How to deal with runners knee?

Pain in the knee of runners is the most common overuse injury that runners get. Making up to around 25% of the injuries. It is more common in females compared to males. The name that is typically given to this condition is patellofemoral pain syndrome or runners knee. The patella is the kneecap and the femoral refers to the femur bone that the patella moves on during movement of the knee while running. The condition needs to be taken seriously and dealt with appropriately as there is a high correlation between this problem and osteoarthritis of the patellofemoral joint in later life.

The classic symptoms are a very gradual onset of a dull pain that progressively gets worse. The pain is typically behind the kneecap that is worse when walking up stairs or running up hills. Other than that, there is no definitive diagnostic criteria for patellofemoral pain syndrome and the diagnosis is generally only applied after other potential causes have been excluded. Typically, the symptoms occur after a period of an increase in the training or running volume that was too quick for the knee to adapt to those loads. It also can follow a change in the running or training routine, such as the transition from road running to speed work to get ready for a competition. A foot that overpronates or rolls in too much at the ankle is also considered a factor that increases the risk for the problem. A weakness of the muscles around the hip are additionally a factor in patellofemoral pain syndrome.

The key approach to the management of this in runners is education. The runner needs to know exactly what the nature of the condition is, what they need to do with regards to modifying their training or running loads so that there are no spikes in there training volumes, and what the consequences of the condition long term and the importance to get on top of it as soon as possible.

To address the problem with the foot overpronation, foot orthotics to help that and advice regarding the proper running shoes may be needed. They will need to be adapted to over time and will help reduces some of the stress on the knee that may be causing the problem. A podiatrist can help with that.

The muscle strength and motor control about the hip is equally important and must be addressed. A physiotherapist can help with that. The muscles that need to be strengthened include those that abduct the hip and the quadriceps in the front of the thigh. Both of these muscle groups are extremely important in controlling the knee joint and any weakness in them is not only going to predispose to the problem, it is going to prolong the recovery. The ability of the runners to control the knee is also going to be assessed and worked on by the physiotherapist using a range of exercises and running drills.

All of these issues were recently addressed by an expert in patellofemoral pain syndrome, the physiotherapist Dr Christian Barton in a recent episode of the livestream, PodChatLive.