How Do I Know If I Have Runners Knee
Runner’s knee is characterized by knee pain after running in a very specific location. Like lateral knee pain being correlated with IT Band Syndrome, there’s a particular location for knee pain that makes it highly probable you have runner’s knee.
If your pain is directly on or along the outside edges of the kneecap, you most likely have PFPS. The pain is typically a dull ache but can occasionally be sharp; it feels like it’s located deep underneath the patella.
Along with the location of the pain, PFPS sufferers typically have more pain when they’re…
- walking up stairs
- after prolonged periods of sitting down
- while pushing on the kneecap
It’s important to note that PFPS is different from patellar tendonitis, which is an entirely separate injury characterized by pain in the patellar tendon. This is the thick tendon that connects your patella to your shin. This is a more rare injury, particularly among runners.
Still Not Sure If You Need To Stop Running My Advice Is To See A Physical Therapist Before The Pain Gets Worse
A physical therapist can analyze your movement, look at your gait and the mechanics of your whole body, and identify what may be the true source of the problem. Why did one knee get injured and not the other? Maybe it’s because of chronic weakness in that one hip. Maybe that ankle sprain 10 years ago made you favor one side. Simply getting a diagnosis from an M.D. is a start, but it takes really analyzing your movement to understand why your pain is there and how to get rid of it.
Knee pain may come and go, but if it doesn’t disappear completely after a few weeks or is bad enough that it is making you stop doing something you love , then it’s time to get it checked out if you haven’t already. Schedule a visit with a physical therapist or an M.D. who can properly assess what’s going on. Thankfully, most running-related knee injuries are from overuse and not traumatic accidents, which means there are ways to intervene.
Arthritis In Your Knee
Arthritis can happen in any joint in your body, but it’s especially common in your knee. It can make it hard to do things like walk or climb stairs.
Osteoarthritis is one of the most common kinds of arthritis. It’s the “wear and tear” kind that usually affects people over 50. OA happens slowly, and it hurts more over time. The cartilage wears away in your joint, and, just like with runner’s knee, bone rubs on bone and causes pain.
If you have OA, your knee may feel stiff and swollen and you may have trouble bending and straightening it. It’s often worse in the morning or during rainy weather. Your knee may buckle or feel weak.
What Is Runner’s Knee
Runner’s knee – also known as patellofemoral pain syndrome – is an overuse injury that affects as many as 30% of female runners and 25% of male runners. That makes it the most common running-related injury.
In runner’s knee, the cartilage in your kneecap gets irritated. This causes pain while you’re running, squatting, bending or even sitting for awhile. I often see patients come in with runner’s knee after they start running at an incline or increase miles or speed.
You Might Have Iliotibial Band Syndrome
If you feel pain outside your kneecap, chances are you have iliotibial band syndrome. The IT band is a stretch of fibers that runs from your hip to the knee on the outer side of the leg and is supported by the bursa to function smoothly, Dr. Logan explains.
Repeatedly bending and extending your knee while running can irritate the IT band and the tissues around it, causing pain and swelling known as IT band syndrome, according to Cedars Sinai. In addition to pain on the outside part of your knee, IT band syndrome can cause clicking, popping and snapping, per the Hospital for Special Surgery.
“Hip abduction is required for any activity that involves one of your feet being off the ground. Your hip abductors keep your pelvis relatively level when walking or running when the opposite side foot comes off the ground. The IT band helps with this, which helps explain why it gets tight,” Dr. Logan says.
“For the IT band to be stretched, your knee has to cross the midline of your body,” he explains. “This rarely occurs during straight-line running, so all it gets to do is contract over and over.”
“I also notice more pain myself when my shoes have too many miles on them. Spend the money to get fitted for the right shoe for your foot shape, and keep track of your miles,” he says. When you feel like your running shoes are worn out, toss them and get a new pair to prevent injury and pain.
Can Someone With Pfp Syndrome Play Sports
Most people with PFP syndrome need to cut back or stop sports for some time. Follow the health care provider’s instructions on when it’s safe for you to go back to sports. This usually is when:
- Hip, leg, and core strength is near normal.
- Flexibility, especially in the hamstring muscle, has improved.
- There’s no pain with everyday activities, such as walking and going up/down stairs.
- Any pain with activity is very mild and goes away within a few minutes of starting the activity.
Runners Knee Myth: My Kneecap Doesnt Track Properly
This is the most commonly cited cause of runner’s knee. The idea is that the patella “tracks” within the groove in your femur. But when it doesn’t slide evenly in this track, you can end up with PFPS.
This tracking problem is why most treatments focus on…
- strengthening the quadriceps
- stretching the IT Band
- using knee braces
- taping the knee
But unfortunately, there’s no clear relationship between a tracking problem and your PFPS .
The patella is more dynamic than we give it credit for: it can move all over the place. If you lie down so your leg is straight and you’re not holding any tension in your knee, you’ll notice the patella seems to hover over the knee joint. Manipulating it in all directions is quite easy.
Like many things in biology, there’s no clear definition of what “normal” tracking is for the patella. Several studies have shown that tilting or displaced kneecaps during activity shouldn’t be construed as “abnormal.” Indeed, abnormal may be normal!
Healthy knees do all kinds of weird things and it’s virtually impossible to tell an injured knee from a healthy knee by looking at the position of the patella.
So if your treatment focuses on correcting the alignment or function of your patella, you should find better treatment.
How Can I Prevent Runner’s Knee
- Keep your thigh muscles strong and limber with regular .
- Use shoe inserts if you have problems that may lead to runner’s knee.
- Make sure your shoes have enough support.
- Try not to run on hard surfaces, like concrete.
- Stay in shape and keep a healthy weight.
- Warm up before you work out.
- Don’t make sudden workout changes like adding squats or lunges. Add intense moves slowly.
- Ask your doctor if you should see a physical therapist.
- If your doctor or physical therapist suggests it. Try a knee brace when you work out.
- Wear quality running shoes.
- Get a new pair of running shoes once yours lose their shape or the sole becomes worn or irregular.
Structures Around The Knee
Besides running form, shoes and surfaces you run on, another reason you suffer from knee pain may have something to do with the structures around the knees
a) Patellofemoral pain syndrome or anterior knee pain is a classic and common chronic injury in runners. It accounts for roughly 20% of all running injuries
The cause of anterior knee pain when or after you run can come from structures which are connected to the knee joint, such as muscles, tendons or ligaments.
If any of the structures around the knee pull incorrectly, or exert too much or too little force, the knee cap can be pulled out of alignment or out of line and it doesn’t roll smoothly as it should.
Misalignment can be caused by strength imbalance of the muscles on the inside and outside of the thigh, for example the gluteus medius which is a stabiliser muscle.
If the knee rolls in as a result of weak inner and outer thigh muscles, the gluteus medius and a muscle called vastus medialis obliquus, can’t do their job properly, so the tensor fasciae latae takes over.
But if the TFL has to do more than the job it’s supposed to do it can pull on the illiotibial band , increasing the lateral pull of the knee cap, again pulling the knee out of the alignment.
A lot to take it isn’t it? The body is not formed of separate pieces, it’s a whole unit. Anything that happens anywhere in the body will have a ripple effect throughout the rest of the body.
b) Iliotibial Band Syndrome
- Bow legs
- Leg length different
What Should I Do About Heel Pain
Andy recommends applying ice to the area. He says the best way to do this is to freeze a small bottle of water, then place it on the floor and roll it back and forth under your foot for about 20 minutes. Never place ice directly on your skin.
There are also several stretches you can do to help heel pain. See the Health A-Z section on treating heel pain for guidance on how to do them.
Stop running and see a GP straight away if there’s a lot of swelling in the heel or the area under your foot. Otherwise, see a GP after a week to 10 days if the pain does not go away.
When Will My Knee Feel Better
People heal at different rates. Your recovery time depends on your body and your injury.
While you get better, you need to take it easy on your knee. That doesn’t mean you have to give up exercise. Just try something new that won’t hurt your joint. If you’re a jogger, swim laps in a pool instead.
Whatever you do, don’t rush things. If you try to get back to your workouts before you’re healed, you could damage the joint for good. Don’t return to your old level of physical activity until:
- You can fully bend and straighten your knee without pain.
- You feel no pain in your knee when you walk, jog, sprint, or jump.
- Your knee is as strong as your uninjured knee.
The Knee Pain Treatment Plan In A Nutshell
To sum up what you need to do in case of knee pain, here are the steps you need to take:
Who Gets Pfp Syndrome
Patellofemoral pain syndrome usually happens in people who do sports that involve a lot of knee bending and straightening, such as , , and . It also can happen to people, particularly young women, who do not do a lot of sports.
PFP syndrome is more common in women and happens most often to teens and young adults.
Tight or weak leg muscles or flat feet can make someone more likely to get PFP syndrome.
Staying Motivated If You Have An Injury
Being injured can be very frustrating. If you’re new to running, you might be tempted to give up at the first sign of injury.
Andy says that having a specific goal, such as a 5km race or charity run, will help you stay motivated through injury.
“If you have something to work towards, you’ll be much more likely to get back into running once you’ve recovered.”
Running with a partner is also a great way to stay motivated. If they carry on running while you’re injured, you’ll want to get back out there once you’re better as you will not want to let them down.
Page last reviewed: 20 June 2018 Next review due: 20 June 2021
Inside Knee Pain After Running
What do we mean when we refer to the “inside” or “inner” knee? Good question. There are a few different parts of your knee that can be injured or irritated from exercise, particularly running.
The inside knee is the relatively small area on the inside of the leg closest to your other knee. So for your left knee, this area would be to the right of the kneecap.
Others runners that have experienced this pain refer to it as a “twinge”, “nagging pain”, or “ongoing soreness” rather than a sharp or shooting pain. But everyone experiences muscle and joint pain differently. If any of these terms accurately describe how the inside of your knee feels, keep reading.
Could I Just Have Arthritis
Sure, especially if you’re an older runner over the age of 55. Typical arthritis is due to wear and tear and you may be at a higher risk of developing arthritis if you’ve experienced a traumatic injury to the knee in the past.
Visit your doctor and get an x-ray to confirm the diagnosis. But don’t worry, just because you have some arthritis doesn’t necessarily mean you’re experiencing any pain. Degeneration of cartilage in the knee doesn’t always cause pain while running.
Defer to your doctor’s prescribed treatment of arthritis, as it will be different from PFPS.
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, you’re, in essence, reaching too much forward with your legs as you swing them forward in front of your “center of gravity
When you do, you’ll 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
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 it’s over 160, you’re 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.
Other Common Causes Of Knee Pain:
There are various conditions that can lead to knee pain, which are not strictly ‘runner’s knee’. I would advise that any ongoing pain in your joints needs to be examined and properly diagnosed before you carry on running, or even give up altogether. Some of the most common knee problems that are treated by the Capital Orthopaedics team are caused by:
Causes Of Knee Pain And How To Fix Them
Sports doctor Jordan Metzl explains the most common knee injuries and how to manage them.
So you’ve got knee pain from running. Whether you’re a complete beginner, or you’re two weeks into your latest marathon training cycle, knee pain is frustrating. We spoke to sports doctor Jordan Metzl, who explains four of the most common causes of knee pain from running, and what you can do about them:
Is Patellofemoral Pain Syndrome Caused By Degenerated Cartilage
Unlikely! The cartilage underneath the patella and on the femur doesn’t have any nerves so it’s not what is causing you pain. It’s relatively inert.
What actually hurts is probably the synovial lining, a fancy word for the soft tissue and fluid that surrounds your knee joint. It acts as lubrication between the moving parts of your knee. It’s capable of irritation which is why it’s the specific part of your anatomy that hurts.
Can I Run With Runners Knee Pain
You should take time off from running when you notice the onset of runner’s knee, but you don’t have to quit exercise entirely. You can as long as the movement is pain-free. You’ll know that it’s safe to start running again when you’re able to run with a normal gait and without pain. If you find that you change your movement or compensate because of pain, you’re not quite ready.
Treatment Of Knee Injuries
- Ice massage. Keep a styrofoam cup in the freezer for this. Ice twice a day, 10 minutes on, 20 off, 10 on.
- Don’t run for at least 2-3 days to get the healing started, longer for a more advanced injury.
- When you start back, run very little at first, every other day.
- No speedwork or hills for at least two weeks, or until the soreness is gone.
- Knee injuries usually take more time because we run on them and aggravate them.
- Even when it seems healed, continue icing, reduce mileage and avoid speed and hills for two weeks.
The best recovery tool that I have found is called the – it invigorates the affected area and brings new bloodflow in!
Common Knee Injuries From Running
Over 28 million people in the U.S run weekly. Ask anyone who has been doing it for a long time and they’ll likely all tell you the same thing: going for a run can be extremely freeing. The wind is at your back, your destination is what you make it to be, and everything comes naturally. But while it may feel like a simplistic motion, there are a number of muscles, tendons, and nerves working together to make it all happen. And unfortunately, a minor breakdown of one of those parts can make the whole experience feel more restrictive than freeing.
It’s not unusual for athletes to sustain injuries without direct trauma, and that’s especially true for injuries pertaining to the knees. In fact, about 40% of all running injuries involve the knee in some way, a majority of which are usually a result of wear and tear. Fortunately, taking preventative steps now can lead to healthier joints in the future. That’s why Rothman put together this compilation of some common knee injuries from running, as well as how to handle them.
Common causes for runner’s knee include:
Overuse and/or repetitive stress
Conditions like chondromalacia patella, which causes cartilage under the knee to deteriorate and soften, bringing inflammation and pain to the knee joint.
Structural deformities in the legs, such as patellar malalignment. This causes the muscles in knees and legs to be weak and/or imbalanced.
Common causes of jumper’s knee include:
Unbalanced leg muscle strength
Diagnosing And Grading Chondromalacia Patellae
Your doctor will look for areas of swelling or tenderness in your knee. They may also look at how your kneecap aligns with your thigh bone. A misalignment can be an indicator of chondromalacia patellae. Your doctor may also apply resistive pressure to your extended kneecap to determine the tenderness and severity.
Afterward, your doctor may request any of the following tests to aid in diagnosis and grading:
- to show bone damage or signs of misalignment or arthritis
- magnetic resonance imaging to view cartilage wear and tear
- arthroscopic exam, a minimally invasive procedure to visualize the inside of the knee that involves inserting an endoscope and camera into the knee joint
What Does It Mean If I Have Pain Behind My Knee While Running
Whether you’ve just started a couch-to-5K running program or you’re a seasoned marathoner, you’re probably no stranger to aches and pains in your legs and knees as you grow muscle and improve your stamina. But how do you know if the pain is normal or part of a bigger issue? Ahat does it mean if you have pain behind your knee when you run?
Watch this video from Greenville health coach Aaron Benator and read on to find out.
What Are The Symptoms Of Runners Knee
Runner’s knee is usually felt as a dull, aching pain around or behind the kneecap, especially where it meets the lower part of the thigh bone . It also cause a sharp pain that pulls you up. It can occur during exercise, or can appear afterwards. Some conditions will also result in grinding or popping sensations, particularly if there is cartilage damage.
What Is Jumper’s Knee
Jumper’s knee – also called patellar tendonitis – is an overuse injury that occurs when a tendon is overloaded, causing it to thicken. I see this most often in younger patients who complain about pain in the front of the knee.
It can be especially painful when you squat, jump or land. Jumper’s knee typically begins in adolescence or early adulthood.
Medications And Steroid Injections
- Corticosteroids. The most effective type of medicine for knee arthritis, triamcinolone acetonide , is the only FDA-approved medication to treat osteoarthritis of the knee. This is a corticosteroid injected into your knee that releases medicine slowly over a 3-month period. The slow release of the medicine has been found to relieve pain and swelling and reduce some of the negative side effects of steroids, such as increased blood sugar.
- Topical pain relievers. The Arthritis Foundation recommends that people who have knee arthritis try topical pain relievers — which is medicine you apply directly on the skin, instead of taking by mouth — because it can help relieve pain without as many side effects.
- Hyaluronic acid injection. Although more on this remedy for knee arthritis is needed, it has often been used to help supplement fluids in the knee joint to decrease pain.
Knee Pain Can Be Caused By A Handful Of Different Conditions
Common conditions include runner’s knee , IT band syndrome, ligament tears , and meniscus tears . Some of the aches and pains associated with these conditions might go away with the right glutes-, quad-, or hip-strengthening regimen, serious foam rolling, footwear changes, and certain stretches. But some require more attention, including rest and/or physical therapy.
Why Your Knees Hurt When Running
1. IT Band Friction Syndrome
IT-band issues are one of the most common nuisances that plague runners. ITBFS occurs when the tendon from your hip to your outer knee gets tight and therefore inflamed, irritating the outer knee bone. If your knees hurt while running and you feel tightness on the outside of your knee, ITBFS may be why.
Fix it: Bummer alert: The only way to ease severe ITBFS pain is to completely rest the tendon , says Leon Popovitz, M.D., founder of the New York Bone and Joint Specialists in New York. Physical therapy may also be needed to ease the inflammation. For mild cases, a foam roller to stretch post-run will quickly become your best friend.
If you’ve recently upped your mileage or have increased your intensity in a short amount of time, the overuse of your knee can cause the tendons surrounding it to become strained and inflamed. This overuse is called tendonitis and can make your morning jogs pretty miserable.
Fix it: Tendonitis issues can typically be resolved with rest, ice, compression, and easing back into your usual routine. Scott Weiss, D.P.T., licensed physical therapist, board-certified athletic trainer, and exercise physiologist also recommends eccentric exercises to gently stretch the tendons and prevent knee pain when running.
3. Runner’s Knee
Fix it: Hamstring stretches and leg lifts can help runner’s knee, according to Dr. Popovitz. Do these post-run stretches to help your legs get stronger and prevent mid-run aches.