Patellofemoral pain is a very common condition. In fact, this pain around or under the kneecap is so common among runners, that it has earned the alternative name, Runner’s Knee. Here are the causes and treatments you should know about. – BY ERNEST COOPER, BIOMECHANIST
Runner’s Knee pain is usually felt during walking, running, squatting and stair climbing, and is often worse when walking or running downhill. Adolescents and young adults tend to be more prone to Runner’s Knee than older adults, and females are at greater risk than males. Runner’s Knee has a number of causes:
• Training overload: When starting with a running programme, or advancing a current programme, it is very important to progress gradually. A sudden increases in running distance and speed places a runner at risk of developing injuries, as the runner requires sufficient time to become accustomed to the load they experience. Novice runners, in particular, are at risk of wanting to do “too much, too soon.”
• Muscular weakness: The hip muscles, in particular the gluteal muscles, control hip motion during the single leg stance. These muscles need to be strong enough to prevent the pelvis dropping to one side and the thigh shifting inwards. Meanwhile, strong thigh muscles (quadriceps) are needed to provide support around the kneecap. People suffering from Runner’s Knee often have weak quadriceps, and strengthening programmes that focus on both the hip and thigh muscles have been shown to decrease pain and improve function.
• Running mechanics: The way we move influences the way forces are applied to different parts of the body, which can lead to certain types of injuries. Over-striding (making contact with the ground too far in front of the body) changes the impact forces that a runner experiences in such a way that it places increased load on the knee. If the pelvis drops to one side on landing, and the thigh collapses or twists inwards, this leads to a change in the alignment of the kneecap and thigh bone, which increases the pressure between bones in the knee and is one of the mechanical features of Runner’s Knee.
So, in addition to strengthening the muscles around the hip and knee, it may be necessary to analyse your running mechanics and then make changes to running technique as part of the treatment for Runner’s Knee. Excessive pronation (where the foot rolls inwards) can also contribute to knee pain. The knee is therefore often the victim of what happens above (at the hip) or below (at the foot).
Since Runner’s Knee may be experienced due to several causes, and each cause is treated in a different manner, every athlete should be managed as an individual. For this reason it is imperative that runners seek the assistance of a qualified professional in order to identify the root of the problem and prescribe the appropriate course of action.
About the Author
Ernest is a biomechanical, video, and running gait analyst at the High Performance Centre (HPC) of the University of Pretoria.