Overuse and High Impact activity


Q: I just started getting back into running. I used to be a distance runner and ran 10 miles everyday. But that was 10 years ago. I started 3 weeks ago and ran 1 mile, 3 to 4 times a week, just got a little sore the first week. Then I ran 2 miles the 3rd week and after that both knees started hurting. On both knees if I'm looking at them its the inside of the front part of the knee that hurts, but a little lower then the knee cap. It does not hurt to ride my mtn bike though,only hurts when I run. The hard impacked of my foot hitting the ground when I run gives me severe pain in my knees. After I forced myself to run one mile yesterday thinking I was only sore, today I can hardly walk. Have I just over done it and it will get better or do I need to go to the Doc to have them look at it? I never had knee problems even in High school when I ran so much for Cross Country. You can hardly touch the spot on my knee that hurts, because it hurts so bad.What do you recommend?


A:   Overuse and High Impact activity
There is a very well described entity in the medical literature called: Overuse Syndrome, which can affect any part of the body that is over stressed with movements or activities in a repetitive way, including occupational, recreational, and habitual activities. Repetition is part of the definition of overuse injury. The concept is that overuse injury is associated with repeated challenge without sufficient recovery time, and this is true for Body Building, Running, Jogging or any other sport or activity in which you exceed the guidelines and your own limits or capacities. The healing time is different for each patient, and also depends on the severity of the initial injury. According to your description , most likely you may have a Patellofemoral Syndrome, which basically is an unbalanced muscle pull that produced excessive pressure or leverage forces on the knee joint surfaces. The pain on the knees after running on a hard surface is a common presentation of the Patellofemoral Syndrome.
The suggested strategy should be: strengthening and stretching the main muscle of the thigh: quadriceps, to restore the muscle balance around the knee joint, for this is indicated physical therapy for 6 to 8 weeks, using ice packs at the end of the exercise routine to decrease pain and swelling. Also, and very important, you have to stretch the hamstring muscles and the activities or sports that require frequent squatting must be avoided until the pain is under control. Check out your foot gear for adequate cushion and try to avoid hard surfaces when running , you can use  anti inflammatory drugs (example: “Advil”) to control the pain.
If there is a limited response to the treatment and locking or instability of the affected knee is noticed, then an orthopedic surgeon evaluation must be considered.Check out your foot gear and use  anti inflammatory drugs (example: “Advil”).

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