Runner’s knee aka Patellofemoral Pain Syndrome(PFPS) is minor injury and can be healed easily. But to let it aggravate can lead to limited or absolutely no running for the keen runner.
What is runner’s knee?
This injury has struck me more than once and I can tell you that it can be demoralizing especially when you are at peak of your training.
As the name suggests, runner’s knee strikes the runners. The term was first coined by Dr George Sheehan in the early 1970s<1>. Runner’s knee is a localized pain around the knee cap or patella. It can be also felt behind the knee. The knee pains when sitting on haunches and then may produce popping sound. It may pain while going downhill or down the stairs. It may also pain while sitting for a prolonged period of time.
Causes of PFPS
The cause of pain for a particular runner can’t be pinpointed but on observing the training pattern and running gear used, a generalized cause can be made out. The most common causes of runner’s knee are -
1. Increasing mileage rapidly before the body gets stronger to sustain it. Also with too much running at the same banked side of the road, hill runs and interval sessions, it has been seen to get aggravated.
2. Quadriceps or thigh muscles hold the knee cap or patella in place during the repeated motion of running. In case the quads are weak, the knee cap goes all over the place and results in pain.
Running places emphasis on hamstrings or back of thigh which leads to stronger hamstrings. The imbalance created by weak quads, glutes and strong hammies can cause runner’s knee.
3. Improper or worn out shoe can be another factor for this injury. If the shoe is too soft, it fails to control the pronation (inward or outward roll of foot) leading to this injury. And old shoes that have their out soles or inner side sole worn out may also cause this problem.
4. Poor running form may lead to this injury especially if you are a heel striker.
5. Flat feet can also cause this injury due to poor foot mechanics.
Treatment of PFPS
A proper diagnosis can help in removing the underlying causes as mentioned above. The treatment can be as follows -
1. Stop running immediately and give your knee some rest to recover and start the healing process.
2. Ice the knee 2-3 times a day for 10 minutes to control the inflammation. You may also consider popping in a ibrufen or any anti-inflammatory medicine after the run.
3. Inspect your running shoe if the soles are worn out. Replace them with a comfortable pair. If the new shoe doesn’t lead to knee pain, go ahead and buy more of them in case the company decides to stop making that model.
4. Get custom fit orthotics to support the arch and control pronation. But try and get over it as I, personally, don’t recommend wearing it throughout your life.
5. Taping the knee with kinesio tape seems to have helped a lot of runners as it helps giving structural support and helps speedier recovery.
6. Elevate knee while sitting or lying down.
7. In case you are overweight, it is a good idea to lose some weight.
Prevention of PFPS
According to American College of Sports Medicine, resistance training can reduce incidence of running related injuries. Following exercises and techniques may be followed to recover from PFPS and avoid it from reoccurring.
1. Improve your running form. In particular, focus on your cadence. Aim for a figure of 170-180 steps per minute. This will prevent you from over striding and heel striking.
One of my friends had the problem of runner’s knee. One day he called me up and narrated his problem. I knew immediately the cause as he was a heel striker. I asked him to increase his cadence to 180 and in a couple of days he was running pain free.
2. Perform the following lower body exercises in case the knee does’t pain during it. You will find explanations of few of the exercises mentioned below here.
- Glute Bridge
- Side leg raises.
- Seated thigh extension – Sit on a chair with both feet flat on ground. Keeping the thigh stationary, slowly flex your leg with toes pointing upwards. Hold for few seconds and change leg. Perform 8-10 reps with each leg and 2-3 sets.
- Calf raises.
- Body weight squats.
- Body weight lunges.
3. Cross training swimming, cycling and yoga to some extent, during this period can help you recover faster.
4. Do lot of stretching of calves, quads and hamstrings after run.
5. Perform a lot of core exercises as researches have proved that more often than not, almost all running injuries result from weak core.
Runner’s knee is a minor injury and can be treated easily. Runners need to be careful when increasing mileage and be wary of the changes happening in the body. Be proactive and do the preventive exercises and be a happy runner.
Till then stay fit and keep running.
Have you ever suffered from PFPS? If yes, then how did you recover and what was your down time?
1. Lore of running by Tim Noakes, page 789.
2. Image - Google. 3. American College of Sports Medicine.