by Dr. Cathy Fieseler
(First in a series)
Knee pain is one of the most common complaints for which runners seek medical evaluation. Running is blamed for many maladies; usually there is an underlying reason for the injury, whether intrinsic (anatomy) or extrinsic (factors outside the body, such as overtraining). Running has been blamed for the development of knee arthritis, though a 20 year study performed by researchers at Stanford University found a lower incident of knee arthritis in runners than non-runners.
Why do runners develop knee pain? A basic understanding of the anatomy is a necessary component in any discussion of knee injuries.
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Barefoot running/minimalist shoe is not a new phenomenon. Olympian, author, running guru and IAWR Faculty Member Jeff Galloway writes: “I’ve seen this fad come and go 5 times during my 52 years of running”.
The current craze results from the simultaneous popularity of two publications: 1) Bestselling book “Born to Run” by Christopher McDougall and 2) Research paper “Foot Strike Patterns and Collision Forces in Habitually Barefoot versus Shod Runners” by a team headed by Dr. Daniel Lieberman of the Department of Human Evolutionary Biology at Harvard University.
The mainstream media started publicizing claims that barefoot running reduces the risk of running injuries. Running shoe manufacturers were quick to jump on the bandwagon and bring out their own minimalist models, citing the Harvard study that purportedly concluded that these shoes would both overcome current injuries and reduce the risk of future ones.
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The Athlete’s Kitchen
Copyright: Nancy Clark MS RD CSSD June 2011
Nutrition for Injury Recovery: Update from ACSM
Each year, more than 5,000 health professionals gather at the Annual Meeting of the American College of Sports Medicine (ACSM; www.acsm.org). At this year’s meeting (Denver, June 1-4, 2011), exercise physiologists, sports medicine doctors, and sports nutritionists shared their research and offered updates. One of the updates will be of utmost interest to women runners.
Nutrition for Injuries
Unfortunately, part of being a runner seems to entail being injured; no fun. Runners with injuries should pay attention to their diet. If they are petrified of gaining weight (yes, petrified is a strong word, but it seems fitting to many injured athletes who seek my counsel), they may severely restrict their food intake. One marathoner hobbled into my office saying, “I haven’t eaten in two days because I can’t run…”
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by Dr. Cathy Fieseler
I’m a 25 year old female, and have been an athlete all of my life. I have been running regularly for 10 years and have experienced recurrent episodes of pelvic pain while running. This does not occur every time that I run and does not seem to be related to my menstrual cycle. I have altered my diet and the pain does not seem to be related to this. What is causing this problem and what can I do?
There are a numerous possible causes of pelvic pain. Osteitis pubis is an inflammation of the symphysis pubis (where the pubic bones meet in the front of the body). This area will be extremely tender to palpation. Most women who have had vaginal deliveries will have some changes on x-ray without any symptoms, so clinical exam is important. Osteitis pubis can cause pain radiating into the thighs and lower abdomen; it is aggravated by running.
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Solutions and preventative measures to preserve
the crucial cushioning in your knee
by Dr. Cathy Fieseler
(third in a series)
I am frequently asked questions about meniscus problems in the knee. The meniscus is a cartilage washer situated between the femur (thigh bone) and tibia (large shin bone); a meniscus is located on the inside (medial) and outside (lateral) aspects of each knee. The meniscus distributes the weight bearing stress placed on the other type of cartilage in the knee (and in all joints), articular cartilage, which lines the end of each bone (think of the shiny material at the end of a chicken bone).
The menisci (pleural) also provide some stability within the knee, acting like bumpers. When you hear about a professional athlete having surgery for a cartilage tear in his knee, this usually refers to a meniscus injury. Significant bending and twisting of the knee may cause the meniscus to tear; injury occurs more easily with age.
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by Dr. Cathy Fieseler
Another relatively common running injury is a stress fracture. My experience in my medical practice is that women comprise half of my initial stress fracture cases, but are four times more likely than men to suffer a recurrent stress fracture.
To understand stress fractures, a basic understanding of bone physiology is helpful. When stress is applied to bone (running), the bone breaks down and then rebuilds, becoming stronger than it was initially. The problem arises when too much stress is applied; the breaking down process overrides the rebuilding. This leads to micro-fractures and eventually a stress fracture. With additional impact, a stress fracture can become a complete break.
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Lack of running-specific strength in the lower limbs is the main reason why most runners get injured. Your hamstrings are no exception. We’ll examine what causes hamstring injuries in runners and the best way to avoid injuring your hamstrings.
In most non-running activities, a muscle is being shortened as it exerts force (e.g. performing a bicep curl). This is called a concentric contraction. However, in running, muscles are frequently being lengthened as they exert force. This action is known as an eccentric (pronounced ee-CEN-tric) contraction. Eccentric contractions are more damaging to muscles than concentric actions. Your hamstrings undergo an eccentric contraction every time you swing your leg forward (during the swing phase of the gait cycle). They contract and pull back on the leg as it moves forward. Regardless, the leg moves ahead, resulting in eccentric strain on your hamstrings. Imagine your hamstrings being stretched to the max as they try to shorten – approximately 90 times per minutes!
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Iliotibial Band Syndrome (a.k.a. ITBS or IT band pain) is one of the most common running injuries. The pain is debilitating, often stopping you dead in your tracks and forcing a long layoff from running. We’ll examine the cause of IT band pain, why commonly prescribed treatments are ineffective and the one exercise that you should do to alleviate this painful injury and get you back on the roads.
Sarah, one of the runners that I recently coached, had been suffering from IT band pain, which was preventing her from doing any running. To alleviate the pain, she had purchased an over the counter knee strap to be worn while running. In addition, her physical therapist had prescribed a heel lift to correct a minor leg length discrepancy. Her ITB symptoms decreased in severity, but two weeks later, she began experiencing knee pain in the same leg. When she attempted to increase her mileage, her IT band pain returned with a vengeance!
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By Dr. Cathy Fieseler
The foot is the body part that impacts the ground no matter what type of foot strike a runner employs. Last month’s article dealt with injuries to the big toe. This month, we’ll look at the most common cause of heel pain in runners – plantar fasciitis. Understanding the basic anatomy and function of the foot will help make sense of the treatment of this problem.
The heel bone is known as the calcaneus; the Achilles tendon attaches to the back of the calcaneus. A thick fibrous band called the plantar fascia attaches to the bottom of the heel. It courses through the arch of the foot and fans out to attach at the ball of the foot. The main function of this structure is to support the long arch of the foot. It assists with push off while running and walking, as it holds the foot stiff. If you pull your toes up, part of the band will be evident on the bottom of the foot.
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We are pleased to announce the first annual IAWR Women’s Running Telesummit. This unique event will be held November 29th – December 2nd, featuring five presentations from guest experts over the course of four days.
You can phone in and listen to each presentation from the comfort of your home, office or car. And – registration is free!
Learn how to:
- Train more efficiently and effectively so that you can improve your running without spending extra precious time
- Practice optimal nutrition for performance and maintaining your ideal weight
- Prevent, diagnose and treat injuries so that you can avoid frustrating layoffs that derail your progress
- Improve your running performance as you age
Join other women who share your passion for running and discover:
- Practical strategies for busy women to carve out time to get in your daily run
- How the women’s running community is revolutionizing both the running industry and fundraising
And more!
Click on Women’s Running Telesummit to find out who is speaking and when!
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