What is Runner’s Knee?

Runner’s knee is a colloquial term used for people experiencing pain in the front of their knee which can be felt specifically on top or behind the kneecap or sometimes can present as variable pain felt either above, below or to one side of the knee cap. Pain is often intermittent and sharp, but can sometimes be described as a pressure sensation behind the kneecap. Other more technical terms for this condition include patellofemoral pain syndrome (pain related to faulty movement patterns of the kneecap within its groove on the thigh bone) or anterior knee pain (frontal knee pain).

What are the symptoms?

Runner’s knee is a sub-type of patellofemoral pain syndrome, which, as its name suggests, is usually triggered by running. The sufferer’s will often experience worsening pain whilst running on a gradient or using stairs (often worse going down than up). Pain is often transient and mainly experienced during the activity and eases during periods of rest. Pain may also be felt with activities such as squatting, jumping, cycling and in some cases, people can experience discomfort after having their knees bent in one position for a sustained period of time, which is often referred to as ‘cinema’ or ‘moviegoers knee’ (depending on where you live in the world!).

What causes Runner’s Knee?

Broadly speaking, there are two types of risk factors which may increase your likelihood of suffering from Runner’s Knee which include modifiable (risks which can be reduced) and non-modifiable risks (risks that cannot be changed).

Modifiable risk factors

  • Weak muscles (particularly quadriceps (thigh), gluteals (buttock) and calf muscles)
  • Poor flexibility of quadriceps, hamstrings and calf muscles
  • Obesity – as the knee is a weight-bearing joint, being overweight will exponentially increase the loading forces through the knee
  • Training error, e.g. poor running gait
  • Overtraining e.g. inadequate rest & recovery between sessions
  • Rapid increase in running duration, frequency or intensity
  • Inappropriate running footwear

Non-modifiable risk factors

  • Sex – females are twice as likely to experience runner’s knee than males
  • Anatomical abnormalities, including pes planus (flat feet), hip anteversion (abnormal hip alignment) or trochlear dysplasia (the groove in which your kneecap sits is flat and shallow as opposed to being ‘U’ shaped).

 

5 Top tips

  1. Include two strength & conditioning sessions into your weekly exercise routine (this can include using free-weights or resistance machines at the gym or home workouts performing body weight exercises (calisthenics) such as squats, lunges, leg raises and glute bridges.
  2. Perform other forms of cardiovascular exercises to complement your running such as using a static exercise bike, cycling outdoors (this will greatly improve your thigh muscle strength) or swimming.
  3. Stretching after exercise – this can be as simple as performing passive stretches, with a focus on your leg muscles or it could include structured routines such as a yoga or Pilates class.
  4. Build up gradually! If you are new to running, have recently returned to running after a long break or perhaps you are a veteran runner, but have recently upgraded from marathons to ultras it is essential to stick to a graduated programme over a period of several months, ensuring adequate periods of rest, good nutrition and high quality sleep in between runs.
  5. Invest in some good footwear. If you are serious about running, it is important to find a pair of running shoes with the right amount of support for you. Most importantly, they should feel comfortable and non-restrictive. Lastly, depending on where and how hard you run, we recommend that on average you should look to replace your runners after 600-700km.

How can Physiotherapy improve Runner’s Knee?

Good news! Physiotherapy has been shown to be extremely effective in helping to resolve the vast majority of cases of Runner’s Knee. Treatment will often be multi-faceted and consist of:

  • Advice and guidance on a period of relative rest from the painful activity, whilst providing you with alternative ways to exercise in the interim.
  • A tailored strength and conditioning programme to build up the relevant muscles which provide direct and indirect support to the knee.
  • Targeted stretches to improve flexibility where necessary.
  • Taping to support the knee and reduce pain to allow you to perform your exercises and activities with less discomfort.
  • And finally, last but by no means least….we provide our patients with an appropriate return-to-run programme based around your personal goals!

The Bottom Line….

Here at BSPC, we know how important running is to the members of our community. It’s not just an inexpensive and practical way to keep fit, it’s also a super effective way of boosting mood and energy levels whilst warding off unwanted stress and anxiety. So what are you waiting for? If your running is being hampered by knee pain don’t delay any further, get in touch with the team here at BSPC where one of our expert physios can help you get back to doing what you enjoy most!