Undoubtedly one of the most common running ailments, runner's knee or patellofemoral pain syndrome (PFPS), can hamper your training or leave you completely sidelined.
The pain associated with runner's knee is located under, slightly above or below the kneecap. It generally worsens when athletes run uphill, downhill or up and down stairs. A popping sensation is sometimes audible. In the worst cases, the knee may swell.
A term used to describe a number of knee issues, runner's knee often occurs because of an increase in mileage. While some harriers will experience sporadic pain, others have problems nearly every time they add miles. The condition can also be related to poor running form and core strength.
"A lot of these injuries result from motion or mobility problems in the hip or low back," explains Dr. Aaron LeBauer, a physical therapist based in Greensboro, North Carolina. "Or it can be an instability issue because of lack of core engagement. If you have an imbalance that causes the leg to be unstable, it may be a hip control issue."
Indeed, strength and mobility imbalances will have a greater effect on the body over increased mileage, resulting in issues like runner's knee. The dilemma is you often won't know you have these imbalances until your knee starts to nag you. At this point, it becomes important to back off and identify where the injury originated.
"The biggest problem is that people don't listen to their bodies and they run through pain," says LeBauer. "Running through sharp, shooting pain just makes the issue worse; [runners who do this] end up in my office because they keep running rather than resting or seeking treatment earlier."
"My main method is to find the area of tension and tightness in the hips, quadriceps, low back and abdominal muscles and, once we can get that to move better, we work on stabilizing the hip, knee, foot and lower leg," says LeBauer.
Research shows that stabilizing the kinetic chain through strength work can do wonders in terms of reducing the pain associated with runner's knee. For instance, one studypublished in the American Journal of Sports Medicine directed 19 participants with PFPS through an eight-week hip and core-strengthening program. At the end of the study, participants reported significant improvements in pain and knee function.
Another study out of the University of Kentucky showed that gait retrainment can be used to reduce the symptoms of PFPS. In guiding a group of runners with PFPS through eight gait retraining sessions, researchers worked on everything from internal hip rotation to pelvic drop in hopes of improving hip mechanics and lessening pain. Following the training, participants reported a major decrease in pain, and improvements were seen in running mechanics.
Even if you've never experienced runner's knee, the treatment plans that deal with strengthening and stabilizing the body through gait retraining also serve as preventative measures. To be sure, any time you fortify your core and hips, you're improving your chances of avoiding a long list of potential injuries.
Another important preventative measure: simply listen to your body and back off if something is nagging you.
"If you're feeling sharp or shooting pain, you might need to stop and check posture or form," says LeBauer. "A lot of times this can help."
If you are taking all the preventative measures and still running into issues, it's worth scheduling an appointment with a physical therapist to identify the root cause of the pain before it turns into a full-blown injury.
"Especially if it's something that is happening every time you run, definitely take care of it before it gets worse," advises LeBauer. "It will cost less in terms of money for physical therapy and [you'll take less] time off of running in the long run."
Hip-Strengthening Exercises
Here are a few of the most commonly prescribed exercises by physical therapists and coaches to help runners strengthen their hips and core region. These moves can help athletes avoid runner's knee.
Clamshells: Lie on your right side and bend your knees at approximately a 45-degree angle. Keeping your feet together, slowly lift your left knee to "open up the clamshell." Pause and then lower your knee to "shut the clamshell." Repeat 10 to 15 times on each side.
Bridge: Lie on your back with your knees bent and your feet flat on the floor. Slowly lift your butt off the ground, keeping your back straight and engaging your low back and glutes. Hold for 10 seconds and lower your body back down. Repeat seven to 10 times.
Plank: Get yourself into a push-up position, but lower down to support your body with your forearms. Keep your back straight and your butt aligned with your body, fighting the urge to bend at the waist. Hold for 30 seconds and repeat four times.
Side Leg Lifts: Lie on your right side, keeping your legs straight. Lift your left leg in the air as far as you can and then lower back down. Repeat 15 times on each side.
Bird Dog: On all fours, lift your right knee and left hand off the ground, bringing them together under your body. After that move, simultaneously stretch your right leg back behind your body and your left hand out in front. Repeat 15 times and switch sides.
