It seems like a dichotomy – we are active to stay healthy but sometimes our activity leads to injury and pain.
Knee injuries are a very common complaint amongst the running population. The term ‘runner’s knee’ is commonly mentioned, but what is it? Unfortunately, there is not a straight forward answer. And, to make matters more confusing, it doesn’t only happen to runners.
What is Runner’s Knee?
Runner’s Knee is an umbrella term that is used to describe pain around, behind, or below the knee cap (patella). The pain can arise from a variety of tissues in the area. The source of pain may be the cartilage behind the knee cap, it may be from the patellar tendon below it, or it may be from other attaching fascial structures such as the IT band or retinaculum. The reason the structure has become painful is variable as well.
Why are runners prone to Runner’s Knee?
Running is a very repetitive activity. With running, the knee joint experiences a continuous, significant, repeated load. If there is a small (or large) impairment somewhere in the movement chain of the upper body or lower extremity, it can alter how your knee joint is being loaded.
For example, if there is weakness in the hip muscles, it changes how the thigh bone will be positioned when foot strike occurs. The patella sits against the thigh bone. Therefore, if the thigh bone is not in its ideal position, it alters the alignment of the patella and knee joint when you land. If you load the knee joint over and over again in a ‘bad’ position, certain knee structures may become irritated or inflamed, which leads to the pain.
What are the symptoms?
Once someone develops Runner’s Knee, the pain will typically be present with running, stair climbing/descending, squatting, stepping up, or sometimes even during walking. Pain is usually present only during and immediately after the aggravating activity. If the injury has been present for a long time, however, one may experience pain at rest as well.
How do I fix my Runner’s Knee?
There is no ‘one size fits all’ approach to rehabilitating a Runner’s Knee injury. That is because the structure causing the pain is different from person to person, as well as the reason the structure became painful in the first place.
Your friend, Cathy, might have Runner’s Knee because her patellar tendon has become very inflamed and swollen. The tendon became inflamed because her quad muscle was too tight. Meanwhile, your dad has Runner’s Knee because the cartilage behind his knee cap has become painful. For him, this occurred because his glute muscles were weak and were not correctly controlling the position of his thigh bone when he ran.
The solution for Runner’s Knee involves determining the knee structure at fault and the contributing factors. The treatment for the injury typically involves exercises to strengthen or lengthen muscles, mobilization of specific joints, and muscular release. Inflammatory reduction measures may be required, such as resting, taping, or icing the knee. Evaluation of running technique, footwear, patient training goals, and training schedules are also important elements to address for each individual.
If you think you have Runner’s Knee, consult your physiotherapist to help identify what tissue is at fault, as well as the contributing factors to that fault.
About Jacqueline Henderson
Jacqueline Henderson completed a BSc.Kinesiology at the University of Victoria in 2006. From there, she obtained a Master of Science in Physical Therapy from the University of Alberta in 2009. Jacqueline has been working as an orthopedic physiotherapist in Alberta since that time and has continued her education to expand the breadth of skills used in her practice. She is trained in Gunn IMS (dry needling), acupuncture, vestibular & dizziness treatment, rehabilitation Pilates, and is a Fellow of the Canadian Academy of Manipulative Physiotherapy (FCAMPT). Jacqueline treats a wide variety of people and conditions, ranging from young to old, and acute to chronic injuries. She is experienced in treating sports injuries, headaches, dizziness, complex motor vehicle accident injuries, and ongoing aches and pains. She also has a special interest in prenatal and postnatal women and the orthopedic issues associated with pregnancy and delivery. You can find out more about Jacqueline here.