How to Avoid Runner’s Knee

“Runner’s knee” is an injury that you could expect worsen if you don’t change what you’re doing. If you feel a dull pain around the front of the knee (patella) you may be experiencing runner’s knee. Symptoms can flare up at or near the kneecap when you perform a lot of activity, or after sitting for a long time with your knees bent.

While there are many, many different mechanisms and structures at the knee that could contribute to issues running, Patellofemoral Pain Syndrome and Iliotibial Band Friction Syndrome are among the most common.

Patellofemoral Pain Syndrome mainly involves the patella (kneecap) tracking too far one direction, usually up towards the hip and out away from the body. When this happens, the cartilage on the underside of the patella – the interface between where the patella glides on the femur as the knee moves—can create increased pressures concentrated in certain parts, potentially irritating that structure with increased compression (as with running, jumping, weight bearing, or lifting), or with repetitive movement.

Illiotibial band friction syndrome mainly involves the iliotibial band—a fibrous tendon sheath that attaches muscles in the hip, the tensor fascia lata muscle and fibers of the gluteus maximus muscle to the tibia, the bone of the lower leg. With a lot of repetitive activity, and use of the muscles mentioned, weakness in some other muscles at the hip, and/or weakness or structural changes at the ankle or foot, there can be increased compression between the lateral femoral epicondyle and the iliotibial band, which can contribute to pain, and feel worse with running.

Symptoms

The symptoms of runner’s knee is pain made worse during a run. As well as when the kneecap is tender to the touch or painful to press on, this can indicate patellofemoral pain syndrome. If the lateral femoral epicondyle is tender to the touch or painful to press on, this can indicate iliotibial band friction syndrome.

Treatment

The treatment for runner’s knee involves identifying the source of the issue, identifying aggravating and alleviating factors, modifying variables in a running program (e.g. speed, volume, and running mechanics), improving specific motions of joints the lower leg and often the trunk – depending on whether there’s a limitation in the range of motion, or the range of motion isn’t being controlled during the run, and, ultimately, allowing the tissue to heal.

Prevention

Generally, progressing exercise appropriately, and often, improving the strength and endurance of the muscles that control movement of the patella and femur – often muscles on the back and outside of the thigh, that help determine where and how much compression occurs at the various sites of the knee during a run. It can be difficult to predict what will cause issues, as each person may respond differently to different activities, for different reasons.

When to see a health care provider

If you’re having pain or issues completing runs or doing any activity when you’re on your feet, if you’re uncertain about when or how to participate in a new exercise or activity program, and definitely if you have had any falls or incidents after you’ve noticed your knee has felt differently.