Happy Labor Day! The YMCA is closed today and we wish you a wonderful day with family and friends.

About six weeks are left until my half Iron Man! My main goals have been to get to that day healthy and to start and finish the race. If I do those two things, I will have reached my goals! And so far so good. However, sometimes people, including myself in the past, go too hard too soon in their training program and end up with injuries such as a “runner’s knee.” So what is runner’s knee?

The medical term for runner’s knee is chondromalacia, which is due to an irritation of the undersurface of the kneecap. That surface is covered with a layer of smooth cartilage. Normally, this cartilage glides easily across the knee during bending of the joint. In some individuals, the kneecap tends to rub against one side of the knee joint, and the cartilage surface becomes irritated, and knee pain is the result.

One of the reasons for chondromalacia is training too much, too soon, too fast. As I mentioned above, starting a running program that is too hard, too long and too high of a tempo can cause damage. Starting a competitive sport, such as soccer or basketball, without having a “base” (lack of conditioning) can cause trouble as well. Another reason can be due to an imbalance either through weakness or tightness of the lateral ligaments, making the patella (kneecap) move towards the outside. As the knee bends, the tension increases which can cause pain with bent- knee activities.

Chondromalacia often strikes young, otherwise healthy, athletic individuals. Women are more commonly affected with chondromalacia. Why this is the case is unknown, but experts think that it has to do with anatomical differences between men and women, in which women experience increased lateral (side) forces on the patella (kneecap). Even doing it the “right way,” you still might end up with chondromalacia.

Fortunately, most of the time, the pain around the patella usually can be resolved with non-surgical treatment with an exercise program led by a physical therapist. Of course, that is after first being diagnosed by an orthopedic surgeon — it might be something completely different. The orthopedic surgeon is knowledgeable about surgical procedures, treatment goals, musculoskeletal anatomy, and will set up a plan to improve the well-being of the patient.

If surgery is necessary, one of the more common procedures is an arthroscopic lateral release. It is aimed to release the tight lateral ligament, thereby decreasing the abnormal pressure on the underside of the patella.

Common preventative, and/or recovery exercises can be:

• Stretching: Stretching is vital to maintain or achieve good range of motion (ROM) around the joint. After an injury or surgery, scar tissue forms and soft-tissue contracts; this is when stretching is most important.

• Strengthening: Strengthening exercises are performed to help improve the function of their muscles. The goal is to improve strength, increase endurance and maintain or improve ROM.

• Ice and heat therapy: Ice and heat are useful to warm up and cool off the muscles. It also can stimulate blood flow and decrease swelling. These can be important aspects of the therapeutic process.

• Ultrasound: Ultrasound therapy uses high frequency sound waves (not within the range you can hear) to stimulate the deep tissues within the body (this case the knee joint). Deep tissues are stimulated by vibration of the sound wave. This leads to warming and increased blood flow to these tissues.

To find out if you have chondromalacia/runner’s knee is to be diagnosed by an orthopedic doctor. With him or her you can set up a treatment plan. Hopefully, sessions with a physical therapist and a regular exercise program will prevent you from having surgery. And if you do need surgery, follow the doctor’s orders! They can only fix the problem and guide you with a treatment plan; you are the one who is responsible sticking to it.

Ester H Marsh, Associate Executive Director JF Hurley Family YMCA