Steve Smith’s Blog

A Friend in Deed

“I have a pain in my knee, what should I do?” I overheard a runner ask his friend last week. I listened, mostly to see what kind of advice would be given, thinking the friend might be a physical therapist or a doctor. This could be good; I might pick up a golden nugget of knowledge. Sure enough, the answers began flowing in earnest. “Well, if you have pain in knee you need to foam roll and get a massage, and ice. And magnesium, take magnesium, it really helps.”

There were no questions about the pain, no inquiry about training or any of the other pertinent history taking that is vital to understanding the problem. There were no questions to rule out stress fracture, patellofemoral pain syndrome, patellar tendonitis, Pes Anserine bursitis/tendonitis, arthritis, torn meniscus, Bakers cyst, ACL/MCL tears, Plica, patellar tracking, femoral rotation control, faulty biomechanics, iliotibial band syndrome, or worse yet—pathology. There is a long list of reasons why a runner might have pain in the knee, but you need to know what the problem is before you recommend a treatment.

Here’s a true scenario of when I was a student and had a car repair shop. I worked with a fellow who was on a fast track to impressing a young lady:

Young lady: “My car is running kind of funny and there’s a ‘chingely-dingeley’ noise when I step on the brake.”

Casanova: “Oh man, that’s really bad. I had that same problem. You probably need a valve job.”

Young lady: “How much will that cost?”

Casanova: “About fifteen hundred”

The Organic Mechanic (Me): “Hang on. Your 12-year-old brother left his jar full of change in the storage compartment. It’s rolling back and forth every time you step on the brakes.” I removed the jar of coins and the noise was gone.

Sometimes it’s that simple: remove the jar of coins, change the lacing pattern on your shoes, place a neuroma pad in the forefoot, or put some tape on the knee and voilà—the problem is solved. I get lucky sometimes with simple solutions, and it’s very rewarding to be the one who solves a runner’s problem.

I would love to have been the guy who told mission control how to reroute the carbon scrubbers on Apollo 13 and save the day. Wow, that would have been fun to be a hero and save the lives of those brave astronauts. But, I just kept quiet and let the engineers do it. It’s their job, and even if I knew how, it’s best to ensure the professional can take a whack at the issue.

Okay, you get the point: unless you are a trained professional and are certain what the problem is, the best advice is to get an expert opinion. Don’t be a hero. Recommend your friend see the doc. The money he may spend will be offset by being able to participate in that race that cost him a hundred bucks or more.

Best of all, his knee will thank you for not running on a stress fracture that likely would have ended his running career.

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