Go slow in return to running


December 29, 2007|DR. PAUL DONOHUE

Dear Dr. Donohue: I am 50 and typically have run three miles a day, four days a week, on street and sidewalk surfaces for more than 25 years without incident. We recently moved to a new home with dirt trails nearby and, after a few months of running, I began to have pain along the medial aspect of one knee. After two rest periods - one for a couple of weeks and the other for a month - I resumed running, and the pain immediately returned.

After keeping my leg extended and applying a cold pack, my knee feels much better. It is almost pain free when I get up in the morning. I have read that the hallmark of patellofemoral pain syndrome is pain after sitting for protracted periods. Given my history of running on pavement for so long, could the cause be the uneven surface of the trail? Do you have any suggestions for me other than hanging up my running shoes and turning me out to pasture? - M.W.

Dear M.W.: Patellofemoral pain syndrome is a common cause of runner's pain. In fact, it's called runner's knee. The patella is the kneecap. The femur is the large thigh bone.

The pain of patellofemoral pain syndrome is more often felt on the front of the knee between the kneecap and the femur. And you are correct. The pain often intensifies when trying to walk after a long rest or when climbing stairs or trying to squat or kneel.

This pain syndrome results from overuse. Overuse is running too many miles, too often, without giving the knee sufficient rest. It also comes, just as you say, when a runner suddenly changes the terrain on which he or she runs.

You've done all the right things. You've rested your knee. Now that the pain has gone again, you are champing at the bit to get running once more. You can, but cut back on your miles. Run a third of what you used to run. Take a long time to reach your former distances of three miles a day. Do buy a new pair of well-cushioned running shoes. Your knee isn't used to running on the ground, and the uneven trail surface is causing it to wobble. It has to get used to this new surface.


Sun Sentinel Articles