Runner's Knee

Woman with ice pack on knee

Runner's knee is one of the most complaint pains among runners. The good news is that it's fairly easy to treat and prevent.

Symptoms of Runner's Knee:

Runner's knee feels like a soreness around the front of and sometimes behind your kneecap. It's usually aggravated by running downhill, squatting, or going up or down stairs. Your knee may feel stiff (feels like it needs to be stretched) and sore after sitting down for long periods.

You might even hear a clicking sound when you bend or extend your knee.

Cause of Runner's Knee:

Runner's knee (also known as patella femoral pain syndrome or anterior knee syndrome) is usually caused by weakness in the middle quadriceps muscles and tight hamstrings or IT bands. Your quads should hold your kneecap in place, so it tracks up and down. But if they're weak, your kneecap moves left and right and ends up scraping your cartilage, causing painful friction and irritation.

You may also be at risk of runner's knee if you have flat feet and you overpronate (your feet roll inward) when you run. Running on uneven running surfaces or running in incorrect or worn-out running shoes may also a contributing factor.

Treatment of Runner's Knee:

First, you can reduce the pain and inflammation by icing your knees immediately after running. Work on strengthening your quad muscles, which will help support and stabilize your kneecap.

You can do simple exercises, such as forward lunges or straight leg raises. Stretching your hamstrings and IT bands can also help.

If you only have runner's knee on one side, don't neglect the other leg. Some runners rehab one leg, only to develop the same pain on the other side. Make sure you do to same exercises and stretches on both legs.

Don't run through pain. Take a couple days off from running or cross-train, as long as it's pain-free. You can start running again when you're able to run without changing your form due to pain. Stick to running on flat surfaces when you first return.

Shortening your stride and striking the ground directly underneath your center of gravity may also help alleviate the problem.

Don't use a knee sleeve or elastic bandage (such as an Ace bandage) to help with the pain. Doing so may just compress your kneecap so that's still rubbing and grinding your cartilage. It's better to keep it loose and free and work on strengthening your muscles.

Make sure you have the right kind of running shoes for your foot type. Also, make sure you're not running in worn-out shoes. You should replace your shoes every 300-400 miles. You may also want to consider buying over-the-counter arch supports.

Although some runners can treat and prevent future runner's knee by following the above steps, others may need further treatment.

You may need to visit a physical therapist who can give you the proper stretches and exercises. If your runner's knee is caused by overpronation (foot rolling inward when you run), you may need to see a podiatrist about getting custom-fitted orthotics. Severe cases of runner's knee may require a cortisone injection under the kneecap.

Source:  Maharam, Lewis, M.D. Running Doc's Guide to Healthy Running, Velo Press, 2011.

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