Runners Knee

Symptoms

• Pain around the front of the kneecap and below the kneecap.


• Pain behind the knee.


• Swelling around the kneecap.


• Grinding feeling in the kneecap.


• Snapping or popping sound when the knee is extended.


• Knee pain when running downhill.


• Pain walking down stairs.


• Pain after sitting for a long time.

What’s Going On?

Runners knee occurs from the mal-tracking of the kneecap (patella) over the thigh (femur) and the shin (tibia).

When the kneecap is out of alignment and is pulled to one side or the other, it scrapes over the femoral condyles damaging both surfaces that touch each other.

Diagram courtesy of In the Groove

If the mal-tracking of the kneecap continues, swelling, heat and soreness builds, which can lead to permanent damage to the knee joint.

This is an artist’s rendition of cross section of knee (above) shows the relationship of the bones of the knee, how close they are together, and how portions of the knee are damaged when there is contact of the underside of the patella and the femoral condyle.

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• Women’s wider hips (Q Angle)


• Knock Knees


• Over pronation (rolling inwards) of the feet.


• Shoes that are worn out or don't provide enough support.


• Tight and/or weak hips and quadriceps.


• Tight and/or weak hamstrings and calves.


• Tight iliotial band.


• Sudden increase in your mileage, speed or hills.


• Excessive running on cambered roads bends on the track or down hill running.

Treatment

• Reduce or stop running.


• Initially apply RICE (rest, ice, compression and elevation) after running and as often as possible.


• Avoid down hill running.


• Change your training from cambered roads to running in the middle of the road. Run in the opposite direction for your warm up and cool down on the track.


• Run on softer surfaces e.g. trails and grass.


• Stretch your quadriceps, hips, calves, hamstrings and iliotibial band.


• Perform the Mulligan Maneuver to see if a knee brace would be beneficial.


• Strengthen your quads and knee with straight leg lifts.


• Strengthen your core (abdominal) and low back.


• Replace your old running shoes.


• Purchase running shoes with good support and anti-pronation features.


• Consider a visit to a podiatrist, as orthotics may be required.

Mulligan Maneuver

Try this simple two-handed maneuver, developed by physiotherapist, Brian Mulligan. It only takes a few minutes to do and may relieve your runners knee pain.

• Sit down in a chair, relax your sore knee.


• Place one hand about 2-3 inches above your knee on the side of your leg.


• Place the other hand about 2-3 inches below your knee.


• Press both hands toward the center of the knee/leg.


• Bend your knee up and down, like you are kicking a ball, 3-4 times.


• Get up and walk around – up and down stairs if you can. You should notice a difference.


• If not, place your hands in the opposite position and do the same steps.

Straight Leg Lifts

Perform this exercise to strengthen your quadriceps and the ligaments around your knee.

1. Lie on the floor (carpet or mat) with your right leg straight in front and your left leg slightly bent and relaxed.


2. Keeping your right leg straight, slowly raise it 30 to 60 degrees. Slowly lower back to the ground. This is one rep.


3. To protect your back, keep your lower back pressed into the ground while you lift your leg.


4. Complete 10 straight leg lifts on your right leg.


5. Switch to your left leg and do 10 repetitions.


6. Begin with 3 sets of 10 and work up to 10 sets of 10 on each leg.

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References:

In the Groove.

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