Is Runner’s knee the price of running?

… It does not have to be …

What is runner’s knee?

Runner’s knee is a term commonly used to describe anterior knee pain and could also be known as Patellofemoral Pain Syndrome (PFPS). This is the most common diagnosis is runners with knee pain. The patellofemoral joint is formed by your patella (kneecap) and the ends of your femur. The patella works as a lever around your knee to enhance the action and force of your quadriceps muscle.

PFPS is often related to overuse and could present if there was a change in the intensity, duration and/or frequency of training. A change in the type of training should also be noted. A history of previous injuries such as patella dislocations, ligament injuries and trauma could increase the risk for PFPS.

Signs and Symptoms

Runner’s knee is usually described as pain “behind”, “underneath” or “around” the patella.

This pain usually occurs gradually as activity increase, but it could also be caused by a traumatic event.

Symptoms include:

• Stiffness and/or pain when sitting with your knees bent for a prolonged time

• Pain with activities that load the PF joint like climbing stairs, squatting and running

• The pain may be difficult to localise and could be described as the whole anterior knee.

• The pain is described as “achy” but could also be a sharp pain

• Patients could report a feeling of the knee giving way, a popping or catching sensation, but no “locking”

Risk Factors

Factors that could contribute to the development of PFPS:

• Anatomic abnormalities of the patella or knee joint – poor tracking, valgus

• Mal-alignment or altered biomechanics of the lower limb including excessive pronation of the feet, rotation of the Tibia or femur/hips.

• Muscle dysfunction – weakness or delayed firing of quadriceps (VMO)

• Hyper-mobility of the patella (ligament laxity)

• Tightness or decreased flexibility of the quads, hamstrings, ITB or gastrocs

Should I hang up my running shoes?

No…

1. Relative rest – If you are a runner, this could entail decreasing your mileage to a level that does not provoke pain. If you do resistance training, decrease the frequency, load or repetitions to a point of no pain. This allows for healing without losing your level of fitness.

2. Alternative exercises – try a different type of exercise that has a decreased loading effect on your PFJ such as swimming, cycling, walking or an elliptical trainer.

3. Physiotherapy – the aim of physio would be to:

• Develop a structured rehabilitation program to correct / address the problem causing the pain.

• Correct patella alignment with taping or exercises

• Strengthen weak quadriceps muscles and optimal firing of the VMO muscle

• Stretch or release tight quadriceps, hamstring or ITB

• Assess and correct abnormal biomechanics of the lower limb kinetic chain including the hips, knees and ankles

• Manage pain, including icing, ultrasound, TENS, laser therapy and taping to enhance recovery

4. Other – bracing, taping, foot orthotics

So, let’s rest and sort out that knee to get you running free of charge again…