Hip and Knee 1

In the third of our `top tips’ series for a healthy run, Professor Benedict Rogers, consultant orthopaedic and trauma surgeon at Spire Gatwick Park Hospital, says look after those hips and knees – and he will be taking his own advice as he gets ready for his third Run Reigate half marathon.

“Every week, around a third of the patients I see have a sports injury. Often it is because they have done too much, too fast, too soon, or have continued to train through pain… don’t ignore symptoms. It is important to know the difference between pain and fatigue – fatigue is all part of the process of training, and this will improve, but if you feel pain, ease back or stop.

Why hip and knee injuries occur

Tendonitis – The most common injury to the knee or hip is tendonitis which is inflammation caused by over strain or doing an activity that your body is not used to.  It often occurs around the outside of the knee (known as Runner’s Knee) with pain when you are active or after sitting for long periods with knees bent. In the hip,  tendonitis can develop in the outer area of the bottom.

If you push through this pain, you will get to the stage when you can hardly run at all. Rest and ice the area and when the pain is alleviated and modify your training schedule. Break your usual running route down into 10-minute bursts and add in a good mix of non-weight bearing exercises (ie. cycling or swimming) to reduce the impact on your knees.

Stress fracture of the femur – I often see this in non-runners who decide to do a half marathon and start too fast. The `honeycomb-like’ centre of the bone naturally breaks down and renews during activity. A stress fracture occurs when this `honeycomb’ is broken down faster than it can be made. If you build up mileage gradually your bones will accommodate that. But if you start too fast it can lead to a stress fracture.  The pain is a deep, dull gnawing or aching in the groin or front of the hip and sometimes felt in the thigh. Rest and seek medical advice. An MRI scan will pinpoint the problem.  Female long-distance runners who are underweight are also at risk of stress fractures. Continued training with a stress fracture could lead  to a complete bone break.

A weighty problem:

When running, the force which goes through the knee is eight to 10 times your body weight (three to five times for the hip). So, if you gain a stone in weight, an additional 10 stone is transmitted through your knees when running.  Aim for a healthy diet and incorporate Vitamin D and calcium for strong bones.

The importance of stretching

The ilio-tibial band is a large muscle-tendon unit crossing both the hip and knee- at its shortest when sitting and longest when running. Changing from sitting to running without warming up and stretching risks injuring this muscle. Stretching is important before and after running and on the days between training sessions – try yoga, pilates or an exercise foam roller.

As you get older, muscle flexibility decreases at a greater rate than its strength so stretching exercises become increasingly important.