One of the most common injured areas that we would see here at the running clinic is the knee. There are quite a few injuries that can occur around the knee and the treatment of which will vary. However, the most common running injury is runner’s knee, also known as patellofemoral pain.
It’s a really common problem in runners, sports players, and especially people who do HIIT style training. It often presents with pain around the inside of the knee that typically gets worse with exercise. In some severe cases, this can cause the knee to become red and swollen. So why is it the knee that is aggravated so easily?
During running the knee will take up to 3 times bodyweight. This is considerably more with exercises that involve jumping and landing. If you think that each step of running takes up to three times body weight and then multiply that by how many steps you take each run, there is considerable work been done by the knee which is why it is easily overloaded.
For the most part, this overload injury can be treated with a slow and gradual return to running or exercise all the while building up your strength and capacity in the muscles that support the knee. In a lot of cases, a tailored exercise program is appropriate as this is an injury that can be easily aggravated, and extra guidance is needed.
Some general tips for exercise that I have for people with Runner’s Knee:
– Start to do a form of strength training 3 x week with a rest day in between.
– Include exercises that build the strength of the quadriceps (squats, lunges, step-ups). Do them slowly and with weight, making sure that your knee pain isn’t flared up by this.
– Add in exercises that build the other muscles around the knee, such as bridges, hip thrusts, clams and calf raises. Look these up if you’re not too sure!
– If this irritates the knee, then you may need a period of rest and assessment by a professional to guide you back into the right level of rehabilitation.
For more persistent cases there are other things that need to be considered. In a lot of presentations that we see here, this injury has been around for more than six months. This means there are adaptations by the body where muscles will become weaker and control around the knee will re
duce. Having a Physiotherapist assess these weaknesses and movement dysfunctions is important to set up the correct
rehabilitation program from the start.
One final thing that can be considered in treating this injury is the impact of running technique. S
ome runners run with different techniques and this may increase how much weight is going through the knee, particularly the patellofemoral joint.
The patellofemoral joint is similar to a boat floating in a river. The boat will easily go up and down the river when tracking smoothly. However, if the knee lands at an angle, moves, or twists slightly with landing, the boat can rub on the sides which can cause irritation. In this case, the patella (knee cap) is the boat and the sides of the river are the end of the femur (thigh bone).
When treating this injury, it is really important to include planning about returning to running gradually, increasing strength and capacity in weak muscles, improving the control around the knee, and finally translating all of these gains into running and improving running technique. This can often be quite difficult to do on your own, having a Physiotherapist assess this initially to set up the correct rehab program can make returning to your desired level of running a matter of weeks compared to a matter of months (or even years!).