Running is one of the best forms of cardio, hands down! Not only is it amazing exercise, but you'll find that it's wonderfully freeing to hit the open road and run the hours away. You sort of self-hypnotize as you focus on your breath, your muscles, and your running. It's a great way to get in a wicked lower body/cardio workout!
But, if you are a regular runner, you may find yourself suffering from one of the most common injuries: runner's knee.
Did You Know: Up to 40% of complaints in sports medicine clinics are runner's knee? 25% of the general recreational running population suffers from runner's knee!
Here is everything you need to know about this injury…
What is Runner's Knee?
Runner's knee is the simple name for "patellofemoral pain syndrome", a repetitive stress injury that occurs when the kneecap (patella) rests on your thighbone. The bone on bone contact can cause pain--both acute (sharp) and chronic (dull)--along with a number of other symptoms (see below).
Oddly enough, the pain may disappear when you run, only to return when you cool down. There are a number of things that can cause this knee pain after running:
Biomechanical issues -- If your leg bones are out of position, misaligned, or malformed from birth, or your kneecap is slightly out of position, the impact on your legs won't be evenly distributed. These biomechanical issues will place higher stress on certain parts of your body, leading to wear and potential injuries to your joints.
Overuse --As mentioned above, runners knee is a repetitive stress injury, which can result from overuse of the joint. If you perform a lot of high-impact activity (lower body workouts, running, jump training, etc.), the activity can cause inflammation in the kneecap joint. Tendons that have been overstretched may also be the cause.
Direct trauma -- If you fall and land directly on your knee, the trauma may lead to runner's knee. The same is true for a direct blow to the kneecap.
Muscular weakness/imbalance -- If your thigh and hip muscles are poorly conditioned, they aren't able to bear up under the strain of your running. Your body will usually make up for it by adjusting your gait or shifting your weight, which could lead to incorrect running posture and ultimately knee injuries. Weak or tight hamstrings, hips, quads, glutes, and lower back muscles can all contribute to a higher risk of knee injuries.
Foot problems -- If you have flat feet, high arches, feet that turn inward or outward, or hypermobile feet (ankle and foot joints that move more than "normal"), your stride may cause wear and tear on your joints, or can lead to biomechanical issues with your knees. The joints and tissues of your knee will be strained, leading to runner's knee.
Symptoms of Runners Knee
Many people experience knee pain after running--or even during their run-- but how can you know if it's runner's knee or some other injury?
According to Web MD, runner's knee is a very specific type of pain. It will be located around or behind your kneecap, particularly where the patella meets the femur (your thigh bone). However, Breaking Muscle states that the pain is located at the front of the knee, often below the kneecap.
If this is a bit too vague to help you be certain, here are a few more symptoms of runner's knee to look out for:
Pain during exercise -- The pain will usually set in SPECIFICALLY during exercises that involve repeated bending of your knee: Squats, Lunges, Stair Climbing, Jumping, etc.
Pain when you bend your knee -- When you walk, kneel, squat, or stand up, does your knee hurt? Such simple activities shouldn't cause knee pain, so any discomfort is a sign that something is wrong. The pain will usually grow worse when you walk downhill or go down stairs.
Pain after long periods of sitting -- When you stand up from your office desk, the movie theater, or in an airplane, do your knees hurt? Pain after prolonged periods of sitting are an indication of runner's knee.
Swelling -- Swelling is ALWAYS a sign of injury! While it's not specific to just one knee injury, it's a good indication (when combined with other signs) that the problem is runner's knee.
Grinding/Popping/Crackling --Does your knee make sounds when you stand up? If your knees grind, pop, or crack--especially after sitting or when climbing stairs--it's an indication of runner's knee.
These symptoms all point toward runner's knee, but there's only one way to be certain: get checked out! Get yourself to a doctor for a physical exam, or undergo an MRI, X-rays, or CT Scan to be certain that it's runner's knee and not some other knee problem.
Note: Runner's knee is NOT the same as a meniscus tear. The pain of a meniscus tear is located on the inner (medial) or outer (lateral) sides of your knee. Meniscus tear symptoms are similar to runner's knee symptoms (pain when moving or exercising), but your knee will often swell up, lock, or even give way when you use your legs. Torn meniscus treatment differs from treatment for runner's knee, which is why it's so important that a doctor diagnoses the problem after a thorough exam.
How to Treat Runner's Knee
There's good news and bad news about runner's knee pain treatment:
The Bad News: You're going to have to quit running for a while, at least until your knee heals. This may be a hard saying for some, but it's worth it!
The Good News: You'll be back on your feet sooner than you'd think. Runner's knee is usually a fairly minor injury, so time and simple knee pain treatment will usually be enough to deal with the problem!
Before we get into treatment for runner's knee, let's look at a few ways to PREVENT it:
- Change Your Running Surface -- Instead of running on concrete or hard-packed earth, run on a softer surface: running tracks, forest trails, grass, etc. The softer the surface, the less impact on your joints!
- Increase Mileage Gradually -- Did you know that adding too much distance to your runs can increase your risk of injuries? Make it a point to only increase mileage by 10% per week!
- Add More Hill Work -- Your body needs to get used to tackling hills--both up and downhills. Don't push yourself too hard, but do acclimate your body to hills by adding more hill work to your runs.
- Shorten Your Stride on Hills -- The longer your stride on up- and down-hills, the greater the impact on the joints. When running up and down hills, shorten your stride and slow your run speed. You'll engage your leg and core muscles more effectively, taking the strain off your knees.
- Find the Right Shoes -- You need a pair of shoes with the right arch support and cushioning, and that fit well. Buy shoes specifically for the type of running you do! (Check out our article Shoes Matter, Here's How to Choose the Best Running Shoes for You for a complete guide to choosing running shoes…)
- Strengthen Your Lower Body -- If your hips, glutes, hamstrings, quads, and lower back muscles aren't able to handle the strain, you're more likely to suffer injuries. Spend more time strengthening those muscles in order to keep up with your runs!
These things will all help you to avoid runner's knee in the future, but what can you do to deal with the problem RIGHT NOW?
Rest -- Most important of all, it's time to GET OFF THAT LEG! The more you use the knee, the longer it will take for your body to repair the damage. You may not be able to spend weeks in bed, but you should try to limit your movement until the pain goes away. Definitely take a break from running for a week or three.
Ice Your Knee -- Ice helps to reduce swelling, speeding up the healing process. As you are giving your knees a rest, apply an ice pack to the injured area. You'll find that it will do wonders! (Check out the Faves below for an EPIC ice pack…)
Use a Compress/Knee Brace -- It's always a good idea to wrap your knee or use a knee brace when injured. Why is this? Knee support serves two purposes: it reduces the risk of further injury, and it increases blood flow to the injured area. Wrap the knee with an ACE bandage or wear a knee brace for a few days after the pain disappears. (We've got a few good options in the Fave list below…)
Elevate Your Knee -- When resting, raise your knee above the level of your heart. According to Wikipedia, "Elevation aims to reduce swelling by increasing venous return of blood to the systemic circulation. This will result in less edema…"
Take Anti-Inflammatory Medications -- Non-steroidal anti-inflammatory drugs (NSAIDs) are an excellent solution to help fight the swelling in your knee. The less swelling, the faster your knee heals! (Our list of Faves has an excellent NSAID to try…)
Use Orthotics -- Orthotics are more than just foot and knee support; they can help to correct your pronation and improve your running posture. If a new pair of running shoes doesn't deal with the problem, buy a pair of orthotics to use in your shoes. It can help to improve your stride and reduce pain.
Note: A study published in the Journal of Applied Biomechanics found that orthotics may have only minimal effects on hip and knee joint mechanics.
Runners Knee Exercises and Stretches
If you're trying to prevent and treat runner's knee, exercising is one of the best ways to do so! Here is everything you need to know:
Strengthen Your Hips
According to multiple articles, having weak hips is one of the biggest contributors to runner's knee:
It's not weak quadriceps that cause the problems, but weak hips!
Here are a few exercises to strengthen your hips:
Side Lying Hip Abduction -- See how it's done...
Single Leg Hip Lift -- See how it's done...
Side to Side Knee Tucks -- See how it's done…
Lateral Squats -- See how it's done…
Split Squats -- See how it's done…
4-Way Cable Hip -- See how it's done…
Clamshells -- See how it's done…
With these exercises, you'll strengthen your hips and seriously reduce your risk of runner's knee!
Stretch Your Legs
You need to not only stretch your quads (the front of your thighs), but also your glutes, hamstrings, knees, and calves. Full lower body stretches help to limber up those muscles, loosening them up for your run.
Here are a few stretches to incorporate BEFORE and AFTER every run:
Anterior Hip Stretch -- See how it's done…
Knee Hug -- See how it's done…
Walking Straight Leg Kicks -- See how it's done…
Glute Bridge -- See how it's done…
Side to Side Leg Swing -- See how it's done…
Just a few minutes spent stretching can make all the difference in your runs!
Try Foam Rolling
Foam rolling helps to loosen up tight muscles and stiff joints, making it easier for you to run with correct posture. Here are two videos with short foam rolling routines specifically for Runner's Knee:
Below, we have a list of a few items you'll need to treat runner's knee! With their help and the advice above, you should be back out on the streets in no time!