Avoiding Common Knee Ailments

Runners might be prone to knee pain, but
they’re not destined for it. Dr. Kevin Plancher on how
to steer clear of the most common injuries

New York, NY and Greenwich, CT, January 2010 –
Running can be great for your heart – but hard on
your knees. Experts agree that as many as 70 percent
of runners will become injured at some point, and the
majority of those injuries will involve the knees. But
running doesn’t have to hurt, and injury is by no
means a foregone conclusion, says Kevin Plancher,
MD, a leading sports orthopaedist in the New York
metropolitan area.

The most common running-related knee injuries are
patello-femoral pain, also known chondromalacia of
the patella or runner’s knee, and iliotibial band (ITB)
syndrome. Runner’s knee is created when the
kneecap (patella) rubs against the bottom of the
thighbone, and can result in irritation and erosion of
the cartilage. ITB syndrome involves irritation to the
band of tissue that runs along the outside of the thigh,
which can become irritated from repetitive rubbing
over the outside of the knee.

Both runner’s knee and ITB syndrome can be painful
and can leave a runner sidelined for weeks or longer,
says Dr. Plancher. “But just because you’re a runner
doesn’t mean you’ll have runner’s knee – or any other
knee injury,” he says. “These problems are typically
caused overuse or by a misalignment of the joint
that’s exacerbated by improper running habits – all
things that can be avoided.”

Here is some advice for runners who’d rather skip the
knee injuries:

Choose the right shoes: Before you take one
running step, be sure you’re using the best shoes –
for you. “Everybody’s feet and legs are different,” says
Dr. Plancher, “and every shoe model is unique.”
Shoes vary widely from manufacturer to manufacturer,
and can also change year to year, meaning even if
you’ve been running in the same brand since high
school, you need to reassess your shoes every time
you buy a new pair (which should be after about 300
miles of wear, or as soon as the soles start to show
signs of breakdown). Consulting a trained
professional for the right shoe fit for you will help
protect your knees. Buying shoes with the right
combination of cushioning and stability, which is the
shoe’s ability to correct any irregularities in your stride,
such as your ankles rolling too far to one side – that
can create big problems in your knees and other
joints, is key to injury prevention.

Train smart: Overtraining – running too many
miles without adequate rest between runs – or trying
to increase your distance or speed too quickly can hurt
your knees. Be sure to incorporate one or two days of
rest each week, and mix a few “easy” (or short) runs in
with the “hard” (or long) ones. Don’t increase your
mileage by more than 10 percent a week. Start at a
slow pace and be sure to stretch before and
afterwards, to keep your muscles limber and your
joints flexible. According to Carl Asker, ultra
marathoner who just completed a 200 mile run
dedicated to Team Time for Lyme and Lyme disease
awareness, “the most valuable tool for saving my
knees while training was to have my feet land
underneath my center of mass and never in front of
me which would lead to over striding and a possible
knee injury”.

Build strength: Keeping your knees healthy
also demands some strength training, says Dr.
Plancher. Many runners do only one thing – run –
instead of cross training. That means they’ll
strengthen just their running muscles, and they’ll do it
only by running. Quite often, runners are out of balance
when it comes to leg strength, with hamstrings (the
muscles that run up the back of the leg, from the knee
to the buttocks) that are much stronger than
quadriceps (the muscles on the front of the thigh). The
result: pain and injury. A smarter strategy is to
incorporate regular lower extremity strengthening
workouts and core strengthening workouts into your
routine, making sure to work on the big muscles
(quads and hamstrings) as well as the smaller ones,
such as hip flexors, adductors and abductors, which
attach to the hips and help move your legs forward
and to the sides.

Supplement wisely: Your knees – like the
other joints in your body- need the right amounts of
certain nutrients to stay strong and injury-free. Calcium
is an essential nutrient, and is used in the body for
several functions, including building and maintaining
healthy bones. Experts recommend that adults get
1,000 to 1,200 mg (milligrams) each day. Food is the
best source of calcium (its plentiful in dark green
vegetables and dairy products), but most Americans
can use calcium supplements, as well.

Some runners – especially those who have had
cartilage damage or knee pain caused by
osteoarthritis – also take supplemental glucosamine
and chondroitin sulfate
, which are natural substances
found in and around the cells of cartilage.
Glucosamine is an amino sugar that seems to play a
role in cartilage formation and repair, and chondroitin
is a complex carbohydrate that helps cartilage retain
water and maintain its elasticity. They won’t help
everyone, says Dr. Plancher, but they might help stave
off cartilage damage, and research shows that a
combination of the two can provide relief for people
with moderate-to-severe osteoarthritis pain. The
recommended dosages are 1,500 mg per day of
glucosamine and 1,200 mg a day of chondroitin

Kevin D. Plancher, M.D., M.S., F.A.C.S., F.A.A.O.S, is a
leading orthopaedic surgeon and sports medicine
expert with treatment in knee, shoulder, elbow and
hand injuries. Dr. Plancher is an Associate Clinical
Professor in Orthopaedics at Albert Einstein College
of Medicine in NY. He is on the Editorial Review Board
of the Journal of American Academy of Orthopaedic

A graduate of Georgetown University School of
Medicine, Dr. Plancher received an M.S. in Physiology
and an M.D. from their school of medicine (cum
laude). He did his residency at Harvard’s combined
Orthopaedic program and a Fellowship at the
Steadman-Hawkins clinic in Vail, Colorado where he
studied shoulder and knee reconstruction. Dr.
Plancher continued his relationship with the Clinic for
the next six years as a Consultant. Dr. Plancher has
been a team physician for over 15 athletic teams,
including high school, college and national
championship teams. Dr. Plancher is currently the
head team physician for Manhattanville College. Dr.
Plancher is an attending physician at Beth Israel
Hospital in New York City and The Stamford Hospital
in Stamford, CT and has offices in Manhattan and
Greenwich, Connecticut.

Dr. Plancher lectures extensively domestically and
internationally on issues related to Orthopaedic
procedures and injury management. During 2001,
2002, 2003, 2004, 2005, 2006, 2007 and 2008, Dr.
Plancher was named among the Top Doctors in the
New York Metro area and to the sports medicine
arthroscopy program subcommittee for the American
Academy of Orthopaedic surgeons. In 2007 and 2008
Dr. Plancher was named America’s Top Doctor in
Sports Medicine. For the past six years Dr. Plancher
has received the Order of Merit (Magnum Cum Laude)
for distinguished Philanthropy in the Advancement of
Orthopaedic Surgery by the Orthopaedic Research
and Education Foundation. In 2001, he founded “The
Orthopaedic Foundation for Active Lifestyles”, a non-
profit foundation focused on maintaining and
enhancing the physical well-being of active individuals
through the development and promotion of research
and supporting technologies. www.ofals.org.

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