FEATURE — There is no doubt that running a marathon is a huge accomplishment. It requires months of training and eating right. However, when pushing your body to its limit, it is most susceptible to injury, and while preparing for the pounding the body takes during that 26.2 miles, it is important to take steps to prevent injury.
Runners often suffer from injuries typically known as “overuse” injuries, meaning they are not caused by an acute incident but rather they are the result of many miles of running.
Dr. Todd Parry with Revere Health Coral Desert Orthopedics shares his insight on knee overuse injuries.
“During the training phase, I too often see people who are only focused on the running aspect and not on building and conditioning the supporting muscle groups that optimize performance and prevent injury,” Parry said. “Strength training and cross-training are essential to prevent overuse injuries.”
By building the supporting muscles, your body maintains proper form and absorbs impacts better. Cross-training also allows continued cardiovascular conditioning while allowing the muscle groups and soft tissues used during running to recover.
“There are also certain people, myself included, who shouldn’t attempt to train for and complete a marathon,” Parry said. “Old sports injuries to knees are the primary limiting factor. Some of us should be content with only training for shorter distances.”
IT Band Syndrome
IT band syndrome is a very common overuse injury in marathon runners, Parry said. The iliotibial band is a ligament that runs down the outside of the thigh from the hip to the shin and helps stabilize knee joints. When the band becomes tight or inflamed, movement of the knee is painful over its outside edge.
IT band syndrome is typically caused by:
- Tight muscle groups, poor flexibility.
- Wearing the wrong kind of shoes or worn-out shoes.
- Training on banked surfaces.
- Running on one side of the road.
- Not taking any breaks between workouts (inadequate recovery).
“IT band syndrome is rarely seen in short-distance runners, but long-distance runners can be sidelined by the pain of IT band syndrome,” Parry said. “Strengthening programs will help balance the kinetic chain of the lower extremity and prevent the syndrome from happening.”
IT band syndrome can be treated with rest and strict adherence to doctor’s orders, but it will take time. In order to prevent the syndrome from ever occurring, it’s important to stretch often, allow time for recovery between workouts, run on flat surfaces and start a strengthening exercise routine to strengthen major running muscles especially the gluteus medius.
Another common overuse injury is known as “patellofemoral pain syndrome” or “runner’s knee.” This occurs when the stress of running causes irritation where the kneecap rests on the thighbone. Runner’s knee is characterized by an aching pain around the kneecap when the knee is bent.
“Within the knee joint, we can have mild patellar maltracting or tilt,” Parry said. “Long-distance runners can often exacerbate this. If someone has a slight scuff to their cartilage or a minor meniscal tear, they may be able to deal with it at a shorter mileage, but it can increase at larger mileage and ultimately be a limiting factor of their training.”
Stretching, strengthening and rest can help treat runner’s knee. The occasional steroid shot may also be beneficial, but this is only a short-term solution. Gel or stem cell injections are sometimes considered.
There is no better treatment than prevention, and there are several ways to prevent runner’s knee, including:
- Avoid running on hard surfaces such as concrete.
- Wear high-quality running shoes.
- Keep your supporting thigh, core, hip and girdle muscles strong.
- Make sure your shoes have enough support.
- Don’t increase your running intensity too fast.
- Take at least one day off between runs, and cross-train.
If you are training for a marathon or race, make sure you remember to take the steps necessary to prevent overuse injuries.
“One of the key things to remember for elite level athletes who are training for a marathon is to cross train,” Parry said. “Weight lifting, biking, swimming and even yoga can help build the core and strengthen the supporting musculature.”
Don’t forget to strengthen, in addition to running.
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