order to hold the ankle joint in a neutral position.
  7. Pick a pair of shoes that provide good arch support.
  8. Stretch your calf muscles and around your feet and ankle.
  9. Perform strengthenging exercises such as hill raises and toe walking.
  10. Always consult with a sports medicine doctor, physical therapist or fitness trainer/specialist for your specific conditions.
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