PUBLISHED 12/31/2003
Greyson Quarles took nearly 14 hours to complete his first Ironman Triathlon in early 2000, not a particularly good time, but he felt proud anyway. After all, he did it less than a year after one of Harvard's finest orthopedic surgeons took apart his left knee and reassembled it at a whole new angle atop his lower leg.
Quarles's surgery was expensive, debilitating, and included a then-unproven variation on cartilage repair. That didn't bother him, however. Certainly not as much as the thought that, without surgery, he wouldn't be able to walk out the door three or four times a week and simply start running. That's what Quarles had been doing for several decades, and that's what he wanted to continue doing. "My tombstone won't say 'CPA' or 'CFO,' " says Quarles, an executive vice president and the chief administrative officer at SAS, the statistical software giant. "It'll say, 'triathlete.' Running is my passion."
Quarles's passion is the simplest and purest of all sports, which probably explains its widespread popularity. To enjoy running, you need little more than a good pair of shoes. Of course, it also takes a decent pair of knees, and that's where the problems sometimes begin. Studies show that anywhere from 30 to 60 percent of runners get injured every year, and 30 to 50 percent of those injuries strike the knees and surrounding tissues.
Anterior knee pain. Patellofemoral pain. Chondromalacia. Iliotibial band syndrome. No doubt about it, the knee is a cranky little thing. You need only look at it to see why, and how it differs from the body's other major joints. The shoulder consists of a huge capsular contraption that holds the bones in place. The hip, too, is built like a suction cup. No such deep-fitting sockets for the knee, which swings almost like a hinge on a gate. But as the knee swings, it pivots to accommodate a thigh bone that's longer by design on one side than the other. Every flexion and extension and simultaneous rotation pulls into play four major ligaments that strap the joint together, some of them passing right through its center. No wonder it sometimes it gets sore or swollen--or worse.
The Knee Crisis
We're in the midst of a knee crisis, says Brian Halpern, M.D., a sports-injury specialist at the Hospital for Special Surgery in New York and author of the just-released The Knee Crisis Handbook. The knee held the No. 1 spot in a notorious top-10 list last year ["The Comprehensive Study of Sports Injuries in the United States," by American Sports Data, Inc.], beating out every other body part for the greatest number of sports injuries, according to a survey of more than 15,000 households.
Fortunately, for all its complexity, the knee is well designed to perform its most basic function--allowing you to walk and run in a straight line. Every fitness and medical expert recommends brisk walking as a great exercise routine, and a long-term study of the 50-Plus Runners Association of Stanford University has revealed that its 70- and 80- and 90-year-old members have few arthritis and joint pains. Fewer than nonrunners, in fact.
That said, no one can deny that runners get knee injuries, sometimes from physical differences that are difficult to control, and sometimes from personal training habits that we should monitor more closely.
High arches and low ones. Bow legs and knock knees. Too little strengthening. Too little stretching. Too many miles. Too many hills. And those are just the major culprits. Another one: the huge number of strides that a runner takes in a week, month, year--about 1,400 per mile. Each stride sends a jolt up your legs and through your knees.
"Think of running as a series of collisions with the ground," says Stephen Messier, Ph.D., a runner and orthotics researcher at Wake Forest University. (An important note: Those jolts also have a very positive effect. They build strong bones. Athletes in nonimpact sports, such as swimming, don't show the same bone-building propensity that runners have.)
When you walk, a force equivalent to several times your weight travels up your leg with each heel-strike. When you run, the shock forces increase. Yet running researchers tend to be running researchers, and while they recognize the price they may pay for enjoying their chosen sport, they don't see it as a reason to quit. There's no perfect training formula, but Messier, Dr. Halpern, and other knee experts believe runners can keep themselves sound--if they pay attention to their bodies and run at a level that's appropriate for them.
