One of the most commonly injured sites in female athletes is the knee! In a previous blog, we talked about Patellar Tendinopathy, or "Jumper’s Knee.” Other common overuse running injuries include:

1. Patellofemoral Pain Syndrome (Runner’s Knee) — pain around the kneecap

2. Iliotibial Band Syndrome (IT Band Syndrome) — pain around the outside of the knee

In the absence of trauma, such as a fall or blow to the knee, if a runner comes in with complaints of “knee pain,” it’s very likely that they ramped up their training too fast, too soon, and they weren’t ready to handle that jump. The number one thing we can do, even before assessing them physically, is to take a look at their training plan. Here are a few questions to ask:

• 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?

For both “runner’s knee” and “IT band syndrome,” the solution isn’t to stop running but rather to find the entry point back to running without aggravating symptoms. Here’s an example of a runner and how we might modify their training plan:

A 32-year-old female runner training for a half-marathon presents with complaints of right lateral knee pain. She had been running 4x/week but stopped running for the past 2 weeks. During her first week back, symptoms occurred at mile 5 (~45 minutes) and worsened throughout the remainder of the run. The next day she ran again, and her knee pain started at mile 3 (~27 minutes) and lasted throughout the day.

Based on the information above, I know that she can tolerate at least 5 miles of running but that running on back-to-back days aggravates her symptoms. A sensible way to modify her training plan would be to have her run every other day and, for the first week, keep all runs between 25-40 minutes.

M: 10 min brisk walk + 20-35 minutes at conversation pace + 10 min cool-down walk T: Strength session + 30-35 minute fitness walk W: 10 min brisk walk + 35 minutes at conversation pace + 10 min cool-down walk Th: Strength session + 40-45 minute fitness walk F: 10 min brisk walk + 35-40 minutes at conversation pace + 10 min cool-down walk S: 50-60 minute fitness walk S: Rest

This is only one way that we can modify her training plan! The important thing is to use running as part of the treatment plan and gradually expose the body to more doses of it. After we have a clear picture of what training will look like, we can dive into the physical evaluation and address any deficits in range of motion, stability, and strength that we might find.

Thank you for taking the time to read! If you’ve been dealing with knee pain and need help getting back to running, schedule a complimentary call today!