MapMyRun
1. What exactly is runner’s knee?
Runner’s knee, also called Patellofemoral Syndrome, is a general term to describe pain located around the kneecap (patella). It is called Runner’s knee because it is commonly experienced by people who participate in sports that specifically involve running, although it can occur with any activity that involves repeated stress to the knee joint. You don’t have to be a runner to have a runner’s knee. Most common symptoms are a dull ache or sharp pain, stiffness, grinding, or clicking on or around the patella. Runner’s knee is more common in women than in men. Runner’s knee, and the subsequent pain, occurs when the patella rubs against areas of the knee it’s not supposed to. This can lead to pain and inflammation. In most cases, runner’s knee is not a structural problem and can be alleviated with nonsurgical means, such as cold packs, anti-inflammatories such as Ibuprofen, a stretching and strengthening program, and working with a physical therapist.
2. Is the runner’s knee caused by just one thing? How do runners find themselves with the injury?
Runner’s knee can have various causes. Some of those possible causes include: weak and/or tight muscles in the hip, knee, and/or ankle, trauma to the knee, osteoarthritis, poor tracking or alignment of the patella, or with overuse with activities such as running, jogging, stair walking, hiking, jumping or squatting..
3. What is the best way runners can avoid knee injury?
Runners can avoid knee injury in several ways.
- Stay conditioned – keep your overall body health in check,eat healthy, lose weight if necessary, and stay fit.
- Slowly increase training intensity – progressing too fast can lead to injury. Often, keeping a log of your training routine can be helpful so if injury does occur, a health professional can refer to the log to determine if something was incorrectly performed or progressed.
- Stretch/strengthen – it is important to incorporate a routine that addresses areas that lack flexibility and muscles that are weak. Stretching before running will allow for ideal flexibility to prepare for running.
- Keep good form/mechanics – maintaining your body, including your trunk, hips and legs, in an optimal position while running, will minimize abnormal mechanical forces that could aggravate certain areas over time. If needed, consult with a physical therapist who among other things, will analyze your gait to advise appropriate education and advice.
- Good shoes – invest in good shoes which will allow for support to the feet which can help minimize impact and excessive stresses into the ankles, knees and hips. Get customized arch support or orthotics if needed for additional support.
- Run on good surfaces – do not run on hard surfaces such as concrete which have little to no shock absorption.
4. What are your three favorite exercises to strengthen knees and prevent runner’s knee (name/short description/why it works)?
In my experience, the most common mistake runners make when attempting to do a strengthening program to prevent a runner’s knee is that their exercises only target the knees. While strengthening the muscles around the knees, including the hamstring and quadriceps, is important, the key areas to target are the hips.
- Bridges: lie on your back with your knees bent and slowly lift your hips up toward the ceiling using your buttocks to stabilize. Hold this position then slowly lower your hips back down to the surface. Make sure to keep the knees apart and parallel to each other and the shoulders, hips and knees aligned when in the bridge position. Can add resistance band around thighs to make it more challenging. Do 2-3 sets of 10, hold 2-5 sec in bridge position. This is a great exercise for strengthening the glute muscles which are important to support the knees. Also, the bridge promotes hip extension which is an important component of running.
- Clamshell exercise: lie on side with knees bent and one leg directly on top of the other. Slowly lift the upper knee while keeping the feet in contact with each other. Slowly lower the upper leg back down. Turn to the other side to address the opposite leg. Can add resistance band around thighs to make it more challenging. Do 2-3 sets of 10.. This is a great exercise for strengthening the gluteus medius. The gluteus medius plays a crucial role in hip stability, which is needed to promote proper mechanics for the hips and legs during running. The clamshell exercise also promotes general hip mobility. Having good hip mobility protects the low back and knees because if the hips aren’t moving then the low back and knees get all of the stress and strain.
- Squats: stand tall with feet shoulder width apart. Keep knees centered over feet. Slowly bend hips, knees, and ankles like you’re going to sit into the back of a chair, until you reach around a 90 deg angle. Slowly stand back up and return to the starting position. Do 2 sets of 10. As it becomes easier, progress to single leg squats lifting one leg in the air as you squat while standing on one leg. Squats are a great total body exercise that strengthen key muscles in a functional manner. Addressing the strength and mechanics of the lower legs by doing squats has a great carryover for runners.
5. Anything we didn’t cover that you think I should mention?
Runner’s knee is common in both runners and non runners. The lower leg relies on a balance of flexibility and strength. Small deviations in flexibility and strength can lead to imbalances in the hip, knee and ankle, and can ultimately lead to altered tracking of the patella. Most often, runner’s knee is very treatable. Schedule a physical therapy evaluation.
Eric Ullman, PT, DPT
Physical Therapist
Owner of ReThrive Wellness, PLLC
ericullman@rethrivewellness.com
www.rethrivewellness.com