You aren’t sure how it started, but now you can’t get through a run without nagging knee pain! At first, it’s only when you are running, but over time, even ice, rest and anti-inflammatories are not enough to give you relief. Even simple tasks like getting out of bed or going up and down stairs is painful. How did this happen and how can you get back to running pain-free again? […]

What is Runner’s Knee?

Runner’s knee – a broad term used to describe pain in the front and around the kneecap – is arguably the most common injury among runners. Typically this is a repetitive strain injury and can refer to several different diagnoses, most commonly patellofemoral pain syndrome (PFPS) and iliotibial band syndrome (ITBS). Runner’s may initially feel pain only with running which worsens as duration and distance increases; as symptom’s become more severe, pain can be felt with stairs, squatting, kneeling or even after sitting for a long time with knees bent. Other symptoms of runner’s knee include rubbing, grinding or clicking sound of the kneecap as you bend and straighten or leg, as well as tenderness around the kneecap.

What causes Runner’s Knee?

The pain experienced in athletes with runner’s knee is commonly due to irritation of the soft tissues or lining of the knee, worn cartilage, or strained tendons. This irritation and strain at the knee joint can be caused from a structural defect or faulty biomechanics with repetitive activities including running, jumping and squatting. Some of the most common causes of runner’s knee include:

• Kneecap is too high
• Weakness in quadriceps and hip muscles
• Tightness in hamstrings, ITB and hip muscles
• Poor foot support or flat feet
• Excessive training or overuse
• Misaligned pelvis or lower extremity
• Faulty biomechanics or movement pattern’s

Can I Run With Runner’s Knee?

Determining whether to continue to run with knee pain or stop temporarily is usually the toughest decision to make with runners and athletes; athletes usually are ok with working through pain, even if its not for their own good. The severity of the symptom’s help determine how much an athlete should be working through the pain, but sometimes shutting it down altogether can actually be counterproductive as it can derail your entire training program. Initially, attempts should be made to dial back the duration and intensity of your runs as well as attempting to get off the pavement and run on the track or off-road trails. If pain persists, the next attempt should be to switch to low impact exercises such as cycling and swimming, although only temporarily to allow pain to settle down. Once pain becomes so severe that it limits workouts altogether, then it is time to see a physical therapist or physician who specializes working with the running population, as the demands of running are unique to other sports such as baseball or tennis.

Runner’s Knee Treatment Options

Runner’s knee can be a very frustrating injury for runners to manage, especially when it impacts training for your next marathon. Here are a few good examples of treatment option’s commonly used to help decrease pain and swelling and therefore help return to sport as quickly as possible:

Home Treatment Options:

• RICE – This classic principle can be used in instances where the runner is limited by a lot of pain. “Rest. Ice. Compression. Elevation – RICE” your injury to assist decreasing pain and swelling
• Foam roller – Used for when the knee is feeling very tight, rolling on a foam roller can help “loosen” up the knee but make sure it doesn’t irritate the knee any further
• NSAID’s – Commonly used to reduce swelling and alleviate some of the pain
• Bracing or Taping – Can help alleviate soreness and possibly decrease kneecap stress

Medical Treatment Options:

• Running gait analysis: If running is the main activity that caused knee pain, having your gait pattern professionally analyzed using high speed camera’s can pinpoint any biomechanical stresses that may be contributing to knee pain.
• Exercises: Addressing muscular imbalances by adding stretching exercises and strengthening exercises helps take the stress off the areas that are inflamed, helping reduce pain. This strategy helps keep knees healthier long-term as well as providing initial relief. A specific program should be designed by a physical therapist to properly address imbalances.
• Orthotic’s: Collapsed arches or overpronation can create stress at the knee joint, therefore using orthotic’s can control motion at the foot and stress at the knee.

Fortunately, there are a good amount of treatment option’s out there, majority of which are primarily conservative in nature, including some that can be done right away at home once you begin to feel initial pain around the kneecap. There are other times when a few home treatment options’ aren’t enough, and these require a more personalized and specific strategy. It is always best to seek out a physical therapist or medical professional that specializes working with runners and athletes for guidance on the most appropriate treatment option for each individual as it varies case by case.

Take-Home Message:

• Runner’s knee is arguably the most prevalent running injury, which can present as pain, swelling, clicking or grinding of the kneecap
• Pain typically worse with activities such as running, jumping, stairs, or even with prolonged sitting with knees flexed
• Some common causes include muscular imbalance, faulty biomechanics, misalignment in pelvis or hips, flat feet, excessive training
• Give your knees some TLC, as running is a demanding sport. This includes:
  • Decreasing duration and intensity of your runs temporarily
  • Change running surfaces – try tracks and trails over pavement
  • Maintain a good balance of strength and flexibility in your core and legs to minimize excessive stresses at the knee joint
• Go see a physical therapist or medical professional who specializes working with runner’s and athletes in the pain persists.