The Myths of Runner’s Knee
Runner’s knee (also known as patello-femoral knee pain) is one of the most common knee injuries experienced world-wide. Pain is felt around the kneecap and can sometimes be accompanied by swelling and stiffness. Symptoms are often worsened after sitting for a long period of time and with activities such as climbing stairs, running and squatting. A common question people ask is “can running damage my knees?".
So, what is runner’s knee and what can you do about it?
It isn’t about kneecap mal-tracking or something being “out of place.”
It’s simply that the joint between your knee cap and thigh bone is temporarily irritated due to excessive loading. Understanding this is crucial. The joint can become irritated due to repetitive or sudden overload (ie. increasing your running distance by a large amount or suddenly taking up an activity that your body isn’t conditioned to).
You don’t always have to stop running or exercising completely.
In fact, stopping completely can make you worse! All joints in the body are designed to move and take load - stopping this will only cause joint stiffness and further deconditioning. The trick is to find a happy medium. Work out how much running/activity you can manage with low grade, tolerable pain that settles within 24 hours. Start from here before a gradual build back up. This gives the irritated knee a little breather.
It’s not all about the VMO!
The VMO (vastus medialis obliquus) is located on the inside part of your knee and is 1 out of 4 muscle bellies of the quadricep muscle. Traditionally, physiotherapists have believed that this muscle was the key to knee pain. If you’ve been told to strengthen the hell out of these tiny fibres, then you are selling yourself short! Many hands make light work, so getting the entire quadriceps, gluteals, hamstrings and especially calves strong is imperative. Did you know, the calf-Achilles complex can absorb up to 6-8x body weight during running!?
Muscle tightness is not a cause, its a consequence!
Releasing the restricted surrounding soft tissues may feel good and allow you to train but it doesn’t fix the underlying loading issue. Use your time wisely and prioritise load management and strengthening and soon enough, the feeling of muscle tightness should disappear.
There is no perfect “one size fits all” running style.
Running gait is dependent on size, strength, genetics and experience. Drastic changes are risky and can cause more problems than solutions. Sometimes, simply increasing your cadence (steps per minute) by 7.5% can reduce impact forces through the knee by 15-20%.
Everyone’s knee injury is unique and there isn’t one magical treatment or exercise that will fix runner’s knee. An experienced physiotherapist should assess muscle strength, endurance, control and perform a running assessment to create an individualised strengthening and load management program for you.
If you would like a strengthening program to build resilient knees, click here.
