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Runner’s Knee

Runners are far more likely to suffer knee pain than cyclists. The most common long term injury in runners is a condition called runner’s knee in which the back of the knee cap rubs against the front bottom of the femur, the long bone of the upper leg. If it hurts to push the kneecap against the bone behind it, you have runner's knee.

The back of the kneecap is shaped like a triangle with the point fitting in a groove in the lower part of the bone behind it. During running, the knee cap is supposed to move up and down and not from side to side. When you run, you land on the outside bottom of your foot and roll inward toward the big toe side of your foot. This is called pronation. It forces your lower leg to twist inward while at the same time, three of the four quad muscles attached to the kneecap pull the kneecap outward, causing it to rub against the bone behind it.

The amount of inner twisting of the lower leg during running is related to how straight your knee is. Bending your knee decreases inner twisting and rubbing of the knee cap against the bone behind it. People with runner’s knee usually can pedal a bicycle with their seats set lower than normal to prevent their knees from straightening completely. Orthotics, custom- fitted inserts in the shoes that restrict pronation, may help. They can also use special exercises that strengthen the vastus medialis muscle above the kneecap that pulls the knee cap inward when they run or pedal.

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Dear Dr. Mirkin: Will eating oat bran help to prevent a heart attack?

No single food causes heart attacks and no single food prevents them. Cereals containing oats may claim that their soluble fiber lowers cholesterol, but you can also get soluble fiber from most fruits and whole grains. You will raise your cholesterol if you take in more calories than you burn, no matter how much soluble fiber you eat. You may read that you should eat olive oil because it contains monounsaturated fats that help to prevent heart attacks, but you can also get monounsaturated fats in peanuts, nuts, sunflower seeds and many other seeds. It's your total intake of nutrients that counts. You can't prevent heart attacks just by eating oat bran, olive oil, fish oil or any other specific food. The best research on diet available today shows that if you want to prevent heart attacks and many cancers, you should eat a wide variety of fruits, vegetables, whole grains, beans and other seeds.

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Dear Dr. Mirkin: What can I do to stop the constant sore throats that get passed around our household?

If you have recurrent throat infections with staph or strep bacteria, check your toothbrush, your nose and your mate. One study showed that beta strep, which causes rheumatic fever, was grown from toothbrushes of 30 percent of children who were infected with that germ. Beta strep can persist in unwashed toothbrushes for 15 days and in washed toothbrushes for 3 days. Another bacteria called staph aureus can persist in the noses of people even after they have taken the appropriate antibiotic. Having staph in your nose also prevents simple cuts from healing.

Staph grows so luxuriously in the wet nasal membranes that it is difficult to cure by taking oral antibiotics. You can also be re-infected by a mate who has no symptoms at all. If you suffer recurrent staph or strep infections, get a new toothbrush and ask your doctor to culture your nose. If you have a staph aureus infection, apply an over-the-counter antibiotic ointment such as Bacitracin in your nostrils nightly for several weeks.

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June 27th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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