If you're a runner, chances are that you've dealt with knee pain in the past. Up to 50% of running injuries involve the knee!

Understanding the Knee

The knee is like a door hinge, it moves up and down, but unlike a door hinge, it has some rotation. The knee has four ligaments to limit unwanted motion and has a set of menisci for shock absorption. The key muscles that support the knee are the quadriceps to extend the knee, the hamstrings to bend the knee, and the hip, lower leg/ankle muscles also play a role in supporting the knee. Since the knee is the middleman between the hips and the ankles, we must assess those joints when dealing with knee pain.

The Role the Knee Plays in Running

One of the roles of the knee is to absorb the shock of impact by bending when the foot hits the ground. The picture below shows one example of what that might look like. On the right, the runner is “overstriding” and landing with more of an extended knee. They are using a “bony strategy” to absorb the shock of impact. On the left, the runner has more knee bend and uses more of a “muscle strategy” to decrease the impact. Which runner do you think is more prone to experiencing knee pain? Of course, running form, is only one factor to consider and is not the only reason for knee pain.

PT TIP: Try to land with your foot “underneath your body” to avoid overstriding

Three Common Knee Injuries

1. Patellofemoral Pain Syndrome (Runner's Knee)→ pain around the kneecap

2. Iliotibial Band Syndrome → pain around the outside of the knee

3. Patellar Tendinopathy (Jumper's Knee)→ pain at the patellar tendon

Let's not get too hung up on the specific diagnosis for now, and let's take a look at some of the things we want to consider when navigating knee pain.

First, we need to ask ourselves a few questions to help us create a return to running plan from day one!

• Do you have knee pain with other activities of daily living (example, stairs, prolonged sitting, walking, etc.)?

• How long can you run before having any knee pain?

• How does your pain change with running uphill, downhill, around a track, etc.?

• How do you feel immediately after a run? 24 hours after a run?

• Do you have to take medicine to help with the pain?

The goal with these questions is to help us determine if we need to temporarily remove running altogether or if we can find a level of running that you can continue to do. Majority of times, we can and should keep some level of running! In the next blog, we will dive deeper into what to do and not to do when dealing with knee pain!

Thank you for taking the time to read! If you’ve been dealing with knee pain and would like to learn more about how to get back to running pain-free schedule a complimentary call today!

References

Gallo RA, Plakke M, Silvis ML. Common leg injuries of long-distance runners: anatomical and biomechanical approach. Sports Health. 2012 Nov;4(6):485-95.

Harvie D, O'Leary T, Kumar S. A systematic review of randomized controlled trials on exercise parameters in the treatment of patellofemoral pain: what works? J Multidiscip Healthc. 2011;4:383-92