The Best Way to Treat Runners Knee

runners knee
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Runners knee a.k.a patellofemoral pain syndrome (PFPS) is the dull aching pain felt at the front of the knee (at the kneecap). It is called runners knee because it is very common among runners, especially long-distance runners.

It is an overuse injury caused by “too much, too soon“. This means you have increased your running intensity/volume beyond what your body can cope.

Sign and Symptoms

The main sign and symptom of runners knee is a dull aching pain at the front of the knee, pain is increased when:

  • You are walking.
  • Bending your knee.
  • Climbing up a flight of stairs.
  • Sit or stand. It hurts more while trying to stand up.

Risk Factor and Cause

Risk Factor

These are some of the well-known risk factors for runners knee:

  • Gender. Female has a higher risk of runners knee due to anatomical differences with male, such as a wider hips and a larger Q-angle. This places greater stress and pressure on the knees.
  • Age. Younger people are more prone to runners knee as their bodies are still growing and haven’t adapt to the stress and pressure of running. Older people are more prone to osteoarthritis instead.
  • Being overweight. An overweight person increases the stress and pressure placed on the knees on top of the stress of running itself.
  • Running shoes. An inappropriate footwear may increase your risk of injury.

Cause

There are many possible causes of runners knee but these are some of the most common ones:

  • OVERTRAINING! When you increased your training volume/intensity abruptly over the weeks, you are prone to many injuries other than runners knee.
  • You may have weak lower limbs muscles which increased the stress and pressure placed on your joints instead of being absorbed by the muscles.
  • You may have muscle imbalances between your left and right leg. This will cause one side of your body to withstand a higher loads and stress, eventually leading to an injury.
runners knee

How To Treat Runners Knee?

Pain Management

If you have mild to moderate pain, you can relief pain by following the RICE protocol (Rest, Ice, Compression, Elevation).

First, you need to stop running immediately, apply ice on your affected knee(s) for 15-20 minutes 3 times per day, wear a knee brace and elevate your knee above your heart level (do this by laying down and raising your leg on to a higher platform).

If you have severe to unbearable pain, please consult your local physician or physiotherapist as soon as possible.

Rehabilitation

After you pain has subsided, you’ll need to rehabilitate your affected knee to restore its range of motion, strength and flexibility. Rehabilitation is crucial in restoring the function of your affected limb and prevention of recurring injuries.

Stretching

hamstring stretch
Hamstring Stretch
Photo Credit: verywellfit

You’ll need to begin stretching as soon as pain subsided, focus stretching the hamstrings and hip flexors.

This is because the opposing muscles usually tighten up due to the injury.

You can do these stretches 5-8 repetitions, hold 10 seconds each, every alternate day. Make sure you don’t have any pain while doing these stretches.

hip flexor stretch
Hips Flexor Stretch
Photo Credit: Back Intelligence

Strengthening

You’ll need to strengthen your quadriceps as your quads will be weaker due to lack of use.

There are many ways you can strengthen your quads and your knee after recovery, and it is crucial that you do it to prevent recurring injuries.

squat
Squat

The squat is the simplest and most basic lower limbs exercise which strengthens most of your lower limb muscle groups.

You can start this exercise with 3 sets of 8 repetitions, every alternate day and increase 2 repetitions every week.

Only do squats and lunges if you don’t have any pain, a little discomfort it okay. If you have pain, stop immediately.

Lunges

Do These Exercises if You Still Have Pain

Adductor Ball Squeeze

Since you have pain while bending your knee or walking, you should do these alternative exercises instead.

These exercises strengthen your quads, hamstring, adductors and gluteal muscles.

The adductor ball squeeze is to strengthen your groin muscles and your vastus medialis (VM). VM function is to stabilise the patella (kneecap) and to keep it in a straight line when you bend your knee.

You can start this exercise with 3 sets of 8 repetitions, with 3-5 seconds hold each repetition, every alternate days and increase 2 repetitions every week.


Bridge Exercise

Bridge exercise is a simple and great way to strengthen your posterior chain muscles (lower back, glutes, and hamstring).

You can start this exercise with 3 sets of 8-12 repetitions, with 3-5 seconds hold each repetition, every alternate days and increase 2 repetitions every week.


Prone hip extension is to strengthen your glutes and hamstring. You can do this instead of bridge if you feel any pain at your knees.

Try to do this exercise with one leg at a time.

You can start this exercise with 3 sets of 8 repetitions each leg, with 3 seconds hold each repetition, every alternate days and increase 2 repetitions every week.


Side-laying leg raise is to strengthen your gluteal minimus and gluteal medius. Hip abduction also involves your glutes.

Always face and point your feet forward, and not upwards.

You can start this exercise with 3 sets of 8 repetitions each leg, with 1-2 seconds hold each repetition, every alternate days and increase 2 repetitions every week.


Supine leg raise is to strengthen your hip flexor and lower abdominal muscles.

You may feel soreness in your abs while doing these exercise, don’t worry, it works mainly the hip flexor.

The sore is mainly in your abs because your hip flexor is generally a stronger muscle.

You can start this exercise with 3 sets of 8 repetitions each leg, every alternate days and increase 2 repetitions every week.


Quadriceps isometric contraction exercise is to strengthen your quadriceps without bending your knee.

This exercise is very useful to maintain your quadriceps muscle mass in the early stage of the rehabilitation phase.

You can start this exercise with 3 sets of 8 repetitions each leg, with 1-2 seconds hold each repetition, every alternate days and increase 2 repetitions every week.


How To Prevent Runners Knee?

Prevention can work for prevention of potential injuries and prevention of recurring injuries (after recovery).

These are some tips that you can follow to prevent injuries:

  • Don’t be cocky and overconfident that you are immune to any injuries.
  • Adhere to the FITT principle (Frequency, Intensity, Time, Type). This is a great way for you to monitor your training volume and intensity.
  • Always warm up and cool down before and after your runs, respectively.
  • Get a good quality footwear with adequate heel cushion and good arch support to prevent ankle or knee injuries.
  • Incorporate a proper strengthening and stretching program into your usual training routine to address any existing strength and flexibility issues, respectively.
  • Learn and implement a proper running technique such as ChiRunning technique.
  • Sufficient rest between hard workout to allow your body to repair itself.

Bottom Line..

It is frustrating to suffer an injury especially if you are a runner regardless of beginners, amateur or professional.

However, with proper conditioning and running technique, you can prevent the potential risk of injuries.

You’ll be surprised that just a minor tweak in your training program can reduce your injuries drastically.

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