How to Treat Runner's Knee

About 40% of running injuries are knee issues and patellofemoral pain syndrome (PFPS), or "runner's knee", is one of the most common. It is caused by the irritation of the cartilage on the underside of the patella (kneecap).

Who's at Risk?
Risk factors include overpronation (excessive inward foot rolling) and weak quads, hips, or gluts. The knee is very often NOT really the problem. Generally, the knee becomes 'stressed' if there is a loss of hip stability and the pelvis tips to the non-weight bearing side OR if the foot is unable to control and decelerate the landing of the foot. Other risk factors include a change in your usual training pattern. Either a run that's longer than usual or if you have done a speed session. You may need some advice about your running shoes or even go to see a podiatrist about foot orthotics.

Can You Run Through it?
Obviously, if the symptoms have become acute you will need to rest. Otherwise, if symptoms are mild, take extra rest days and reduce your mileage as necessary. Run every other day and only as far as you can go without pain. Some runners find that uphill running is less painful. Uphill running has the added value of working your gluts and strong gluteal muscles help control hip and thigh movement, preventing the knees from turning inward. Avoid running downhill, which can exacerbate pain. Cycling may also speed up your recovery by strengthening the quads.

Rehab Exercises
Many YouTube clips and magazine articles recommend exercises such as yoga/Pilates shoulder bridges but, in my opinion, it is better to do exercises that feel closer to running i.e. standing upright rather than lying down on a mat. Try these three exercises to strengthen weak hip and glute muscles:

1. Lateral side steps
Place a loop of resistance band just above your ankles or knees. Separate your feet and bend your knees, lowering down into a slightly crouched position. While staying in this position, walk sideways for 10 to 15 steps, keeping your feet straight and your upper body still. Then reverse directions. Keep your feet separated to maintain band tension. When this becomes easy, try doing this on your toes with your heels off the ground.
2. Grapevine walking pattern with a mini curtsy squat
Stay strong and stable and keep the movement smooth and controlled.
3. Progressive lunge step with trunk twist
Step forward into a lunge with the rear knee hovering above the ground. Walk forward, through from one lunge into the next lunge step. As you progress forward, turn your trunk to the leading knee and hold your hands up high as if holding a Pilates ball. To make this more challenging, perform this as a reverse lunge step.

How to Prevent a Relapse
When running, try shortening your stride length and landing with the knee slightly bent and the foot underneath you more, which can take up to 30% load off the joint. Having the foot too far in front of you may in fact be causing the leg to decelerate too quickly.

For more information on runner's knee or to book an appointment in Bridgnorth or Shrewsbury, please call 01746 761050.​ 

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