Is running a marathon or half-marathon on your bucket list? Undoubtedly one of the common running ailments, patellofemoral pain also known as “runner’s knee”, can hamper your training. Patellofemoral pain is pain in the front of the knee caused by irritation of the cartilage behind the kneecap. Not just runners get this condition; it can occur in walkers or with any exercise activity. The kneecap normally glides in a groove within the thigh bone as the knee is flexed and extended. If there is an imbalance, the kneecap may not always glide smoothly, and the cartilage can become irritated. With repetitive flexion/extension of the knee (such as with running), the cartilage can become irritated enough to cause pain. Usually, there is not any significant damage to the cartilage, but once it is irritated, the pain can flare up more quickly.
Patients with runner’s knee complain of anterior knee pain worsened by activity, especially stairs or hills, but also with prolonged sitting. The seated position causes the kneecap to be pulled tightly against the thigh bone, and this intensifies the cartilage irritation. Pain usually improves with straightening out the leg and with rest from prolonged walking or running.
The way to treat the pain associated with runner’s knee is to correct the imbalance causing the kneecap to not glide properly. Some people have anatomy that can predispose them to runner’s knee. One anatomic factor that can be corrected is pronation. Pronation means that the foot rolls inward during the walking or running movement. This can put stress on the knee. Stability or motion control running shoes can help correct over-pronation. You can visit your local running store or go online at runnersworld.com to check out the different shoe types.
Muscular factors that contribute to runner’s knee are tight iliotibial bands, tight hamstrings, weak quadriceps muscles, or weak hip abductors (the muscles that raise the leg to the side). A weak core can also lead to increased stress on the knee and an increased risk. Correcting these muscular imbalances allows the kneecap to glide correctly. A simple program can be found on FamilyDoc.org under Patellofemoral Pain Syndrome.
Long-term, the treatment for runner’s knee is proper running shoes and rehabilitation. Short-term, however, the kneecap position can be improved with athletic taping or bracing. Taping or bracing can allow you to continue running while addressing the other factors leading to your pain. Anti-inflammatory medications and ice can also help alleviate the pain. Cross-training is a good idea whenever you have an overuse injury. Alternate run training days with cycling or pool training to allow the knee to rest while still maintaining your cardiovascular fitness level.
If you finish the race, but still have the pain, then it is a good idea to take a break from running for a while and focus on rehabilitation. The majority of runner’s knee pain gets better, but sometimes the knee needs a rest from the overuse!
Dr. Marjorie Delo is a primary care sports medicine provider at Lakeshore Orthopaedics.