Running with Knee Pain?

Runner's Knee is also called patellofemoral pain syndrome(PFPS), anterior knee pain or chondromalacia of the patella. The cause and treatment is complex as several factors are involved. The knee consists of soft tissue components connecting the thigh (femur) and shin (tibia) bones. The joint can act as a pain center for anatomical and biomechanical problems with the source ranging from the hips to the toes. The cause could be age, overtraining, excess weight or biomechanical.

Another factor is the iliotibial band (IT), which is a band of thick tissue running from the hip to the knee. When the IT is involved, the pain is often felt a mile or two into the run as the discomfort comes from friction. Chemicals are released causing inflammation and the overall process develops with time, which results in the delayed onset of pain during activity. Weak hip abductors and external rotators are often the cause of this problem. Strengthening the hips is important to both prevent and alleviate the pain. There are specific exercises and stretches to target this area. To start getting relief and return to running pain free, the Running Doctor can help identify the weak areas and provide specific exercises to care for the current condition and prevent future injuries.

Another contributing cause is the Q Angle. The Q Angle (quadriceps angle) is located where the quadriceps tendon attaches to the knee. Pronation can exasperate this angle, causing the knee to rotate further than normal. This is a biomechanical issue that can be addressed with proper alignment with a biomechanical evaluation and possibly orthotics to correct the imbalance.

Are You Prone to Runner's Knee?

Do you have shoes on, take them off. Stand up and look down at your feet. Examine your arches. Do they collapse inward or roll out toward your pinkie toes? Or are you balanced with equal pressure on all sides of your feet? Most people roll inward or outward. Overtime this imbalance begins to place stress on the inside or outside of the knee. The next time you walk barefoot, try to be conscious of your steps and resist the inward or outward role to strengthen the arches. Walk with balance and equal pressure avoiding the typical arch collapse.

• Weak quadriceps muscles
• Tight hamstrings or calf muscles
• Feet pronation
• Wide hips (female runners)
• Knock knees (Genu Valgum)

Runner's Knee Relief

With the initial onset of pain or minor twinge, begin taking steps to limit the long term damage and to speed up the recovery. Backing down on mileage to allow for healing may be needed but more importantly avoid downhill running. Also avoid exercises performed with the knee bent.

Tight posterior muscles, such as the hamstrings and calves should be stretched. When these muscles are tight, it can lead to foot pronoation during walking or running. The domino effect of tight muscles leads to pronation creating an internal rotation of the leg and further increasing the Q angle. A tight IT band has a similar affect and puts strain on the knee and should also be stretched. Core exercises are also suggested, along with strengthening the glutes. A strong core helps to improve form and can lessen the stress on the knees.

Proper shoes with stability works to correct the pronation however further support may be needed. Orthotics are the next step as molds are made to address your exact arch support needs. Although knee pain is typically lumped into the category of Runner's Knee, it is important to get a proper evaluation to rule out other knee problems.

Run Knee Pain Free