Running with Runner's Knee: How to Manage Patellofemoral Pain Syndrome
So, you’ve got runner's knee…now what?
If you are like many of my patients you are probably wondering, “Can I keep running even though it’s painful?” “If I can push through the pain, am I going to make it worse?” “How much running is too much?” Running with runner's knee: what a pain. Literally!
As a performance physical therapist and running specialist, I often encounter runners with patellofemoral pain syndrome (PFPS) facing the dilemma of whether to continue their favorite activity, running, despite experiencing the nagging knee pain commonly known as “runner's knee.”
In this blog, we'll explore the causes, symptoms, and management strategies for PFPS and I will provide guidance on how recreational runners can modify their running routines to run safely.
Because "just stop running" is not the answer
Understanding Runner's Knee (PFPS):
Patellofemoral pain syndrome is a common condition among runners, characterized by pain around or behind the kneecap (patella). It typically arises from improper tracking of the patella along the femoral groove, leading to increased pressure and irritation.
Common Causes of Runner's Knee
Several factors contribute to the development of PFPS, including:
Weakness or imbalance in the muscles supporting the knee, especially the quadriceps, hamstrings, and hip abductors.
Overuse or sudden increase in running mileage or intensity.
Inefficient gait mechanics, such as heel striking, overstriding, and low step-rate.
Improper footwear for the runner’s running style, i.e. a narrow toe box with a high degree of heel to toe drop for a midfoot striker.
Common Symptoms of Runner's Knee:
Runners experiencing PFPS often report:
Dull, aching pain around the kneecap during or after running, especially when going downhill or descending stairs.
Swelling or localized tenderness around the patella.
Crepitus or a grinding sensation with knee movement.
Stiffness and limited range of motion in the knee joint.
The Importance of Strength Training to Treat Runner's Knee:
Strength training plays a crucial role in managing and preventing PFPS. By targeting specific muscle groups, runners can improve knee stability, increase neuromuscular control, and alleviate pain. Key exercises for PFPS include:
Quadriceps strengthening: Spanish squats, cyclist squats, Poliquin step-ups improve the strength of the quadriceps muscles that control how the patella tracks along the femur. The stronger and more controlled your quads are, the better control you will have over your knee cap and will be less likely to get painful sheering!
Hip strengthening: Exercises like standing clamshells, copenhagen planks, and lateral banded stepping challenge the hip abductors and adductors, which in turn improve control over the knee in the frontal plane (moving from side to side).
Hamstring strengthening: Rower hamstring curls and single leg Romanian deadlifts target the hamstrings, balancing out muscle strength around the knee joint.
Running with Runner's Knee: Continuing to Run Safely
While rest may be necessary during acute flare-ups of PFPS, completely abstaining from running isn't always required (and hardly ever what I recommend!). Recreational runners can continue to enjoy their favorite activity by following these guidelines:
Modify mileage and intensity: Reduce running volume and avoid hills or uneven terrain that may exacerbate knee pain.
Incorporate cross-training: Supplement running with low-impact activities like cycling, swimming, or elliptical training to maintain cardiovascular fitness without aggravating the knee.
Listen to your body: Pay attention to pain signals and adjust your running routine accordingly. More often than not, our bodies will heal if we place them in an environment that is conducive to healing! Therefore, if you continually push past your own pain threshold, it’s not fair to expect our injuries to heal.
Remember, a little bit of discomfort is part of rehabilitating from injury, but if your pain increases more than 2/10 points above your baseline pain, modify as needed!
Conclusion:
Runner's knee, or patellofemoral pain syndrome, can be a frustrating obstacle for recreational runners.
However, with proper management strategies like strength training and smart modifications to running routines, individuals can continue to pursue their passion while minimizing discomfort and reducing the risk of injury.
Remember to prioritize strength, listen to your body, and seek guidance from a qualified healthcare professional to ensure safe and enjoyable running experiences.
Physical Therapy Treatment for Runner's Knee:
We understand that running is a part of your identity. That's why we're so committed to providing performance physical therapy services that will help you to actually return to your sport, rather than telling you to just stop running.
If you're located in the Jacksonville Beach, FL area and are looking to get treatment for any injuries that you are facing, reach out to us. You can read more about our physical therapy services here or schedule a free call by clicking here.
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