One of the most common running injuries we hear about are arguably knee injuries. I’m willing to bet my favorite pair of Saucony’s, that every single person reading this has had some form of knee problem or problems at least once in their life. Okay, maybe not my Saucony’s but you get what I’m trying to say…
Nonetheless, knee injuries remain a constant issue amongst recreational and professional runners. So our aim today is to dive into one of the most diagnosed (probably) conditions in the sport of running: Runner’s Knee
What is Runner's Knee?
Well the truth is Runner’s knee isn’t actually a specific condition. It’s actually a term used to describe one of many different overuse injuries affecting the knee joint. In short, any injury that isn’t a ligament, meniscus tear or anything else that results in permanent structural damage is usually thrown under the blanket term: Runner’s Knee.
Woah, that’s a mouthful. But do you guys understand why Runner’s knee (RK) isn’t technically a specific condition. So as a runner if you suffer from one or more of these conditions you will most likely be diagnosed with RK.
What Causes RK?
Almost 90% of RK cases are caused due to overuse. The problem with most of us runners is that we don’t know when to stop… Much less rest. Yes, we all have a scheduled rest day here and there but when it comes to listening to our bodies we’re actually quite dreadful. I don’t mean that with any disrespect but we would much rather run an extra mile than rest because of any sort of niggle.
What are the Signs and Symptoms of Runner’s Knee?
Anterior knee pain (AKP) and Patellofemoral pain syndrome (PFPS)
These conditions are very similar in their presentation. Both manifest as pain and discomfort at the front of the knee or behind the patella. The pain is usually a dull aching pain that may persist for hours at a time. The symptoms may worsen when:
In short, when it comes to AKP and PFPS there is a distinction without a difference. They are essentially the same condition with a different name. The only meaningful difference is that PFPS is a chronic diagnosis. Meaning that if you have been suffering from AKP for a prolonged period of time it can become a chronic syndrome i.e. Patellofemoral pain syndrome.
Chondromalacia Patella (CMP)
CMP is another condition that falls under the umbrella term of RK. However, it presents with a very unique pathology, chondromalacia patella is characterized as the degeneration of the cartilage at the back of the patella. In most cases there will be a grinding feeling within the knee joint that accompanies the pain. This is the result of the posterior aspect of the patella rubbing against the hard bony tissue inside the knee joint.
Patellar Tendinitis and Jumper’s Knee
Jumper’s knee and Patellar tendinitis are used interchangeably. These conditions describe the onset of moderate to severe inflammation of the patellar tendon. Overuse activities cause microtears in the tendon tissue that worsen over time (You see, we just don’t rest haha).
Technically, Jumper’s knee isn’t directly related to running. However, a lot of recreational runners do end up struggling with this condition. This is due to the fact that it can occur without any actual jumping movements. Running on even surfaces, doing a lot of hill work and even trail running may all potentially cause these conditions.
This is an acronym for Iliotibial band friction syndrome. ITBS presents uniquely on the lateral aspect of the knee joint.
So we’re going to try and explain the anatomy of this condition as simply as we possibly can. The iliotibial band is a long connective tissue that originates at the hip and attaches to the outside of the knee. The ITB plays a major role in single leg movements i.e. Running. Where the ITB attaches at the side of the knee is a protruding bony structure. Now when we run the ITB moves forward and backward. Now when we overdo it with our training this movement can result in friction around the bony attachment area which ultimately results in the ITB becoming irritated and inflamed.
How Do I Treat Runner’s Knee?
When it comes to RK, your treatment protocol is broken down into 3 phases:
- 1Immediate Management
The focus of this phase is pain management and treating the general symptoms of your specific case. This would usually occur within the first 7 days of your symptoms starting. A combination of the RICE protocol as well as NSAIDS should be implemented as needed through this phase.
- 2Intermediate Management
During this phase, which is usually ± the second week after your symptoms started, you will need to focus on modifications. And by this we mean making changes to your current running routine. In order to rule out any potential underlying issue that could be the cause or just contributing to your condition. Changes such as wearing different running shoes, changing up your training schedule or adding more designated rest days.
- 3Long Term Correction
With RK it’s usually a process of elimination. And by this we mean you will need to pinpoint, as closely as possible, the exact cause of your RK. If you can successfully identify the cause or causes of your RK, you can implement a long term strategy to permanently correct this issue. This is usually carried out by a specialist such as a physical therapist.
The combination of these 3 phases should get you back on the road within 6-12 weeks depending on how bad your initial case of RK might have been.
How to Treat Runner’s Knee in a Hurry
First things first, you will need to rest. No really, on top of your regular rest days you will need to incorporate resting the injury. The human undergoes major stresses on a daily basis. Now add exercising into the equation and all of sudden our bodies are taking a real beating. That’s why rest has always been the number one prescribed method of recovery.
In conjunction with rest you will definitely need to treat the painful symptoms. Cryotherapy (cold therapy) and non-steroidal antiinflammatories (NSAIDs) are effective methods of treating the acute symptoms related to RK.
If you implement this strategy daily for 7-10 days, most of your symptoms should be gone. However, every case is unique in its pathology so every person will react differently to this advice. Please consult your doctor or specialist with regard to your specific treatment needs.
Corrective Exercises for Runner’s Knee
Overuse injury rehabilitation is a tricky one and RK is one of the trickiest conditions out there…
This is because RK isn’t a specific condition and most of the time is a combination of one or more overuse injuries. Therefore it isn’t a set physical therapy protocol like you would have with an ACL tear, for example.
Nonetheless there is a general approach you can take in order to treat your specific condition:
Collectively additional exercising in combination with your running training is really your best bet at both treating Runner’s knee and preventing it all together.
To recap, Runner’s knee is a term used to describe one of many different overuse injuries affecting the knee joint. It’s predominantly caused by overtraining but can be the result of a few other factors as well. You will need to, through the process of elimination, identify which of the different conditions that make up RK, you’re suffering from. Once identified you would follow the 3 phases of treatment in order to fully recover from RK. Stretches and eccentric training will help you rehabilitate and prevent Runner’s Knee.
Honestly guys, when it’s all said and done please listen to your body. Our knee joints are single handedly keeping us upright… Literally. Take care of them, because without them we can’t run. And I don’t know about you guys, but that’s not something I am willing to live with.