“Knee problems should be checked out“

On April 22 and 23, 2017, thousands of runners will once again lace up their trainers to take part in races during the weekend of the Vienna City Marathon (VCM). In the run-up to the event , the medical team is pulling out all the stops to minimize the health risks to participants and to ensure that they can be on hand to provide the best possible assistance in the event of any competitors suffering falls.

“Many runners are so excited and enthusiastic about taking part in the marathon or relay events that all thoughts about their health go out of the window,” says Prof. Dr. Christian Gäbler, Head of the Center for Sport and Joint Surgery at Josefstadt Private Hospital and Medical Director of the VCM. “We believe it is our responsibility to encourage the participants to pay more attention to their fitness and physical condition. We do this using tools such as email campaigns and the VCM website.” For example, entrants new to running are advised to fill in the PAR-Q questionnaire*, which aims to help them determine whether they should consult a physician before taking up exercise. Moreover, for the last four years, every participant who registers for the VCM has also been asked to provide information about their health, such as details about any pre-existing conditions, medication they are currently taking or allergies. “We once, for instance, attended a runner who had collapsed on the course, but after entering his start number into our system we discovered, at the click of a button, that he had blood sugar problems. This enabled us to get to the root of his condition extremely quickly and respond appropriately,” says the VCM Medical Director. “The response rate is pleasingly high, with more than 50 percent of participants providing us with medical information before the event ,” says the specialist in trauma surgery and sports traumatology with some enthusiasm.

Runners forced to pull out in extreme cases

The VCM Medical Center at the Vienna Sports World Marathon Expo serves as a last-minute port of call for runners experiencing worrying health problems. The on-site team comprises experts in sports traumatology, sports physicians, sports scientists, orthopedists, internists, specialists in physical therapy and physiotherapists, all of whom have a keen interest in running. “Anyone who isn’t sure whether it is safe for them to run – due to a cold or muscular pain, for example – should drop in,” says Prof. Dr. Gäbler. “While we come across quite a few runners with cramp, for instance, every year we also see people suffering from cardiac arrhythmia, for whom the race could cause a serious medical emergency.” Each year, an average of 400 people attend the Medical Center with health problems before the start of the marathon. “Of these, we force around five percent to pull out. Without a doubt , this is one of the reasons why we haven’t experienced any serious medical emergencies at the Vienna City Marathon in recent years.”

Excessive strain a frequent problem

According to Prof. Dr. Gäbler, problems caused by excessive strain are the most frequent medical issues experienced by runners during training. “The Achilles tendon is the worst affected, followed by the knee and the foot – which is commonly afflicted by a heel spur or other similar problems,” explains the specialist in sports injuries. “More often than not these conditions are caused by unsuitable footwear,” says Prof. Dr. Gäbler. “Time and time again, I’m astounded by how much energy people put into this hobby without taking the time to undergo a running style and treadmill analysis and seek expert advice to help find the right footwear.”
He claims that fatigue fractures are quite a frequently occurring problem, especially in spring. “Vitamin D deficiency is endemic in Central Europe. Runners who increase the length of their training sessions very quickly and extensively are at a particularly high risk of suffering rapid stress reactions in their bones that subsequently develop into fatigue fractures. These are especially common in the knee, tarsal region and shin.”

Beware of meniscal damage

Prof. Dr. Gäbler claims that the majority of athletes unfortunately don’t consult their physician until a problem has already arisen. “At the Sportordination clinic in Vienna, I see around 4,000 athletes from a wide range of disciplines every year, and the majority of them suffer from knee or strain-related problems. Runners in particular have a tendency to trivialize knee complaints,” he continues, adding that this is especially problematic when meniscal damage is at the root of their knee pain. “The meniscus is a natural shock absorber. Over time, anyone who runs with a torn meniscus damages their knee as well. I often find that my patients already have significant cartilage damage.” Prof. Dr. Gäbler therefore makes an urgent appeal to all runners to always have knee problems checked out. He has successfully treated many patients with orthopedic aids. “I especially like to use the GenuTrain P3 in runners with maltracking of the knee. I’ve experienced a lot of positive results with this, as it often eases or even stops the athletes’ symptoms very quickly.
Above all , the specialist in trauma surgery and sports traumatology believes it is very important that “the use of orthopedic aids is always accompanied with targeted physiotherapy.” And what does Prof. Dr. Gäbler make of the rising popularity of compression stockings, which are also an increasingly frequent sight at the Vienna City Marathon? “I’m very pleased by this development! They are especially beneficial for long-distance runners during both training and races. I notice that runners who wear compression clothing recover a lot better than those who don’t.” As a marathon and half-marathon runner himself, he also has experience of this first hand: “I’ve felt the beneficial effects of these products on recovery in my own body, which is why I always wear compression stockings whenever I run more than 10 kilometers.” 

* The PAR-Q (Physical Activity Readiness Questionnaire) helps individuals determine whether they are ready to begin an exercise routine and was developed by the Canadian Society for Exercise Physiology.

Images: VCM/Michael Gruber, Foto Wilke