Runners Knee

by Kenny Crampton, answer by Marius
(California)

Runners knee in the final period of training before a marathon is quite common.

How do you deal with this and what are some other possible explainations for knee pain while running - especially in a marathon training cycle?

Kenny sent this question which is in fact the second question with almost the same problem I've received in the last two weeks :

"With two weeks to go in my marathon training, I have some minor knee pain, but I am concerned.I really have had a great training experience leading up to the big day. Is it possible to just take the final 2 weeks off (and not lose my conditioning) to recover and still run a succesful marathon? Thanks!"

Kenny, this is quite interesting and I've been asked this many times before.

My experience, is that knee pain in a healthy runner like yourself is in 95 % one of two conditions :

• Runners knee with inflamed bursa


• Synovities in the knee

To get the right diagnosis see a running doctor - someone who is familiar with runners. Otherwise chances are they won't get you the right treatment.

How To Deal With Runners Knee/Knee Pain In Marathon Training Last Cycle

This is the deal : Both the conditions I refer to above are inflammations within closed "compartments" in the body - the bursa for the runners knee being a closed "sac" of fluid to prevent tendon friction against bone. The synovities being an inflammation of the synovial membrane around the knee joint.

In both cases you only have two "main" options :

1. Cortizone injection.

Which is recommended as this can clear the pain permanently within 2-3 days. Remember, these are closed areas meaning you will do absolutely no harm to "structures" around which is the common reason for avoiding using cortizone.

2. Rest with short runs to release knee pain.

The other option is to do the good old rest. In your case with the marathon coming up, taking total rest periods can lead to even more problems midways through the marathon as your muscles will be "off" from the lack of training last two weeks before.

My recommendation is therefore : 2 days off training, then one day with 20 minutes run in the morning on soft surface. Then 20 minutes in the evening the same day. One day off. Then 30 minutes in the morning, 30 minutes in the evening. Two days off, then 40 minutes in the morning, 40 minutes in the evening and so on.

Also, in the runs you can experiment with running and walking alternations. Either way, try and find a good way to keep some training going in the last two weeks - just to keep your muscles "going".

A third thing : you may try cross friction massage for the outer quad muscles. This can release some tension especially as you will be training less.

Best of luck with you knee and the marathon.

Marius