Runner’s Knee 101: How to Handle Knee Pain After Running

Runner’s knee is a common source of pain in the knee area after running. How do you know if you have runner’s knee?

Patellofemoral pain syndrome, also known as runner’s knee, is a genuine source of anxiety for both runners and physical therapists because there is no consensus on what causes PFPS or how to treat it.

There are no clear treatment options if you have runner’s knee. Frustrating, isn’t it?

Thankfully, there are still some very good options. It’s always best to focus on prevention first. It’s better to invest a little time in staying healthy than a lot of time in getting healthy again.

Conservative treatment for Patellofemoral Pain Syndrome typically results in dull aching pain, as opposed to sharp, stabbing sensations.

The key to preventing further cases of PFPS and staying healthy overall lies more in your training than in any specific preventive exercises. The most important factor in staying healthy is how you train.

The injury may cause mild symptoms that last for a long time. If you have runner’s knee, your training may not be limited much, but it may be interrupted by a constant, annoying pain.

What causes runner’s knee and how can you tell if you have it?

What is Runner’s Knee?

Patellofemoral Pain Syndrome is a knee injury that is common among people who engage in activities such as running, cycling, hiking, and playing basketball, volleyball, or track and field.

PFPS is an injury that creates knee pain after running, but the cause is unknown. But there are plenty of theories:

Some claim it’s because the kneecap (patella) does not track well in its groove in the femur
Others claim that it’s because the quadriceps is weak and does a poor job of controlling the kneecap during activity
And some others go on to claim that PFPS occurs because the cartilage of the knee has degenerated. While some research has concluded that there can be some cartilage degeneration accompanying runner’s knee, it’s not necessarily the cause.

There are many theories about what causes PFPS, but no one knows for sure. There are many possible reasons for this issue, including weak muscles in the thighs and hips, excessive use, and lack of flexibility. How you run may make you more likely to get this injury.

If we keep investigating the reason for PFPS, it will be helpful to understand that your knee is a joint that is alive and it is stressed almost all the time (even when you are sitting!). The most likely explanation for your PFPS is that it is a minor, non-traumatic injury, and your knee is telling you that it is tired, potentially inflamed, and overused.

This joint irritation is caused by constant abuse, which may be made worse by slight biomechanical inefficiencies.

From this perspective, runner’s knee is most likely to respond positively to rest and conservative treatments.

How do I know if I have Runner’s Knee?

The pain associated with runner’s knee is felt in a specific location on the knee and is brought on by running (or during running). There is a particular location for knee pain that makes it highly probable you have runner’s knee, just like lateral knee pain (on the outside of your knee) being correlated with IT Band Syndrome.

If your pain is on or along the outside edges of your kneecap, you very likely have PFPS. The pain is typically a dull ache but can occasionally be sharp; it feels like the patella is being pushed deep into the knee.

Patients with patellofemoral pain syndrome (PFPS) often have more pain when they are…

walking up stairs
running uphill
squatting
after prolonged periods of sitting down
while pushing on the kneecap

PFPS is a condition that is different from patellar tendonitis, which is a separate injury that is characterized by pain in the patellar tendon. This tendon is thick and connects your patella (kneecap) to your shin. This is a more rare injury, particularly among runners.

Runner’s Knee Myth: “It’s Because of my Q-Angle! Or…”

Many therapists will blame the “usual suspects” for a case of PFPS:

Leg length discrepancy
Q-angle
Severe pronation

The most likely reason you have runner’s knee is not due to any of these issues. There is no research to support these claims.

Although patellofemoral pain syndrome (PFPS) is relatively unknown, I cannot blame clinicians who may automatically assume it is caused by common injuries. However, there is no concrete evidence that supports this claim.

Although biomechanical issues may be a contributing factor to runner’s knee, there is no definitive evidence to support this claim.

Runner’s Knee Myth: “My Kneecap Doesn’t Track Properly”

The most commonly cited cause of runner’s knee is incorrect form while running. It is believed that the patella moves along the groove in the femur. If the kneecap doesn’t slide evenly in the track, you can end up with PFPS.

This tracking problem is why most treatments focus on…

strengthening the quadriceps
stretching the IT Band (but you should know that it’s impossible to stretch this thick piece of connective tissue)
using knee braces
taping the knee

There is no clear relationship between a tracking problem and your PFPS. A tracking problem could be a contributing factor, but it is not the direct cause of the injury.

The patella, or kneecap, is not as static as we once thought. It is able to move around much more than we realized. Lying down with a straight leg and no tension in the knee, you’ll see that the patella hovers over the knee joint. Manipulating it in all directions is quite easy.

However, the current thinking is that when the patella tracking is “off,” it can cause knee problems There is no one clear definition of what normal patella tracking is in biology, however the current belief is that when patella tracking is not functioning properly, it can lead to knee problems. Some research has suggested that having your kneecap out of place while being active shouldn’t be seen as unusual. In fact, what might be considered abnormal could actually be normal!

The position of the patella cannot be used to determine whether a knee is healthy or injured.

If you want to improve your condition, you should focus on fixing the alignment or function of your patella.

TREATING RUNNER’S KNEE JOINT PAIN

There are a few things that runners can do to help treat their knee pain. You will eventually talk to your doctor to figure out if there are any permanent causes or risk factors for runner’s knee that you can fix. The pain from the injury should be treated immediately to prevent further damage and so that you can return to your normal activities. Mueller Sports Medicine is focused on providing athletes with the materials they need to treat stress injuries like runner’s knee at home.

Here’s how to ease the pain and get back to your run:

WEAR A SUPPORTIVE KNEE BRACE

If you are experiencing swelling or pain in your knee, it is not advisable to run. However, wearing a supportive knee brace may allow you to continue running. Depending on the brace you choose, a knee brace can take some weight off the knee, hold your knee in alignment as you run, or offer extra support for controlled knee flexing.

A compression brace or wrapped elastic bandage should be worn on your knee to help with healing and/or if your knee is swollen. Wearing a compression bandage on your knee can help reduce swelling and keep the area warm, which promotes healing. After the swelling from the injury has subsided, you can try different types of knee braces to see which one gives you relief from the pain.

The type of knee brace that will work best for you will be dependent on what is causing your pain. If a hinged brace is the solution, then the problem may be misalignment. If you are wearing a compression brace, it is likely that you have a minor injury or a weak muscle.

ICE FOR SWELLING, HEAT FOR HEALING

Both ice and heat can help reduce pain and promote healing. Although both these groups have similar goals, they go about achieving them in different ways. Ice is only appropriate if your knee is swelling. The cold helps reduce pain and swelling by numbing the area and slowing down blood flow. Apply ice to the injured area for 30 minutes at a time, followed by a two-hour break. You should hold your ice in a cloth to avoid hurting your skin.

If you are not experiencing swelling, then heat is the best way to treat the pain. If your knee pain is caused by strained soft tissue, try using hot baths, hot compresses, or a hot water bottle. These can often provide relief. The heat helps muscles and tendons relax, and promotes blood flow, which speeds up healing. The heat lessens pain by also lessening the tension around your knee.

REST AND ELEVATION

There is nothing better than taking a break when you have an injury that is caused by overuse. It is best to rest an injured knee as much as possible. Apply a cold compress to the injured area for a few hours in the evening. Pampering your knee for even just one night can make a real difference. If you’re an active person who uses your knees a lot, it’s especially important to take care of them.

If you sit at a desk all day, try to find a way to prop up your leg while you work, or while you are doing school work if you are a student. This will help blood to circulate better throughout your body. If you’re looking for a way to give your knees a break, this can be a great solution. By stealing a few extra hours during your day, you can help your knees recover faster.

STRETCHING AND MASSAGE

Finally, never underestimate the value of stretching and massage. The soft tissue around the knee can become tense or begin to grate, causing runner’s knee. A massage can loosen the muscle tissue and help improve blood circulation. Stretching can help loosen knots, improve alignment of the knee, and assist in the healing of soft tissue.

CAUSES & CURES FOR RUNNER’S KNEE PAIN

The symptoms of runner’s knee can be treated at home, and any minor injuries that may be causing it can be healed. The true source of your discomfort should always be your long-term solution. There are many possible causes of the pain experienced as runner’s knee. Every runner, and every knee, are different. Depending on what caused your pain, the best way to stop it may vary.

POOR RUNNING FORM – MINOR STRAIN

Your running form could be the reason you are experiencing runner’s knee. If you ran with better ergonomic movement, you could improve your physical precision. Your ankles may be rolling in or your feet may be flaring out too far. Impacts that cause the knee to move out of alignment can cause pain that eventually becomes a constant sensation.

TREATING POOR FORM

If you suspect that the runner’s knee is coming from Poor running form, the best answer is to naturally improve your form. Pay very close attention to how you are running. The movement of your legs starts from the hips, then goes to the knees, and finally reaches the feet. Do your feet kick out? Do your hips feel stressed? You can improve your running form by comparing it to videos of running instructors on YouTube. If you are looking to improve your running form, you can ask your trainer, friends, or a professional at your local gym for advice.

WEAR & TEAR FROM REPETITIVE MOTION

Sometimes, you might be overexerting yourself. Or the work you’re doing is wearing down your knee with repetitive motion. If you exercise on a short track or do high-impact exercises often, you may start to feel pain in your knees. If you run too much, you may get runner’s knee pain.

TREATING WEAR & TEAR RUNNER’S KNEE

If your knee is overused or used with poor form, the best solution is to rest for a few days or weeks and then change your routine. Stop doing whatever you’re doing so repetitively. If you want to avoid injury while running, it’s important to change up your route and focus on upper-body exercises. At work, be sure to take breaks and move around frequently to avoid stiffness and soreness. Both massage and stretching can help promote healing.

IMPERFECT FEET OR THE WRONG SHOES

Lastly, there are the feet. If you have flat feet, overpronate, or have hypermobile feet, you may be more likely to develop runner’s knee.

Similarly, the wrong shoes can worsen foot problems. If your shoes are not at the right angle, it will cause pain in your ankles, knees, and up through your body.

TREATING FOOT AND SHOE PROBLEMS

If you have foot problems, the best way to treat them is by being patient when shopping for shoes. A runner needs a pair of shoes that corrects their foot alignment, regardless of the specific needs of their feet. If your shoes lack good arch support, or you are experiencing problems with your feet, prescription inserts may help alleviate the issue.