What is runner’s knee and how is it treated?

This is an injury that most people have probably heard of, or even experienced, but what actually is it and how does it come about?

Also known as patellofemoral joint syndrome or patellofemoral pain syndrome (amongst other things), it is basically an inflammation of the area where the back of the knee-cap (patella) meets the front of the bottom part of your thigh bone. This tends to happen as a result of friction in the joint where they start to rub together as often happens with runners.

As an aside, despite the name it could easily be renamed ‘Walkers’ Knee’ or even Cyclists’. While running is a higher-impact activity, the contact time is actually lower than it is when we’re walking. Also considering the fact that we spend a lot of time walking, it’s arguably more likely to come from this.

Why does it happen?

This often happens as a result of muscle imbalances, particularly when tight muscles on the outside of the knee and thigh pull the patella towards the outside. As a result the patella doesn’t sit properly in the groove of the femur, resulting in a rubbing between the outer part of the groove and the patella as shown in this vine.

It can also be an issue with ‘timing’, where the outer quad muscles contract slightly before the inner muscles, pulling the patella slightly out of position and again resulting in rubbing between the patella and the groove.

Another reason is from an increase in exercise or activity, resulting in muscle fatigue of the quads which normally keep the knee straight. The knock-on effect is the same as the above where you’ll feel a pain as a result of the patella rubbing on the groove. What’s the solution? Once diagnosed, the first step is reducing the symptoms. This can be done through a combination of deep tissue massage to loosen off any tight muscles, acupuncture and joint mobilisation techniques where necessary. The best approach can be defined by your physio and in the early stages any treatment will probably be accompanied by simple exercises to activate the quads properly such as a straight leg raise as shown here.

After the symptoms have been reduced, treatment can progress to finding a full resolution and preventing the problem happening again.

This can be done by more ‘functional’ exercises such as split squats as shown below, as well as providing guidance on how to progress training plans at a sensible rate to avoid any recurrence.
Runner’s knee can be a painful experience particularly if it’s not treated quickly and properly – but it’s something that’s very treatable. With the right plan and initial treatment it’s possible to get back to exercise much quicker than people often think.




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