Health Column: Runner preparation can pave the way

Common afflictions many runners experience can often be addressed with moderate changes that don’t require abandoning the sport altogether.

Runner’s knee, known medically as chondromalacia patellae, is associated with excessive wear between the kneecap and the end of the femur, the upper leg bone. When the bones meet properly, the kneecap moves smoothly within an indentation at the lower end of the femur. When alignment is incorrect, the kneecap grinds against one of the slopes in the indentation instead of staying in the hollow where it belongs. If the grinding is prolonged, some of the kneecap’s cartilage becomes worn, resulting in pain, stiffness, and swelling.

The exact cause of runner’s knee is still unknown. Many doctors will encourage their patients to stop running. Most runners, of course, would never consider this suggestion. Often, such drastic measures are not really necessary.

Runner’s knee is often relieved by reducing distance, special exercises to strengthen the quadriceps muscles and running on a surface that slopes downward toward the injured side. Many doctors believe runner’s knee is not really a knee ailment at all, but a foot problem. It’s caused by faulty weight-bearing characteristics that produce misalignment of the tendon in which the kneecap lies. This subjects the kneecap to a great deal more motion and stress than it was designed to take. The condition will often disappear after a runner starts wearing inserts — orthotic devices — that change the foot’s support patterns and shift the relationship of the kneecap and femur.

Shin splints are inflamed muscles and tendons. Although they occur most often in beginners, they sometimes develop in advanced runners during intense training. Shin splints range greatly in severity. Sometimes they’re nothing but a dull ache. At other times they’re painful enough to make running impossible. The usual cause of shin splints is an imbalance between the muscles in the front and back of the leg. The problem is precipitated by jolts, running too high on the toes and wearing shoes that are too stiff. Running on a softer surface and wearing flexible, well-padded shoes usually help clear up milder cases. Heel lifts may provide relief and orthotic devices will rebalance the foot if necessary.

Stress fractures can occur anywhere, but are most often found in the longest toe bones (the metatarsals) and the two bones of the lower leg, the tibia and fibula. They’re minor changes in a bone’s structure, usually brought about by strain, and often are mistaken for shin splints or bruised feet. Some authorities feel there is more of this type of disorder today than ever before because of the current trend toward distance training. Stress fractures almost always heal in six weeks or so if running is reduced to the point where it is comfortable. Running on a soft, yielding surface and orthotics for any correction of imbalance and redistribution of weight stresses help.

Dr. Peter Kilfoil is a podiatrist with offices in the Feather Hill Shopping Center in Southold and the Riverhead Professional Building.