I used to run regularly but stopped when my left knee began to hurt. When I restricted my gym sessions to the cross-trainer I was pain free, but 10 minutes after going back on the treadmill, my knee started hurting again. It then made a “clicking” sound as I walked home. What have I done and how can I make it better?
Most of us will have knee trouble at some point in our lives, often because we expect this complicated joint to withstand all manner of use and abuse. Running sends large impact forces through your knees, so over time it is not so surprising that they start to complain.
It sounds as though you have developed a “chronic” injury: one that appears as a result of repeated stresses, sometimes over a very long period, rather than arising from a particular incident (twisting your leg, knocking your knee etc). There is usually more than one factor at work in chronic injury, combinations that might include your particular anatomy, a past injury affecting your running style, worn-out trainers, a change in your training pattern, or even your genes, age, or a bit of extra weight.
At its simplest, you may have been skimping on your stretching routine – if you don’t regularly stretch tight muscles, this over time can cause the kneecap to be pulled very subtly out of alignment. Another common runners’ problem is unbalanced leg muscles: too much outer thigh muscle development and not enough inner thigh, bum and hamstring strength. Again, this will upset the precisely tensioned ligaments that keep the knee moving smoothly.
As we hit our 40s, “wear and tear” becomes a factor, and the shock-absorbing knee cartilage can start to fray and tear, without much provocation. This is another common cause of pain, discomfort and a locking or clicking sensation.
Once chronic injuries appear, they tend to hang around unless you take action. Rest, by itself, is rarely the answer, but neither is ignoring the injury or simply carrying on training through pain. I suggest a visit to a sports physiotherapist or osteopath, so that they can examine your lifestyle and your legs to try and discover what has gone wrong.
A good sports physio is a detective: they will always try to find out what is causing the problem as well as treating the site of the pain or discomfort. This is essential if you are to return to running and avoid a repeat occurrence six months down the line. The physio may do hands-on treatment such as manipulation, massage or ultrasound, but they will almost certainly also give you stretching and other retraining exercises to do at home. And don’t be surprised if they locate the source of your trouble to your hip, back, ankle or foot: any of these could be the culprit.
With a good diagnosis and careful rehabilitation, most chronic injuries can be sorted, so don’t anticipate the worst. If you are diligent in following the therapist’s advice you should eventually be able to resume your running free from pain.