Are you increasing the distance you are running? How are you knees?
Recently in clinic I noticed I am treating more clients who are starting to increase the distance they are running ahead of a half or full marathon. What they had in common was tight Iliotibial Bands (ITB).
Iliotibial Band Syndrome or Runner’s Knee is characterised by pain on the lateral side of the knee joint (epicondyle of the femur) when running. The pain stops when you are resting and then returns again when you resume running. It often feels like something catches or “twangs” over the bone.
It’s mostly the running activity itself that causes IT band irritation. For instance, a motion like running causes repeated extending and bending in your knee. This motion stretches the band, which makes it become tight, and even swollen. If it does become swollen it will benefit from being iced and resting. If your IT band is irritated then it along with the rest of your legs may benefit from massage.
It is also worth trying to avoid running on cambered roads. In addition if you notice that when you run, one or both of the soles of your feet tilt outwards (eversion of the foot) then you may want to consider if you need orthotics.
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Runner’s Knee
What is runner's knee? Iliotibial band (ITB) syndrome, or runner's knee, got its nickname for an obvious and very unfortunate reason—it's common among runners. The resulting pain on the outside of the knee, comes on when running, stops when you rest and then starts again when you resume running. Some runners feel something catching on the outside of their knee or a "twang" over the bone on the outside of their knee. What causes runner's knee?
- Long distance running
- Excessive eversion of the feet
- Running on uneven terrain or on cambered roads
- Lack of core strength
- Mobility issues in your lower back or hips
- Listen to your body - stop running if you feel and sharp or shooting pains and review your running style.
- Strengthen your core including your glutes as this will help you run longer and longer distances and will ensure you have adequate strength when running up and down hills.
- Ensure your Iliotibial band and thigh muscles are flexible.
- Avoid running down hill or on a cambered road
- If your feet naturally evert then book an appointment to see a podiatrist to see if you need shoe orthotics.
Introduction to Delayed Onset Muscle Soreness
Delayed onset muscle soreness (DOMS) also called muscle fever, is the pain and stiffness everyone is familiar with after strenuous exercises. It is noticeable worse 24 to 72 hours after exercise and it can occur anywhere in the body. However it is more memorable when it affects the lower body i.e. the legs, due to it being so inhibiting. For a long time the cause of DOMS was thought to be the build up of lactic acid and toxic metabolic waste in the muscles. However this theory has now been thoroughly rejected. While the cause of DOMS is not well understood, the current consensus is that DOMS is a result of inflammation triggered by microscopic tears in connective tissues that sensitise nociceptors and heighten pain. The pain of DOMS and the sever soreness may decrease capacity to perform in subsequent workouts. In addition to physical symptoms for some people it can decrease motivation to exercise. So is the pain worth the gain? The short answer is no. DOMS doesn't mean you will build more muscle although it may enhance it a little. References Brad J Schoenfeld, 2010, The mechanisms of muscle hypertrophy & their application to resistance training, Journal of Strengthening & Conditioning Research, vol 24, (10)
