DON'T BE A KNEE-DY RUNNER
Athletes must take special care when it comes to protecting their most vulnerable joint
For runners suffering from their first knee injury, there's no shortage of advice about the best way to nurse their joint back to health. But what most runners really want to know is how long it will take before they can get back to pounding the pavement. Will a few days of rest do the trick, or can they expect the pain to stick around for weeks?
Knee injuries are so common among runners that the topic has warranted a respectable amount of interest from researchers, with one study suggesting it takes 75 to 88 days to recover from chronic knee pain. There are two primary locations for running-related knee injuries: around the kneecap (patellofemoral syndrome) or along the side of the knee (iliotibial band syndrome). Much of the blame for runners' knee pain falls to overuse — too many miles and not enough rest. But there's actually lots of blame to go around, including biomechanical or structural abnormalities and the favourite among the over-45 set: age-related wear and tear.
In an attempt to find out more about runners and their knees, a group of researchers from the Netherlands reached out to novice runners registered for three popular road races, involving distances from five to 42 kilometres. Questionnaires were distributed before the race, one day after the race and again one month later. The initial query gathered baseline information: age, weight and height, along with training frequency, experience, running speed, average weekly mileage and training surface (pavement, concrete). Runners were subsequently grouped based on their experience (zero to four years, four to 10 years and more than 10 years) and average mileage (zero to 15 km, 15 to 30 km and more than 30 km).
Anyone who reported a knee injury — which was defined as any musculoskeletal complaint of the knee that restricted training frequency, distance, speed or duration for at least a week or that needed consultation with a medical professional — was included in the study. Injured runners were asked about the severity of pain at rest and while running, how long it took for the pain to subside and their diagnosis (self-diagnosis or that offered by a medical professional) as to the type of knee injury. Information was also collected about how they managed pain, whether they consulted a health-care professional and what type of treatment plan, if any, they employed.
Fourteen per cent (277) of the 2,000 runners who responded to the initial query by the research team reported experiencing a knee injury sometime after competing in the road race for which they were registered. Males who ran twice a week totalling an average of 2.5 hours at a 6 min/km pace were the most likely to be injured. More than half of everyone with knee pain either modified their training frequency or their speed as a consequence of the injury.
Most of the runners recovered within eight weeks of first experiencing pain, but onethird claimed to fall short of full recovery up to a year later. Males recovered faster than females, with women taking, on average, two weeks longer to heal. As for what type of injury was the slowest for recovery, osteoarthritis of the knee earned the dubious honour of keeping runners laid up the longest.
“This association is in line with the fact that knee osteoarthritis is a chronic progressive condition and a major cause of musculoskeletal disability in older populations,” said the study's authors.
What does all this mean to the average recreational runner?
First of all, knee pain happens at one time or another to almost all runners, so don't fret. But what's worth noting in this study is that once pain sets in, it can be weeks before the knee feels better. And despite attempts to dial back speed, distance or training frequency, there's no proven shortcut to healing.
The key to keeping the knee healthy, especially among novice runners, is to avoid that first bout with pain by following a progressive training routine that errs on the conservative side when it comes to volume and frequency. If and when pain does flare up, treatment guided by a medical professional is worth considering. And while there's no guarantee that your time on the mend will be reduced, education on the best path to recovery and advice on how to ease back into running are investments worth making.
“The relatively long duration of knee symptoms after an injury emphasizes the need for optimal treatment, education and injury prevention programs for recreational runners,” said the researchers.
The knee is a runner's most vulnerable joint, so don't make the mistake of waiting until the injury progresses to the point that it forces an extended road to recovery. Early diagnosis and treatment are the keys not just to getting back up to speed, but to years of pain-free running.
What's worth noting in this study is that once pain sets in, it can be weeks before the knee feels better.