PATELLOFEMORAL PAIN SYNDROME (RUNNER'S KNEE) - CAUSES AND TREATMENT

written by: Nem​​
​Do you have pain around your knee cap when squatting or descending stairs? Does it get worse after prolonged sitting? In case you have any of these symptoms, chances are that you might have patellofemoral pain syndrome (PFPS), also called "the runner’s knee".

​Runner’s knee got its name for an obvious reason – it is highly prevalent among runners. But why is this the case? Running represents a cyclical activity, which means that phases of the running movement repeat over and over again.

In case you have even a small movement flaw within any phase of the running cycle, that flaw can become a big issue down the road if you run with enough intensity and duration.

​Specifically for the runner’s knee, there are certain biomechanical and structural factors that indicate a higher risk for developing this condition which we'll discuss later in this article.

WHAT IS RUNNER'S KNEE AND WHAT CAUSES THIS CONDITION? 

Runner’s knee is the most common running injury and can account for up to 16% of all running injuries. Common symptoms include dull ache behind and around the kneecap, that usually gets worse after sitting.

In addition to squatting and descending down a flight of stairs, you might have issues running downhill, as well as resisting leg extension (i.e. straightening of the knee joint). As you warm up you might feel ache subsiding, only to return after cessation. 

The exact cause of runner’s knee is difficult to pinpoint. However, we know that there are certain factors that increase the likelihood of someone developing this condition:

• Doing too much, too soon – abrupt increase in volume and/or intensity so that body cannot handle this extra load;
• Quadriceps and especially hip musculature weakness.
• Poor neuromuscular coordination – individuals with runner's knee often display poor single leg balance and poor vertical jumping ability;
• Reduced flexibility – iliotibial band, quadriceps, hamstrings and calf musculature stiffness, all play a role in this condition;
• Poor running form – foot overpronation and hip adduction have been implicated in the development of runner's knee. Overstriding when running may be another thing to look at, since this might produce high forces and sensitize tissues around the knee cap.
• Gender. Women are more susceptible compared to men. This is partly explained by wider pelvis in women, which indirectly affects knee mechanics. Another explanation is that on average women have lower hip strength, which forces thigh bone into adduction and subsequently causing knee collapse and abnormal kneecap tracking and pain;

​RUNNER'S KNEE FIX

Based on what we've discussed so far, you might've already guessed what needs to be done in order to get rid of this persistent condition:

1. Muscle strengthening,
   
2. Focused stretches and mobility work,
   
3. Running form correction and neuromuscular control training.
   

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​To get you started here are some exercises that you can use right away to get you back on the road of recovery:

1.Band Clamshell

​2. Isometric Quad Strengthening

​3. Side Step Band

​​4. Single-Leg Deadlift

​5. Standing glute med

​Depending on the severity of your symptoms, you might only need a week or two off, but if you are having this issue for a while now, then it might take up to 4-6 weeks or more until you can get back to running pain-free.

​SUMMARY

First step when dealing with PFPS is to reduce load on your knee joint and let the inflammation calm down. During this time it is prudent to focus on progressive strengthening of the knee and hip muscles, that will help to support your knee joint.

​In addition to strengthening, flexibility work for particular muscle groups will aid in the recovery as well.  And lastly, pay attention to your running form and make sure that you are not putting excessive strain on your knee joint by overstriding, having excessive foot pronation and knee collapse.

Knee Pain. Kneecap pain. Runners knee.

HOW TO KINESIOLOGY CAN HELP YOU

​If you wish to accelerate the rehab process and make sure you are doing everything right for your body and your goals, then we can help!

We are experts in human movement and rehabilitation. After going through a comprehensive kinesiology assessment we'll develop an individualized plan that's specific to you. We'll guide you through the whole process and make necessary adjustments to your program and form to ensure best results.
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Here are some of the ways we can help you:
- In-person kinesiology and personal training
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- Our full service offering
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Other articles you might be interested in:
- Exercise and low back pain: rehab and conditioning
- Do you have pain while running?
- Sitting too much? How to fix sitting-related aches and pains
- Patellofemoral pain syndrome (runner's knee) - causes and treatment 
- How to prevent running injuries