Runners knee is the most common non-traumatic injury runners experience around the knee. Here’s the thing though it’s not just runners who experience this. It’s extremely common in the general population particularly those who are active.
It’s fairly common that patients present with a diagnosis of runners knee but it actually falls under one of three more specific diagnosis.
- Patellofemoral Syndrome (PFS)
- Iliotibial band friction syndrome (ITBFS)
- Chondromalacia patella
PFS and ITBFS are generally caused and worsened by two things. The first is an overload of particular structures in your lower limb. Overload is not when you physically can’t do an activity anymore. It occurs when certain muscles fail to control and stabilise the area as they are meant to.
This leads to biomechanical changes and overload to other areas. This can often manifest in pain in the knee. Imagine going for a run with muscles not doing their job. The first few steps may be fine even the first few kms or runs. Fast forward to when you have done 1000’s upon 1000’s of steps, eventually one of these steps is the straw that breaks the camels back.
This isn’t just running, I often see this in gym goers who may have a breakdown in their chain with things like squats, box jumps and particularly lunges.
When this occurs, most people take a week or so off, attempt to get back at it to find the pain is still there. They then take longer and longer off hoping that time will be the saviour.
As we now know time won’t strengthen that underlying weakness.
So what will?
As a physiotherapist, we look to address two important things.
- How do we get you out of pain and back to full activity?
- How do we keep you injury free and performing to your full potential?
These two aspects aren’t independent of each other and often overlap.
Once we have confirmed the diagnosis we look towards how to get you out of pain. This could be one or a combination of multiple techniques such as taping, deep tissue release, self-release techniques, joint mobilisation and exercises.
This is often the techniques we can apply in the clinic. Outside of it, we work towards modification of your aggravating factors (the things that set it off). Looking at your technique (running, squatting, lunges, jumping) is often the first point to address.
Once we look at your actual technique we can see where the weaknesses are, and the subsequent overload is occurring. If it is purely a technique issue we will develop strategies to address this. More likely than not the technique issue is underpinned by a muscular or stability issue.
Getting you out of pain is generally easy. The plan to keep you out of pain is where it takes some effort from both parties. Often it can be a case of two steps forward one step backwards. For example, winding back the distance or intensity of your workouts to allow you to keep active and be pain-free.
The knee can be a complex region due to the other contributing areas such as the hip, foot and other leg but with the right assessment, tools and plan it is highly likely to have a full recovery and be back to doing what you love pain free.
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