If you run like a duck, your knees may pay the toll

No matter what you think of George W. Bush the president, you have to admire George W. Bush the runner.


He's devoted to fitness, and he's fast.

But lately, Bush is an also-ran -- so to speak.

The president was sidelined in December by a knee injury. As of last week, he had run only once this year, a White House spokesman said.

Instead, Bush is using an elliptical trainer, jogging in deep water and taking some rest days from exercise.

That sounds familiar. I'm in the same fix. Like the First Runner, I had the symptoms:


  • Pain on the inside of a knee during and after exercise.



  • Pain if I pulled the heel of the problem leg tightly up to my buttock for a "quad stretch."


    So the president and I had x-rays and an MRI. And then we heard the same diagnosis: damage to the knee's medial meniscus cartilage, a crescent-shaped pad of shock-absorbing tissue that runs horizontally on the inside of the kneecap.

    Aha, runner's knee.

    This is a fairly common injury, especially among those who've run for a couple of decades.

    It's often caused by impacts to the outside of the knee, and by doing deep knee bends.

    But one expert says it also can be the result of bad running form. Exercise physiologist Richard Lampman is so concerned that, when I called him about my knee, all he wanted to talk about was the president's knee.

    "I'm writing a letter to him," Lampman said. "I think he's hurting himself, the way he runs."

    Lampman, 61, was a college star at Penn State and is a former triathlete who still runs a lot. He has strong opinions about form. In this case, the problem can be "running like a duck," as he puts it. That's running with the ball of the foot landing outside of where that heel landed.

    So I asked him to share his letter to the White House. Now, you and I can see excerpts at almost the same time as a certain runner in Washington, D.C.:

    Dear President Bush,

    ... As you know, the usual prescribed treatment for knee discomfort from running starts with the simplest approaches: nonsteroidal anti-inflammatory drugs, icing, rest and cross-training with nonimpact activities ...

    But before you return to running routinely, Mr. President, I encourage you to check your form against a simple principle of biomechanics ...

    I did note on a television video clip that you might be landing at the point of heel strike with your right toe pointed somewhat laterally; that is, not parallel to where your left foot had struck the ground. At the time of heel contact with the ground, the front of your running shoe should be pointed directly forward.

    If the front of your shoe angles to the outside, the result can be excessive pronation of the foot, producing abnormal torque to the knee, and possibly resulting in a knee injury -- especially after the repeated impacts of a habitual runner.

    Good luck with your jogging program ...


    Richard M. Lampman, PhD
    Director of Research, Department of Surgery, St. Joseph Mercy Hospital; and Department of Physical Medicine and Rehabilitation, University of Michigan Medical Center, Ann Arbor, Mich.


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