Just what is runner’s knee? Unfortunately the term “Runner’s Knee” has been abused all too often and covers a whole host of knee conditions. For many, the diagnosis is quite simple, find a runner with a sore knee and wisely diagnose the problem as, “Runners Knee”. We will spend a bit of time specifically looking at Patella Femoral Pain Syndrome.
To be a bit more accurate, Runners Knee refers to a vague, hard to pinpoint pain either behind the knee cap or at the base of the knee cap that can be experienced while running, climbing steps and sometimes after a long ride. The technical name for this is Patellofemoral Pain Syndrome, or PFPS.
This is the most common injury reported by runners. It is also possible to pick up the injury from cycling. Athletes who run and cycle need to be aware that they should look at both their running shoes and bike setup as far as equipment is concerned.
The injury is caused by an incorrect tracking of the knee cap as it travels over the Femoral head. There are a number of factors that can cause this, namely:
· Flat feet causing Tibial torsion.
· Pronation, also causing Tibial twisting/torsion. Running in the correct shoes will make a massive difference.
· A high Q angle.
· Quadricep weakness, especially of the Vastus Medialis Muscle.This will allow the knee cap to track too far laterally (toward the outside of the knee joint)
· Hamstring tightness – This places posterior force on the knee, causing pressure between the patella and femur to increase.
· Tight calves can lead to compensatory foot pronation.
· Weakness or tightness of the hip muscles (adductors, abductors, external rotators)
Via our Runner’s Leg Assessment program we have found the following steps to be the most useful.
- Ascertain that it really is PFPS and not one of the other knee injuries.
- Check that the runner is in the correct pair of shoes. Cognisance should be taken regarding both rates of pronation and foot arch type.
- Ascertain if the runner also cycles, as incorrect bike setup might contribute to the problem.
- Strengthen Gluteus Medius Muscles if necessary. We can give you exercises to get this stronger.
- Strengthen Vastus Medialis Muscle.
To strengthen the muscle you can use the leg extension machine at your gym. Focus on working the last/top 15 degrees whilst palpating the VMO.
This will help to pull the knee cap to a more central position as you run and cycle.
- Stretch leg or hip muscles that are tight.
Give me a call if you feel I can help.