What is Runner’s Knee?

Approximately 36 million Americans participate in running each year, with roughly 10.5 million running at least 100 days a year. With so many health benefits, from reducing chronic disease to the feels good runner’s high, it is easy to see why so many people participate in this movement pattern. As with any sort of movement, injuries and pains can occur, and this is no exception when it comes to running.

The knee is the most common site of running injury, and a common thing you might hear amongst runners is, “My knees hurt”. If you ask them where, they might point towards the area below their patella (patella) or maybe towards the medial/lateral side of their knees. It can also appear in people when they hike, use the stairs, or after sitting for a long time. This pain is potentially patellar femoral pain syndrome (PFPS), or  “Runner’s Knee”, a catch-all term for pain around the knee.

Why Does it Happen?

There are several theories out there that can explain why this knee pain happens. One theory is that the most common mechanism of injury in PFPS is maltracking of the patella. In a normal knee, the patella should glide smoothly in between the two condyles of the femur in the trochlear groove, sort of like a train on a track. In individuals with PFPS, it has been observed that the patella does not track in the grove, but instead takes a different path during knee flexion, generally over the lateral condyle of the femur, similar to a train going off its tracks.  This abnormal tracking can lead to increased pressure and grinding underneath the patella, which leads to damage of the cartilage and pain throughout the area. The cause of this maltracking is multifactorial, with muscle weakness and/or muscle tension being the main culprits.

What Can We Do?

When we talk about stretching and strengthening, we have to consider that the knee is a joint that is in between two other joints; the hip and the ankles. Pain that is localized around the knee can be caused by issues upstream and downstream from the affected location. Starting from the hips, we can work on stabilizing the hips better by strengthening our hip abductors, external rotators and gluteal muscles (particularly glute medius), along with stretching our hip flexors, IT band, and hamstrings. Looking at the muscles that attach around the knee, many runners tend to have strong, overdeveloped quadriceps and weak, tight, underdeveloped hamstrings. Correcting this muscle imbalance can not only help you prevent runner’s knee, but also help you improve your performance. Moving downstream, we have to pay attention to how our foot and ankle moves. People who over pronate (foot/ankle roll too much) or under pronate (foot/ankle do not roll enough) can be vulnerable to knee pain, so make sure to have proper footwear and body awareness. A running gate analysis is a valuable tool for identifying and correcting pronation and body movement.

Even with proper strengthening, stretching and footwear, your knee might still give you problems. If this is the case, you need to take into account your running stride and training plan. Over-striding can cause knee pain due to inefficient body position, despite good strength and flexibility. Proper progression during training is vital as well. The body needs time to rest and recover. This is where your body and muscles will adapt and grow stronger from the stresses due to running and strength training. Going overboard by adding mileage, intensity, and duration can lead to overuse injuries and will not allow your muscles that time to rest. Some people have asked if they could use something to place over their knee to help with the pain. These devices, such as KT tape or a knee brace, can help decrease the pain and symptoms of runner’s knee, but does not fix the underlying problem.

If you ever need any help or have questions regarding runner’s knee or how to correctly train, strengthen and become more mobile, don’t hesitate to stop by The Training Room and check with our coaches. Remember, with great movement comes great responsibility!

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