If an exercise or activity gives you any pain or discomfort, it may not be wise to ignore it. Running is no different: very rarely is there an exercise that cannot be modified to feel better while helping a person progress towards the same goals. “Runner’s knee” is one of those injuries that you could expect worsen if you don’t change what you’re doing. If you feel a dull pain around the front of the knee (patella), where the knee connects with the lower end of the thighbone (femur), you may be experiencing runner’s knee. Symptoms can flare up at or near the kneecap when you perform a lot of activity, or after sitting for a long time with your knees bent.
One of Professional’s physical therapists Kris Camelio PT, DPT, MS, CSCS, goes into what exactly “runner’s knee” is and the best ways to avoid it:
“Runner’s knee” can be used as a catch-all phrase to simply mean ‘knee pain made worse with running’. While there are many, many different mechanisms and structures at the knee that could contribute to issues running, Patellofemoral Pain Syndrome and Iliotibial Band Friction Syndrome are among the most common.
Patellofemoral Pain Syndrome mainly involves the patella, (kneecap) tracking too far one direction, usually up towards the hip and out away from the body. When this happens, the cartilage on the underside of the patella – the interface between where the patella glides on the femur as the knee moves—can create increased pressures concentrated in certain parts, potentially irritating that structure with increased compression (as with running, jumping, weight bearing, or lifting), or with repetitive movement.
Illiotibial band friction syndrome mainly involves the iliotibial band—a fibrous tendon sheath that attaches tensor fascia lata, (a muscle in the front of the hip that helps pick the leg up during a run), as well as some fibers of the gluteus maximus (a muscle in the back of the hip that helps the leg push off/straighten and hold your pelvis in place during a run) to the tibia, the main weight-bearing bone of the lower leg. With a lot of repetitive activity, a small previous injury that inflames the bursa that’s over the lateral femoral epicondyle, a lot of activity in the muscles mentioned, weakness in some other muscles at the hip, weakness or structural changes that can take place at the ankle or foot, and/or, maybe even a long history of activity of muscles that attach to the lateral femoral epicondyle that causes the bony attachment site to grow—there can be increased compression between the lateral femoral epicondyle and the iliotibial band, which can contribute to pain, and feel worse with running.
Symptoms
The symptoms of runner’s knee are, patently, pain made worse during a run. As well, more specifically, when the kneecap is tender, to the touch or painful to press on, this can indicate patellofemoral pain syndrome. If the lateral femoral epicondyle is tender to the touch or painful to press on, this can indicate iliotibial band friction syndrome.
Treatment
The treatment for ‘runner’s knee’ involves identifying the most likely source of the issue, identifying aggravating and alleviating factors, modifying variables in a running program (e.g. speed, volume, and, most often, running mechanics), improving specific motions of joints the lower leg and often the trunk – depending on whether there’s a limitation in the range of motion, or the range of motion isn’t being controlled during the run, and, ultimately, allowing the tissue to heal and empowering the runner to implement sustainable running habits for the long term.
Prevention
Generally, progressing exercise appropriately, and often, improving the strength and endurance of the muscles that control movement of the patella and femur – often muscles on the back and outside of the thigh, that help determine where and how much compression occurs at the various sites of the knee during a run. It can, however be difficult to predict what will cause issues, as each person may respond differently to different activities, for different reasons. Other common running injuries include plantar fasciopathy, achilles tendinopathy, hamstrings strain, ligament sprain of knee, ankle, or hip, etc.
When to see a health care provider
If you’re having pain or issues completing runs or doing any activity when you’re on your feet, if you’re uncertain about when or how to participate in a new exercise or activity program, and definitely if you have had any falls or incidents after which you’ve noticed your knee has felt differently!
If you are experiencing any of these symptoms, it’s important to take a break from running and pay a visit to your physician. If these symptoms are ignored, the injury may worsen and become a more severe matter. For more information on knee pain treatment, visit https://www.professionalpt.com/pain-treatment/knee/.
Resources
https://www.rchsd.org/health-articles/runners-knee/
https://pubmed.ncbi.nlm.nih.gov/22994651/
