Humans run. Some do it for fun, some for fitness, some for the runner's kick, and some even run for a living. Usain Bolt is one such example.

A survey of runners preparing for a marathon revealed that 58 percent incurred some form of injury while preparing for the race. Almost all involved lower limbs, with about 32 percent affecting the knee.

In another study on running injuries in Canada in 2002, the most frequently injured part of the runner was once again the knee (42.1 percent) followed by the ankle/foot (16.9 percent) and the lower leg (12.8 percent).

The knee is the most important body part as far as running injuries are concerned. This is because the force of impact on our heels during every step, which then is transferred to our knees, is about 2 to 3 times our body weight.

To further compound things, there are runners who have too much or too little pronation, too low or too high foot arches, one leg shorter than the other, muscle imbalances and stiffness and other bodily issues. Thus, diagnosing a running injury is not easy.

Almost all surveys on injuries related to running reveal that the most common injury is 'runner's knee'. This condition is also known by other terms, such as anterior knee pain, Patello-Femoral pain syndrome, or Chondromalacia Patellae.

The condition was present in 38 percent of male runners and 68 percent of female runners, according to one survey.

Reasons for this injury are mostly bio-mechanical. Most often, there is excessive lateral (outward) tracking of the knee cap (patellar) which may be related to tight lateral thigh structures or poor muscle control at the hip.

When combined with the frequent and repetitive usage of the knee during running, this results in pain and eventually wearing out cartilage over time.

The short-term treatment of runner's knee involves resting, icing, use of a knee support and anti-pain/inflammation medication.

If the problem persists, a proper bio-mechanical examination is carried out by a sports doctor or physiotherapist to determine if there are other correctable factors and whether causes of abnormal tracking of the knee cap need to be addressed.

Meanwhile, long-term measures include training of the inner quadriceps and hip muscles, and stretching of the outer structures.

Additionally, running shoes appropriate to the foot-type; motion control or stability shoes for flat-footed runners; cushioning shoes for high-arched runners; and customised insoles may also be necessary for some runners. Training program modification to incorporate reduced running reduced mileage, surgery in cases of severe cartilage damage, and newer treatments such as Platelet-Rich Plasma, are other treatment options.

Another woe, Iliotibial Band (ITB) friction syndrome, is the second most common knee condition in runners.

The ITB is a long tendon running down the entire side of the thigh from the hip to the knee. It may be irritated as it rubs back and forth against the bone at the side of the knee, while the knee is flexing and extending during running.

Pain is felt at the outer side of the knee and is typically worse on running downhill, or running along a cambered road. Tightness or weakness of the buttock muscles may contribute to the injury.

It is frequently related to runner's knee as the tight ITB can be a cause of excessive lateral pull on the knee cap.

Treatment of ITB friction syndrome involves resting and icing in the early stages, as well as specific stretches for the ITB and gluteus muscles. As with runner's knee, bio-mechanical factors need to be identified and addressed in order to obtain lasting relief.

Meniscus injuries runners injure their meniscuses by loading them too much over the many miles they run. Frequently, the damage is that of degeneration to the medial meniscus, which may result in loss of ability of the meniscus to absorb shock, and eventually to tears in the meniscus. Diagnosed with the help of MRI scans, the meniscus can be treated by the strengthening of knee support muscles and reducing impact forces at the knee.

This may mean running less or running on softer surfaces or a treadmill rather than on road. There is some evidence that running with less of a heel strike, and more or a mid-foot strike, may result in less impact forces at the knee. In cases where the damage to the meniscus is significant, surgery may be required.

The writer, a specialist orthopaedic surgeon in private practice at the Mt. Elizabeth and Mt. Alvernia hospitals, was educated at the National University of Singapore (NUS) and is a Fellow to the Royal Colleges of Surgeons in Glasgow and Edinburgh.

Popular

TNI hands over acid attack case to military prosecutors

Govt doubles down on diplomacy as Hormuz risks persist despite ceasefire

Rupiah’s confidence test