"Runners Knee" and how it happens:
The most common long-term running injury is appropriately called ‘runner’s knee’ and is loosely defined as a generalized pain behind and under the patella (Fig. 1). Runner's knee, also known as patellofemoral stress syndrome, is a condition characterized by the kneecap rubbing against the thighbone (femur) when moving. Your probably have runner’s knee if your knee cap hurts during long runs or when walking down stairs. Oddly, bicycling doesn’t seem to flare it up and may even help some who suffer with this troublesome condition.
Runner's knee may be caused by a structural defect, or a certain way of walking or running. Other causes may include the following:
- a kneecap that is located too high in the knee joint
- weak thigh muscles
- tight hamstrings
- tight Achilles tendons
- walking or running with the feet rolling in, while the thigh muscles pull the kneecap outward
In 2001, Long Beach, California’s VA Hospital (1) released a study that sheds some light on why runners are far more likely to suffer knee pain than cyclists. When most people run, they land on the outside bottom of the foot and roll inward toward the big toe (pronation). Their research demonstrated that the amount of inner twisting of the lower leg during running is related to how straight the knee is.(Fig. 2)
What are the symptoms of runner's knee?
- pain in and around the kneecap that may be felt with activity, prolonged sitting, occasionally resulting in weakness
- rubbing, grinding, or clicking sound of the kneecap that can be heard when the knee is bent and straightened
- kneecap is tender to the touch
Those are the most common symptoms of runner's knee. However, each individual may experience symptoms differently. As a result, I have begun advising my clients suffering from runner’s knee to integrate bicycle training to avoid ‘flare-ups’. Since bicycle training prevents complete knee extension, it seems to lessen patellofemoral pain.
A movement cue I’ve found helpful for relieving patellofemoral pain and many other lower quadrant problems is to ask the client to strongly contract your same side Glute-max upon heel strike during walking or running. The firing of Glute-max causes co-contraction of biceps femoris which prevents complete knee extension.
Treatment for runner's knee:
- your age, overall health, and medical history
- extent of the injury
- your tolerance for specific medications, procedures, or therapies
- expectations for the course of the injury
- your opinion or preference
The best course of treatment for runner's knee is to stop running until running can resume without pain. Other treatment may include:
- stretch exercises
- strengthening exercises
- arch support in shoes
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