Why Knee Pain affects Runners?
Why runners? It is due to the repetitive nature and high forces involved with running. Release techniques and strengthening exercises for treatment are available, however there are other factors to consider.
Runner's knee is a common condition that is caused by decreased mobility of the knee cap (patella) on the thigh bone (femur). If lacking proper movement the patella can be compressed into the joint causing irritation and pain in the front of the knee. Sometimes people even feel an ache that extends down into their shin. This is called Patellofemoral Pain Syndrome. Clicking or popping is often reported, especially with squatting or stairs. Some clicking here and there is fine, but the knee should not be clicking repeatedly. Pain often occurs when first moving after a period of rest, or can also occur with prolonged activity towards the end of a run. If this is the case, do not wait, call your physical therapist to do something about it. Otherwise, the cartilage under the patella can be worn down over time causing lifelong effects.
Weakness of the core, hips, and inner thigh, cause increased stress and formation of muscle imbalances. Muscle imbalance is one of the likely causes of increased tension . Muscle tension then builds up along the outer portion of the thigh down to the knee. These connections to the patella cause it to tilt compressing it into the joint. A physical therapist can diagnosis this condition and begin treatment to both release the areas of tension, and provide proper strengthening exercises to keep knee pain from coming back. One of my favorite techniques for release with quick results is myofascial decompression. This helps to lift the tissue increasing circulation and promoting proper mobility of muscle fibers. Self treatment tools can be valuable as well.
Runner's knee can also occur due to lack of control of the foot during initial contact to the ground, causing "over pronation" or when the arch of the foot collapses too fast. This is where it is important to replace your running shoes every 300-500 miles, because the foam is no longer supportive. It is also important to have the proper shoe for your body and is recommended that you go to a running specialty store for proper shoe fit. Holabird Sports or Charm City Run are good examples in Baltimore. Some people have high arches, while others have flat feet. High arches cause increased force translating up the chain to other joints especially if you are a heel strike runner. On the other hand people that roll over too quickly may develop discomfort too due to lack of control (too much side to side motion). Repetitive stress in this manner will also increase compression of the patella. If strengthening alone isn't enough, lack of control of the foot and ankle may be remedied with motion controlled shoes or orthotics. When running the lower leg should be stable and controlled when your foot is in contact with the ground without excessive rotational or side to side motion.
Exercise is the fountain of youth, but proper body maintenance is required to continue to lead a happy and active lifestyle. Stay moving my friends.
James Dulkerian, DPT
Active outdoorsman with an honest soul and a passion for health.