If you’re a runner, and especially if you’re a new runner, chances are that at some point you have had knee pain. Knee injuries account for 20% of all running problems, but there are plenty of things you can do to get back on the road or trail, or even avoid these injuries altogether! Let’s take a look at 2 of the most common knee issues for runners.
The first is known as runner’s knee. The medical term for this is patellofemoral pain syndrome (PFPS). This problem is characterized by pain at the front of the knee and around the kneecap (patella). It occurs when there is increased friction between the back of the kneecap and the thigh bone (femur). Causes include weakness or stiffness in the muscles around the knee, repetitive or excessive use of the knee, and abnormality in the way the hip, knee and foot line up (faulty mechanics). PFPS can occur when people increase their activity level (such as starting a running program), increase their intensity level by doing a lot of speed or hill work, or with overstriding (taking excessively long strides). Sometimes the pain may get to the point where you can’t run, and stairs and squatting may also cause symptoms.
If any of this sounds familiar, the first thing to do is take a break from running. Cross train by aqua-jogging, swimming, or biking, and work on strengthening the quadriceps (thigh) muscle and hip. Good exercises include leg press and sidelying leg lifts (see picture). Use ice liberally to reduce inflammation, and perhaps most importantly, be sure you are wearing the right kind of running shoes for your foot type. A good running shoe store can help with this or schedule an appointment with one of SSI’s Physical Therapists for a recommendation.
After 1-2 weeks, resume running on flat surfaces for short distances at an easy pace. Stop if you experience pain! Gradually increase your distance and intensity until you are back at your previous level without symptoms. It’s a good idea to continue with strengthening exercises even after the pain disappears.
The other well-known knee issue for runners is ITB syndrome. ITB stands for iliotibial band, which is the tendon that runs along the outer part of the lower thigh and knee. This tendon connects the tensor fasciae latae muscle from the outer hip to the outer knee. Sometimes, due to weakness or tightness, the ITB will rub on the bone beneath it and create pain over the outer part of the knee. This injury can also be caused or exacerbated by always running on the same side of the road, especially if there is a slant to the road.
Like PFPS, the initial treatment for ITB pain is rest and ice along with cross-training. Sidelying leg raises can help strengthen the outer hip muscles to improve alignment, and once again proper footwear is very important. The ITB should also be stretched (see picture). When you start back with running, try softer surfaces if possible, and again, if symptoms reappear, stop!
If the above self-management strategies don’t take care of your knee problems, give us a call at SSI Physical Therapy so we can get you back out there doing what you love to do!