What Is Runners Knee
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Runners knee, also known by its more scientific name as patellofemoral pain syndrome, refers to pain around the kneecaps that can be caused by running. Although non-runners certainly experience this issue too.
Without getting too science-y, knee pain happens when the patella is misaligned and rubs against things its not supposed to . This image shows where the pain usually occurs:
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Doctors and physical therapists generally agree that muscle weakness is the root cause of runners knee. Weak muscles cause various issues, like pelvis misalignment, and that results in the knee cap hitting the sides of the femoral groove because its not aligned correctly .
Hip, glute, quad and hamstring weakness are the main culprits.
But before starting a strength training regimen assess how much pain youre in now and read the next section before doing anything. Plus, we always recommend consulting a professional before beginning a strength training plan.
Hate Running Injuries?
Running Techniques To Help Avoid Pain In The Knee Joint
Depending on the cause of your patellofemoral pain, reducing the discomfort may be as simple as taking more days off or buying the right running shoes. Modifying your running technique can help too.
Keeping your knees soft can reduce the stress placed on this joint during the landing phase. Also, watch your foot position when it lands. If the toes point out to the side, you may feel pain on the inside of the knee. Instead, the foot should be pointing in the direction you are traveling. Correcting this issue slowly is best. If you try to make significant changes in your foots landing position all at once, this can aggravate the pain versus lessening it.
Pay attention to where you place your weight on the feet during the landing phase. Ideally, you want to land on the whole foot. If you land on the ball, this can increase your risk of injury. Land on the heel, and this places more stress on the knees.
If you run slowly, speeding up a bit can help you avoid knee pain. This is because a slow stride allows for bigger steps, and landing on your heels. Both place more stress on the knee. Aim for a tempo of around 180 steps per minute. Running to music that is 180 beats per minute can help you keep this cadence.
Have Knee Pain Or Injury Now Learn To Rice First
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R.I.C.E. is a common acronym among athletes with injuries and stands for: Rest, Ice, Compression, and Elevation.
Runners follow this advice for many muscle-related injuries .
Rest: Stop running. Rest for a few days, or even weeks, depending on the severity of the injury. Do not start up again too soon or you risk re-injuring yourself. Proper healing is important to runners knee recovery!
Ice: My Physical Therapist generally recommends icing for 24-48 hours after the injury. Icing reduces muscle and tissue inflammation by reducing blood flow. Place a bag of ice onto the knee for 20 minutes on, 20 minutes off. After 24-48 hours, some professionals say to switch to heat it increases blood flow again to start healing the torn and bruised muscle and tissues.
Compression: Use a compression bandage or wear a compression knee brace. Again, this is to reduce and prevent swelling in the knee. Use caution though dont wrap the knee too tightly.
Elevation: For the first day or so after the injury, prop your leg up to elevate it higher than your heart to further reduce the swelling. Elevating the injury is best kept to the day of the injury .
Its always better to rest an injury before getting back out there. Runners knee is no exception.
Now lets talk about how to prevent runners knee from happening in the first place.
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Pick The Correct Running Shoes For To Save Your Knees
Picking the right pair of running shoes can be really challenging, thats for sure! However its such an important part of you being able to run without knee pain.
Your knees, and the patellofemoral joints in particular thrive on stability and alignment of your knees to be able to function properly, without knee pain as you run. That stability comes from the joints above and below the knees, namely the hips, feet and ankles.
Ill talk more about hip stability later in this article. However, when it comes to the foot and ankle, the stability provided by the inherent characteristics of your feet and your choice of running shoes will massively influence the way your patellofemoral joint loads as you run.
Because of the repetitive nature of the running gait cycle, small areas of overload around your knees caused by a bad footwear choice, will build-up over time and potentially cause you knee pain, or another injury.
The best advice I can realistically give you without seeing your feet, is to get yourself to a specialist running store. Not one of the big-box sports outlets, but a proper old school running shop with staff who actually run and geek-out about running shoes.
Theyll be able to look at your running gait and suggest the right amount of support, cushioning, heel-to-toe drop etc you need in a running shoe to accommodate your individual biomechanics.
Is It Common For Runners To Have Knee Pain
Unfortunately, knee pain is incredibly common among runners, especially those with improper form, who constantly run on pavement, or who continue to run on an unhealed injury. Runners experiencing knee pain should talk with their physician or call Kneecare Clinics to determine the exact cause of their pain, so that they can craft an effective treatment plan.
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Whats Causing Your Knee Pain
Runners knee can stem from several different conditions, the most common of which is iliotibial band syndrome. Made up of fibrous tissue, the IT band stretches from the hip to the knee. Its main function is to encase and stabilize the muscles around the joint, which allows the knee to easily move and flex.
Regular trips around the running track put the IT band in frequent contact with the lateral femoral epicondyle, a bony protrusion at the side of the knee. This friction can lead to pain and limited movement. Other symptoms of IT band syndrome include swelling and a popping noise in the knee.
Another common ailment suffered by runners is patellofemoral pain syndrome. This condition is marked by pain under and around the kneecap that worsens when walking up or down stairs, squatting, or kneeling down. Typically the result of overuse, patellofemoral pain comes about when the tendons and cartilage underneath the kneecap become inflamed. A kneecap out of alignment, weak or tight thigh muscles, and flat feet can also cause this condition.
Prevent Knee Pain From Running 5 Increase Your Cadence
Another technique tweak to consider when dealing with knee pain from running is to to avoid overstriding.
So what is it all about?
When you overstride, youre, in essence, reaching too much forward with your legs as you swing them forward in front of your center of gravity
When you do, youll be slamming your foot down, creating a braking action with each stride.
Then, all of these impact stresses of hitting the ground goes right up your feet to your knees.
This, in theory at least, limits your efficiency and increases your risk of injury.
As a result, most experts agree on the fact that overstriding is bad.
Do not let your feet get ahead of you.
Make sure to stay ahead of your feet.
Do not let your legs swing forward, not to the rear.
Here is the good news:
Reducing stride length can put a stop to overstriding, thus decrease injury risk, research shows.
And one of the best ways to do so is to simply increase your cadence.
In fact, research conducted at the University of Wisconsin found that an increased cadence reduces the impact load on the lower body.
Here is how to improve your cadence:
Determine your current cadence by counting how many times your feet hit the ground in one minute of running.
If its over 160, youre in the clear.
But, if your cadence is below 160 steps per minute, they should increase it by 5 to 10 percent from one week to the next.
For the full guide to improve running cadence, check my article here.
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Warm Up And Cool Down Properly
Running with tight muscles is one cause of runners knee.
To make sure your body is properly warmed up, do a 5-minute series of dynamic stretches or walking.
This gets the blood flowing and warms up the muscles so theyre ready for the movements and impact running requires.
Then, after your run, stretch it out!
Static stretching keeps the muscles from tightening up too.
Attacking tight muscles before and after running helps prevent runners knee.
Bonus tip: Add some foam rolling in too and youll improve your chances of avoiding tight muscles even more!
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What Can You Do To Prevent Knee Pain
A significant factor in reducing knee injury and pain caused by improper biomechanical forces is something thats frequently overlooked the use of custom orthotics to improve alignment issues.
Custom orthotics are used to align and support the foot and ankle in a more normal position to prevent dysfunction and/or improve function of movable body parts. We recommend them in order to:
- Promote a symmetrical foundation by blocking pronation or supporting supination.
- Provide heel strike shock absorption.
- Prevent biomechanical stress up the kinetic chain.
- Enhance neuromuscular re-adaptation.
In short, custom-made orthotics can help reduce overall pain caused by poor biomechanics. But there are also some running habits that you can change in order to supplement the support that you will find in orthotics.
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Orthopaedic Specialists Talk Common Causes Of Knee Pain
Knee and joint pain may be common complaints among runners, but chances are slim that arthritis is the culprit. In fact, multiple studies have shown that regular running strengthens the joints and actually protects against development of osteoarthritis later in life.
Its very common for people to say, How do you run? Doesnt that ruin your knees? says Steven Mayer, MD, a physician in physical medicine and rehabilitation at Northwestern Medicine Orthopaedics. There have been several recent studies that have debunked that myth. In fact, they have shown the opposite that running tends to be protective of knee arthritis.
Why Do My Knees Hurt When I Run
Theres research saying that running injuries are caused by mismatches between the structures of your knee.
Additionally, the same research says that 80% of these injuries are caused by overuse .
This makes so much sense because those imbalances flat feet, weak and/or tight muscles, rotated hips, poor running technique, etcetera alter the biomechanics of your knee. And, the more you subject your knee to these imbalances, the higher the chances that they get hurt. Age plays a factor, too, of course.
That being said, here are some of the most common knee injuries involved in this sport:
- Patellofemoral pain syndrome
- Iliotibial band syndrome
Another question you might be asking is this:
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Know When To Take It Easy
Maybe you tweaked your knee again or feel it acting up? Learn to take your training down a notch.
When youre trying to treat runners knee you must know when to take it easy. Because pushing it too hard when injured doesnt do you any good.
So take a deep breath and dial back the miles, or the intensity, or the speed, or all 3 of those, and let your body heal.
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Vmo / Cyclists Squats
VMO Squats are a simple and awesome way to build strength through a full range of movement for your legs. By using a book, wedge, or small block to put your heels on, we free up any potential restriction of movement in the ankles that can limit how low some people can squat. As a result, it is easier to perform a full depth squat with the knees fully flexed so your quads get stronger in the end range of movement. Start off just bodyweight with this exercise until you can comfortably perform 20 reps in a set, then you can increase the intensity by holding weights.
Set your heels up on your book, wedge, or small block so they are hip-width apart and your feet are angled downwards. Make sure you feel stable before you start squatting, if not, put a chair on either side of you so you can hold onto the back of each chair with your hands to guide and assist you up and down through the squats. Keep your chest as upright as possible, then drive your hips downwards over the back of your ankles into a deep squat. Your knees should track forwards over your feet at hip-width as you squat up and down doing your reps. Watch this video to see how to do VMO Cyclist Squats
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How To Prevent Knee Pain In Yoga
In order to prevent knee strain and avoid knee pain in yoga we have to keep two principles in mind:
- Having a basic understanding of how joints are designed to move.
- Knowing the difference between stress/ discomfort and pain.
The knee joint is a hinge joint. This means that the knee can open and close, just like a door. Anatomically speaking, the knee joint mainly allows for flexion and extension, BUT it also allows a small degree of medial and lateral rotation. This rotation can only occur when the knee is flexed. If the knee is not flexed, the rotation happens at the hip joint.
In my experience, treating the knee as if it cant rotate helps me and my students to keep the knees safe. Its incredibly difficult to measure or sense the safe range of rotation, as we are engrossed in our practice.
Now, in our yoga teacher training courses, we speak a lot about the functionality of yoga practice, versus an aesthetic approach. Each yoga pose has muscular target areas that we want to place appropriate stress on. That stress can be in terms of feeling a stretch, but it can also be a contraction, an activation. To measure the appropriate amount of stress, we use the tool of the traffic light.
The Wisdom Of Acquiring A Knee Brace For Running
You do everything it takes to keep your knees in good shape, but as the co-director of Mayo Clinics sports medicine center Dr. Edward Laskowski says, braces can reinforce your knee area until your own, natural muscle brace heals itself. Todays product offerings are expansive. The most common come in three categories:
1. Bands and Straps. Easy to wear these fit under clothing and they do a decent job of applying effective, pain-relieving pressure during the healing process.
2. Most often recommended for runners suffering from mild to chronic knee pain and arthritis, compression sleeves/braces redistribute weight to relieve pain throughout the healing process.
3. Wraparounds work best on mild to moderate knee pain as well as dislocations and patellar instability. Wrap style braces can be custom fitted to your knee so you focus on your run, not your pain.
Additionally, a clinical study described in the U.S. National Institutes of Health website compared a prophylactic knee brace and two types of neoprene knee sleeves to see how they contributed or detracted from runners’ performance. All three proved equally beneficial ways that recommend a knee brace for running.
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Prevent Knee Pain From Running 1 Wear The Right Shoes
The foot is a very complex part of the human anatomy.
Its made up of 19 muscles, 26 bones, 107 ligaments, and 33 jointsand these take the brunt of a foot strike when running.
Since running is a high impact sport that places a great deal of stress on the knees, wearing the right trainers not only helps you to run faster and longer, but may also reduce risks of pain and injury.
A good running shoe is designed specifically to diffuse the load shooting up the rest of your leg.
Just dont get me wrong.
Im not suggesting that proper shoes are the ultimate solution to your knee issues.
But its a start, and an important part of an overall prevention and treatment and plan.
That said, I should also point outand this may surprise some of youthat the current research on the effectiveness of running shoes in improving performance and preventing overuse injury is, at best, mixed.
This link provides you with more insight on the subject at hand.
Yet, in my experience, a proper pair is non-negotiableregardless.
Therefore, to stay safe, you got to find a shoe that fits your feet properly.
More importantly, go for a pair that supports your natural foot typewhether youre neutral, high arched , or flat-footed runner.
To find a suitable pair, head to your local running store and ask for a foot type and gait analysis, which will help you find what best matches your physiological and training needs.
Also, be sure to replace your trainers regularly.
Strength training is good for you.
Keep Your Feet Aiming In The Direction You Are Running
When your feet splay, they can cause knee pain as you are torquing your knee with every foot strike you make. However, you must always run with your feet pointing in the direction you are running. You can do this by rotating your leg inward towards the centerline until your feet are parallel as well as a point forward. This is a great, permanent solution as it keeps strengthening your adductors to realign your legs.
The misalignment of your legs is sometimes mistaken for a knee problem. However, the foot splay can develop inflammation in the iliotibial band, which is attached to the tibia right below your knee. Besides, you can also consult a whiplash doctor or chiropractor for the inflammation.
Altering the biomechanics of your body takes time and some persistence, but it is worth it because it can help prevent knee pain. By increasing the medial rotation of your legs over the period of few weeks will give your legs the time it needs to adjust to the new direction of movement.
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