Running Q&A: What's behind sudden knee pain?

IT-band syndrome and other knee problems are among the most common overuse injuries  Credit: Clive Mason/Allsport
Q: I am a runner and have been a long-distance runner for the past 15 years. I have had no injuries, until now. I have just moved into a new home, and I am running the same distance I ran before the move. However, I have the worst pain on the outside of my right knee. Why, after all these years, has it popped up now? K.C.

A: My best guess is iliotibial band syndrome, unless you sustained an injury during your move.

The iliotibial band is a sturdy sheet of tissue that runs from buttock muscles down the outside part of the leg to insert in the topmost part of the lower leg bone the tibia.

Test my diagnosis: Bend your right knee 30 degrees. Hurt? A 30-degree bend of the knee is the point of maximal pain in this syndrome.

Overuse is a common cause of the trouble. You can't be faulted for that. You've been running the same amount for 15 years.

If the surface you run on is different from the surface at your former home, then I'm even more convinced the answer is iliotibial band syndrome. A sloping road puts abnormal force on one leg and that, in turn, irritates the iliotibial band.

Rest and anti-inflammatory medicine aspirin, ibuprofen and the rest can usually put an end to the pain.

If your doctor concurs in this diagnosis, and when you are pain-free, begin exercises that strengthen hip and leg muscles. Since it's your right leg, I'll tailor the instructions for right iliotibial band syndrome:

Lie on the floor on your left side. With the right leg straight, lift it 30 degrees and hold it there for one full second. Repeat the exercise 15 times. Increase the number of lifts by five each day until you can do three sets of 30 lifts throughout the day. If, at any time, the exercise hurts, stop and return to your doctor.

Q: When doing stretching exercises, how long do you hold the stretch? R.R.

A: Hold the stretched position for 15 to 30 seconds. If pain occurs, cut the stretch time and/or reduce the distance stretched.

Stretching improves flexibility, and that enhances athletic ability.

Q: What's the word on caffeine and endurance? I hear two different stories. One says that caffeine increases endurance; the other, that it either has no effect or that it tires you out more quickly. M.R.

A: Caffeine does enhance endurance. Its use has the Olympic Drug Committee in a quandary. They allow a caffeine blood or urine level that's indicative of having drunk three to six cups of coffee in one 24-hour period. Some members feel that this is far too lenient an allowance.

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