#1: Runner's Knee and ITBFS
Runner's knee is often called ITB friction syndrome (ITBFS), but the two are actually different things. "Runner's knee happens when cartilage in the kneecap is irritated, while ITB friction syndrome occurs when the tendon from your hip to the outer knee gets tight and inflamed, irritating the outer bone of the knee," says Leon Popovitz, MD, founder of the New York Bone & Joint Specialists in New York. Combined, these two make up a majority of the knee problems runners experience.
So how do you tell the difference? With ITBFS the pain is usually isolated outside of the knee, says Dr. Popovitz. The tendon will feel very tight (almost like a cord) and pain will often radiate up into the hip. Both runner's knee and ITBFS will flare up when you're going up or down stairs. Or if you sit for a while you might have some stiffness and difficulty getting up.
Fix It Fast: Dr. Popovitz says the number of patients he sees with ITBFS and runner's knee increases right before the New York City Marathon, as runners are increasing their mileage. With runner's knee, Dr. Popovitz recommends hamstring stretches and leg lifts at home, in addition to physical therapy — though he's aware many of his patients suffer through it until after their race. For ITBFS, the only way to cure it is to completely stop running, rest, and alleviate the tendon inflammation with physical therapy. (We know. Not something you want to hear a week before your big race!)
The meniscus is a C-shaped disc that cushions your knees on both sides to absorb the shock in your joint and to hold your knee in place. Through sharp pivoting and turns, you can tear the meniscus — and in extreme circumstances your ACL, the ligament in the center of your knee that limits rotation and forward motion. "If you find yourself feeling suddenly stiff, or have an occasional sharp pain inside the knee with swelling, as well as your knee locking or buckling, these could all be signs of a meniscus tear," says Dr. Popovitz.
Fix It Fast: Dr. Popovitz says that not all tears have to be repaired with surgery. But because it's such a minimally invasive procedure, many runners choose to get it done so they don't have to constantly worry about their limbs. Depending on where the tear is and how serious it is, smaller ones can be treated with resting the knee, frequent icing, and physical therapy.
You could run 5Ks or marathons, but eventually almost every runner suffers from shin splints, often caused by overuse. You'll know you have them if you feel a dull throbbing in your shins every time you go to lace up. However, Dr. Popovitz warns that shin splints can often be sign of an underlying issue. If you experience pain when you're not running, especially when walking on concrete or at night, you'll need to see a doctor for an X-ray or MRI to make sure it's not a stress fracture.
Fix It Fast: For immediate relief, Dr. Popovitz says you can use an anti-inflammatory like aspirin to ease any discomfort. Regular stretching, physical therapy, and running with neoprene sleeves to warm up the leg muscles also may help.
Exertional Compartment Syndrome
If you're jogging along as usual and suddenly about a mile in you feel a shooting pain up your leg, you may suffer from exertional compartment syndrome. This is when the pressure in the compartments of your leg increases to the point of extreme pain — and because your legs are encapsulated, that pressure has nowhere to go, explains Dr. Popovitz. It may not bother you in your everyday life when you're not running, but this condition needs immediate attention.
Fix It Fast: The fastest way to alleviate symptoms of exertional compartment syndrome is to rest. In severe cases, surgery may be needed to release pressure of the muscles. Either way, make an appointment with your doctor if you notice symptoms. "Pain can be a good thing — it tells us something is not right with our bodies," reminds Dr. Popovitz.
Another common condition is Achilles tendinitis. This is when the tendon that connects your calf muscles to your heel bone becomes overused or suffers from tendinopathy — micro partial tears of the tendon, Dr. Popovitz explains. Symptoms include heel pain or stiffness after exercising, or swelling that is present all day, and gets worse during exercise.
Fix It Fast: To prevent tendinitis from occurring in the first place, it's important to take the time to stretch before and after running. Dr. Popovitz also recommends making sure you have the right running shoes and replacing them often — every six months or 300-400 miles.
Originally published on FitnessMagazine.com, April 2013.