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Week of 13 February 1998

Vol. I, No. 20

Health Matters

Answering your knees when they knock

I recently took up running, and my knees are sore after I run. Is this normal, or should I stop?

You don't need to stop forever, but you do need to determine the cause of the pain. Until that happens, follow this simple piece of advice: if it hurts, don't do it. According to Anthony Schepsis, M.D., chronic overuse injuries (as opposed to acute injuries, such as a sprained ankle or torn ligament) may have many different causes, which may take time to isolate and treat. The worst thing you can do is ignore your pain, because you may make the problem worse.

Faulty training accounts for most sports overuse injuries, according to Schepsis, who is director of sports medicine at the Boston Medical Center and associate professor of orthopedics at the BU School of Medicine. "If people have been sedentary for a long period of time and decide they want to train, they can't just start out going full tilt," he warns. "Often people will start by running too fast, too hard, and for too long a period of time. If you haven't been exercising, begin with short runs at slow paces, slowly increasing your speed and distance and taking days off in between to allow your body to adjust."

The quality of your exercise shoes is also vitally important for healthy joints, bones, and muscles. "You used to be able to look at a shoe and know its condition," he says. "But running shoes today are made with very resilient outer soles, so you cannot know at a glance whether or not you need a new pair." He recommends getting new running shoes every 400 miles.

Another factor that could cause overuse injuries is the improper alignment and movement of your body when you exercise. In addition to speaking with a sports medicine physician, you can also seek advice from physical trainers and others who have extensive experience with the sport. Frequently they will have certain tips that may help you with your problem.

If you try changing the way you exercise, but still feel sore or notice swelling, locking, or buckling of the joint during or after exercising, you should seek medical help from an orthopedic specialist. Fortunately, most overuse injuries do not require dramatic measures such as arthroscopic surgery. Often you will require only some advice and physical therapy.

Individuals recovering from overuse injuries in sports that involve running, such as tennis, basketball, and soccer, should try activities that do not place a high amount of stress on their knees and ankles. Swimming usually provides good exercise during rehabilitation, for instance. You can switch to a stationary bike and ultimately return to the regular exercise. The amount of time for rehabilitation will be different for each injury; your doctor will be able to set up an exercise regimen with you.

A knee brace may be effective with certain kinds of injuries. "While most research indicates that braces offer only minimal protection, users feel a greater sense of protection and assurance from wearing them," Schepsis says.

Finally, if you have a previous acute injury, be especially cautious when resuming your sport. According to Schepsis, sports that involve vigorous running can accelerate the wear and tear that occurs with joints. If you listen to your body, he advises, you will know your limits.

"Health Matters" is written in cooperation with staff members of Boston Medical Center. For more information about knee injuries or other health matters, call 800-841-4325.